ai4data/datause-dataset-rechunked huggingface dataset:
From Roraima, the Government implements a voluntarily internal relocation program
(interiorização) to facilitate the socio-economic integration of refugees and migrants. As of
October 2024, over 141,000 Venezuelans have been relocated to some 1,000 municipalities
across other Brazilian states. The continued influx of Venezuelans into Brazil – which have been
on the rise since 2023 – has required the Government and the humanitarian community to
continue focusing on the humanitarian response in Roraima, while moving toward the integration
of “Operacao Acolhida” within the regular national protection system, reducing duplications and
ensuring the sustainability of the response.

In addition to Venezuelans refugees and migrants, Brazil hosts individuals from various countries,
including from Cuba, Haiti, India, Sri Lanka, Vietnam, Nepal and Bangladesh; which places
additional strain on local protection networks, particularly in border states and cities with
international airports, in the absence of a national response mechanism beyond “Operacao
Acolhida”.

UNHCR / October, 2024 8
UNHCR is committed to ensuring that refugees and asylum seekers have access to lifesaving and lifesustaining health services. To achieve this, UNHCR continues to advocate with the Ministry of Health
for the inclusion of refugees in the national health system, including enabling access to national health
insurance, working towards the achievement of SDG 3 (Good Health and Well-Being). All registered
asylum seekers and refugees have access to low-cost primary health care at the local Community
Health Centers (PUSKESMAS), managed by the Government of Indonesia. Individuals requiring
emergency or advanced health treatment may be financially supported by UNHCR through our health
partner YCWS, within the parameters of established guidelines and budgetary restrictions. UNHCR
coverage is limited to critical interventions, mental health services, immunization, natal care, and

UNHCR / 1 November 2024 5
professions (physicians, dentists, nurses, and midwives) have opened to migrants and refugees to reduce shortages, and while the shares for all of them stand at just 0.9% compared to 1.9% for Polish citizens, the gap is actually very narrow for physicians and dentists, who constitute 0.7% of Ukrainian refugees and 0.8% of Polish citizens. In legal professions (legal counsels, barristers, notaries, and bailiffs), the gap remains wide, although in addition to occupational licensing, the likely causes may be the differences between the Polish and Ukrainian legal systems as well as new entrants’ struggles with attracting clients due to advertising restrictions. In effect, just 0.02% of Ukrainian refugees work in legal professions, compared to 0.4% of Polish citizens. There are also high contrasts across the remaining regulated professions, which employ 0.8% of Ukrainian refugees and 3.3% of Polish citizens. These are construction engineers (0.02% Ukrainian refugees), pharmacists (0.01%), and psychologists (0.09%), compared to the following shares for Polish citizens: 0.26%, 0.19%, and 0.18%, respectively.

**One of the most effective forms**

**of support offered to refugees**

**and other immigrants in terms of**

**employment and earnings to be found**
The primary data for this report come from a comprehensive 2024 socioeconomic survey conducted by UNHCR

which recontacted households which were initially surveyed in 2019, prior to the Shona acquiring nationality. The

follow-up survey aimed to capture the transformative impact of citizenship on the Shona community in terms of

employment, education, income, and access to essential services, while also incorporating new modules on social

cohesion, community engagement, and civic participation to better understand the broader integration of the Shona

into Kenyan society. The 2024 survey provides rich insights into the Shona’s post-citizenship journey and the

challenges and opportunities they face as newly recognized citizens of Kenya.

The findings are complemented by the 2019 household survey of the Shona community, conducted jointly by

UNHCR and the World Bank [[8]] establishing a baseline of the Shona community’s socioeconomic conditions while

they were still stateless. This study revealed significant disparities in access to services and opportunities compared

to Kenyan nationals, highlighting the detrimental effects of statelessness on employment, financial inclusion, and

educational attainment. These findings informed policy recommendations that ultimately contributed to the

recognition of the Shona as Kenyan citizens in 2020-21, providing a crucial foundation for evaluating their post
citizenship outcomes.
Mobile network operators still accept refugee identity cards issued by CNARR as valid proof of identity.
Refugees without an identity card must still be vouched for by those who possess one to enable SIM card
registration. Through their phone numbers, refugees have access to payment and money transfer facilities
offered by telecommunications operators. Asylum-seekers still do not have the right to acquire a SIM card
with the asylum-seeker certificate.

10 R E F U G E E P O L I C Y R E V I E W F R A M E W O R K > **R E P U B L I C O F C H A D**
In the absence of comprehensive national refugee laws and national RSD processes, UNHCR
undertakes refugee status determination (RSD) in Indonesia. As asylum-seekers have access to the
same rights and services as refugees in Indonesia, UNHCR uses RSD strategically for individuals with
an immediate third country solution which requires refugee recognition (resettlement and some
complementary pathways), cases with heightened protection concerns, and cases presenting with
issues that need to be clarified through the RSD process. UNHCR also conducts RSD as part of its
emergency response in the context of boat arrivals to identify those in need of international
protection.

### **Child Protection**
Gender disparities are also evident in labor force metrics. The labor force participation rate [19] for women is notably lower at 59% compared to 71% for men. Furthermore, 35% of women not in the labor force cite household responsibilities as their primary engagement, a stark contrast to the 6% reported by men. Although the difference in the unemployment rate is less significant, a gender gap is still discernible – this indicator stands at 15% for women versus 12% for men.

### **Methodology**

Each country adopted a unique sampling approach to their respective surveys, dependent on factors such as the availability of sampling frames and information regarding population distribution by

---
[19] Also defined here for the 15+ age group
occupations and perform the same tasks, the native workers do not change their occupations and tasks, while firms do not adjust (at least in the short term).
In effect, immigrants grow output, but slightly lower wages. This is the case in the modelling performed (Chapter 3), as well as in the NBP general equilibrium modelling exercise for the pre-2022 Ukrainian workers 2013-2018 performed by Gradzewicz, Jabłonowski, Sasiela, and Żółkiewski (2021). Conversely, Peri (2014) surveys 270 econometric estimates from 27 studies published over the 1982-2013 period on the impact of immigration on native wages. He shows that effects for a very large immigrant inflow of 10 percentage points (five-times larger than the refugees from Ukraine share in Poland) on native wages range from -1% to +1%, with most estimates clustered around zero, from -0.1% to +0.1%. Similarly, Gromadzki and Lewandowski (2023) examine econometrically the monthly impact of refugees from Ukraine inflow from January
**General SRH Services Access**
Acknowledging that 63% of the Ukrainian refugees are women and girls, with 34% of the total refugee population being women in reproductive age between 15- 49 of age, the survey added a focus to explore access and barriers to sexual and reproductive health (SRH) services for women. SRH services include family planning; prenatal and postnatal care, safe delivery including Emergency Obstetric and Newborn Care (EmONC); clinical management of rape; prevention, detection and treatment of reproductive tract infections, sexually transmitted infections and HIV; and referrals to higher level obstetric care or specialized SRH services.

Across the region, 5% of women reported to have faced barriers in accessing SRH services, though access level varies by country. In Latvia and Bulgaria, only 1 % and 2% of women respectively reported barriers, indicating good access to SRH services. However, in Lithuania and Romania 9% and 6% of women respectively reported barriers in accessing SRH services.
NAVIGATING HEALTH AND WELL-BEING CHALLENGES FOR REFUGEES FROM UKRAINE

# Mental Health and Psychosocial Support (MHPSS)

### **Reported mental** **health and** **psychosocial** **problems**

Regionally, 23% of individuals reported experiencing mental health and psychosocial problems that affect their daily functioning, with 36% of households reporting at least one member affected. This is an increase compared to 2023, when 19% of individuals and 30% of households reported mental health and psychosocial problems. There are notable regional variations in reported MHPSS needs, with the percentage of individuals with such needs ranging between 13% (Czechia) and 33% (Romania). In 2023, Czechia also had the lowest and Romania the highest percentage of mental health or psychosocial problems on individual and household level. Stigma surrounding the disclosure of mental health challenges within the Ukrainian community likely means that the actual prevalence of mental health and psychosocial problems may be underreported.

**% OF INDIVIDUALS EXPERIENCING MENTAL HEALTH OR**

**PSYCHOSOCIAL PROBLEMS BY COUNTRY**

Regional Romania Lithuania Poland Bulgaria Hungary Slovakia Estonia Moldova Latvia Czechia 23% 33% 27% 26% 25% 24% 21% 20% 18% 17% 13% (N=8,540)

**% OF HOUSEHOLDS WITH AT LEAST ONE MEMBER WITH**

**MENTAL HEALTH OR PSYCHOSOCIAL PROBLEMS BY YEAR**

**AND COUNTRY**

2023 2024 Regional Romania
HIGH EMPLOYMENT RATES, BUT LOW WAGES: A POVERTY ASSESSMENT OF UKRAINIAN REFUGEES IN NEIGHBORING COUNTRIES

**Living in a vulnerable household is associated with higher poverty risks**

Just like last year, members of households with vulnerabilities were found to more likely be living in poverty than the general refugee population. Almost half of individuals living with an older adult (age 65+) reported an equivalized disposable income below the poverty threshold. For individuals living with household members with a disability or members with MHPSS needs [11] these rates stood at 41% and 27%, respectively. Gender of the head of household, however, was not found to have a significant impact on the poverty rate. Mixed gender (at least one male and one female head) was associated with higher income, though likely due to increased chances of multiple breadwinners being present in the household.

**REFUGEE POVERTY RATES BY VULNERABILITY CHARACTERISTIC AND GENDER OF HEAD OF HOUSEHOLD**

No Yes Female Male Mixed Head of household gender Older adult Household (65+) present member with a disability present Source: Survey data, SAG estimates Household member with MHPSS needs present

**Refugee housing expenses are on average much higher than for nationals, which implies an**
Deloitte (2024). Analysis of the impact of refugees from Ukraine on the economy of Poland, UNHCR Reports and Assessments, March, https://data.unhcr.org/en/ documents/details/106993 Foged, M., & Peri, G. (2016). Immigrants' effect on native workers: New analysis on longitudinal data. American Economic Journal: Applied Economics, 8(2), 1-34.

Foged, M., Hasager, L., & Peri, G. (2024). Comparing the effects of policies for the labor market integration of refugees. Journal of Labor Economics, 42(S1), S335-S377.

Gromadzki, J., & Lewandowski, P. (2023). Refugees from Ukraine on the Polish labour market. Social Insurance. Theory and Practice, 155(4), 29-40.

GUS (2024a). Structure of wages and salaries by occupations for October 2022, Statistical Office in Bydgoszcz, https://stat.gov.pl/en/topics/labour-market/ working-employed-wages-and-salaries-cost-of-labour/structure-of-wages-andsalaries-by-occupations-for-october-2022,4,8.html GUS (2024b). Education in the school year 2023/2024 (preliminary data), Statistical Office in Gdańsk, https://stat.gov.pl/en/topics/education/education/ education-in-the-school-year-20232024-preliminary-data,13,2.html Heller, B. H., & Mumma, K. S. (2023). Immigrant integration in the United States: the role of adult English language training. American Economic Journal: Economic Policy, 15(3), 407-437.

Jaumotte, M. F., Koloskova, K., & Saxena, M. S. C. (2016). Impact of migration on income levels in advanced economies. International Monetary Fund.
UNHCR supports CNARR in the popularization of the asylum law and its implementing decree, including
towards ONAPE with the aim to develop a Memorandum of Understanding that would lift the challenges met
by refugees while accessing the job market including in the private sector.

In the private sector, practical experience shows that some employers still hire refugees without the approval
of ONAPE and may treat them less favorably in terms of wages and social benefits. There has been no
legislative or policy change regarding child labor.

There is no reliable data on the percentage of refugees employed in the formal sector.

Many refugees work in the informal sector, but data on this is equally unavailable. Most refugees engage
in independent work, particularly in agriculture, which remains the backbone of the Chadian economy.
However, agricultural value chains are very weak in the country, affecting both refugees and host populations.
The main constraints, even more pronounced for women, relate to difficulties in accessing agricultural land,
infrastructure, agricultural inputs such as certified inputs, and financial services.
_Woman occupation_
Earns cash 0.90 0.059** 0.89 0.007
Works all year 0.88 -0.047 0.88 0.023
Not working 0.25 -0.021 0.24 -0.015
Agriculture 0.19 0.055 0.25 0.011
Service & sales 0.39 0.057 0.35 0.016
Professional 0.05 -0.028 0.04 -0.010
Manual 0.11 -0.063*** 0.12 -0.003

_Note:_ Column (1) is a sample at 20 to 100 km from a nonactive mine.
Column (2) difference for sample at 0-20 km from an nonactive, compared with column (1)
Column (3) is a sample within 20 to 100 km of an active mine.
Column (4) difference for sample at 0-20 km of an active mine, compared with Column (3)

*** p<0.01, **p<0.05, *p<0.1. Univariate regression model.

Appendix Table A2 also shows selected child health outcomes as summary statistics across the

four treatment groups. We note that, once again, the sample looks quite balanced in the first

three columns, although children seem to be worse off in communities close to mines that have

not started producing, evidenced by the fact that infant mortality is 8 percent compared to 7

percent farther away, and 6 percent in communities with active mines. The anthropometrics

height-for-age (stunting or chronic malnutrition), weight-for-age (wasting or acute
**The Shona originally came from Zimbabwe and migrated to Kenya as missionaries majorly between the 1950s and**

**1970s, settling in the Greater Nairobi area.** According to community elders, the Shona were issued certificates of

registration under the Alien Restriction Act upon arrival. However, a change in the Registration of Persons Act of

1978 prevented them from accessing identity cards. As a result, most of those who were among the first wave of

arrivals do not hold valid legal identity documents. At the same time, Zimbabwe and Zambia do not consider them

as nationals since many of those who were born there did not have their births registered and lost all traces of their

ancestry since they never returned, hence rendering them stateless. [[8]] Subsequently, they settled and assimilated

with the local Kikuyu community which welcomed them. Since their arrival, they have practiced wood carving for

men and basket weaving for women as their primary economic activity outside of preaching activities. Ten

individuals from the Shona community were granted Kenyan citizenship on 12 December 2020 and a further 1,649

were recognized as Kenyan citizens and issued with registration certificates on 29 July 2021.

- **Box 1: Data Sources**
UNHCR [1] supports the Government of Indonesia by undertaking core refugee protection functions,
including registration, refugee status determination, gender-based violence prevention and response,
child protection, legal protection, and the pursuit of durable solutions. Approximately 48% of the
refugee population in Indonesia is residing in IOM-managed accommodation centers, established as
part of the Regional Cooperation Agreement (RCA) between Indonesia, the Government of Australia,
and IOM in 2000. 42% of the refugee population – largely those who arrived in Indonesia after 2017

- are living independently and, with the exception of the most vulnerable, do not receive financial
support for food, rent, and basic needs. Approximately 10% of the refugee population is comprised of
Rohingya refugees who arrived by boat in recent years and who are residing primarily in temporary
shelters in Aceh and North Sumatra.

---
[1] The Government of Indonesia-UNHCR host country agreement has been in place since 1979.
NAVIGATING HEALTH AND WELL-BEING CHALLENGES FOR REFUGEES FROM UKRAINE

### **Barriers in** **accessing care**

For individuals who experienced challenges in accessing care, the main barriers were long wait times (33%), unaffordable transport costs (23%), and inability to make an appointment (21%), indicating a shift in barriers compared to 2023. With the health worker shortage in Europe long waiting times are renowned and potentially exasperated by the increase in the refugee population. Although challenges in making an appointment remain among the top three barriers, the percentage of those experiencing this difficulty has decreased to 21% from 38% in 2023, when it was the topmost challenge. For those who arrived in 2024, challenges in making an appointment remained however the top barrier (34%). This points to improvements in navigating the host country’s health systems for those who arrived before 2024, supported by the extensive information and awareness efforts of health authorities and RRP health partners. At the same time, it highlights the continuous need for information sharing to ensure effective access to care.
NAVIGATING HEALTH AND WELL-BEING CHALLENGES FOR REFUGEES FROM UKRAINE

# Context

In its third year, the war in Ukraine continues to have a devastating impact on the people in Ukraine and causes massive displacement of populations into the European region and beyond. As of 12 December 2024, 6.2 million refugees from Ukraine were recorded in Europe [1] . Approximately 81% of the refugees are women and children and 13% of the population is older than 60 years [2] . The refugee population includes other vulnerable groups such as persons with disabilities, stateless persons, sexual and gender diverse minorities, and ethnic minorities. In June 2024, the European Council adopted a decision to extend the European Union (EU) Temporary Protection Directive until 4 March 2026 [3], granting Ukrainian refugees in the EU access to benefits, including health.
International   Refugee   Law   governs   the   protection   of   refugees,   including   the   realisation
of   solutions   to   their   plight.   UNHCR’s   mandate   is   to   provide   protection   to   refugees   and
seek   durable   solutions   for   them   and   UNHCR’s   Statute   and   numerous   Executive
Committee   Conclusions   provide   the   legal   framework   for   its   lead   role   in   voluntary
repatriation   operations [6] .   UNHCR’s   Statute   provides   for   key   activities   in   this   regard,
including   promoting   with   Governments   measures   to   improve   the   situation   of   refugees
and   to   assist   Governmental   and   other   efforts   to   promote   voluntary   repatriation.

In   its   involvement   with   durable   solutions   for   IDPs   UNHCR   is   committed   to   contributing
to   an   inter-­‐agency   approach   framed   by   the   standards   set   out   in   the   Guiding   Principles
on   Internal   Displacement   and   the   Framework   for   Durable   Solutions [   7] .
Over 11,000 indigenous Venezuelans currently residing in Brazil have been identified by UNHCR
and partners. Compared to the overall Venezuelan population, they face compounded challenges
accessing basic rights and services, including higher rates of food insecurity (58% vs 52%), health
care needs (75% vs 59%) and out of school children (21% vs 15%). [3] Language barriers and limited
formal education of adults (indigenous refugees are 5 times more likely to have no formal
education when compared to the general Venezuelan population in Brazil), significantly affect their
prospects for successful integration. [4]

### Protection brief in graphics

Population category Population category

Breakdown by nationality

_2 World Bank and UNHCR (2021), Integration of Venezuelan Refugees and Migrants in Brazil,_

_[https://documents1.worldbank.org/curated/en/498351617118028819/pdf/Integration-of-Venezuelan-Refugees-and-Migrants-in-Brazil.pdf;](https://documents1.worldbank.org/curated/en/498351617118028819/pdf/Integration-of-Venezuelan-Refugees-and-Migrants-in-Brazil.pdf)_
_ACNUR & Ministerio do Trabalho e Emprego (2024), Informe sobre o mercado de trabalho formal para Haitianos no Brasil,_
_[https://www.acnur.org/br/sites/br/files/2024-11/informe-mercado-trabalho-formal-haitianos-brasil-jun-2024.pdf](https://www.acnur.org/br/sites/br/files/2024-11/informe-mercado-trabalho-formal-haitianos-brasil-jun-2024.pdf)_
_ACNUR & Ministerio do Trabalho e Emprego (2024), Informe sobre o mercado de trabalho formal para pessoas refugiadas afegãs no Brasil_
https://www.acnur.org/br/sites/br/files/2024-11/informe-mercado-trabalho-formal-pessoas-afegas-no-brasil-junho-2024.pdf

---
[3] R4V (2023), Refugee and Migrant Needs Analysis, https://rmrp.r4v.info/rmna2023/](https://rmrp.r4v.info/rmna2023/) p. 85
School feeding programs are largely implemented by the World Food Programme, reaching a total of 13,000
refugees in 14 schools in the provinces of Lake Chad and Logone Oriental.

The Unified Social Registry (RSU), launched in 2019, has made limited progress in capacity, governance and
financing, despite continuous support from WFP and NGOs.

**4.4** **Protection for vulnerable groups**

In practical terms, the national protection system for the most vulnerable has not undergone any changes
and the measures in place to support victims of human trafficking are still insufficient. This holds true for
victims of Gender-Based Violence (GBV) and at-risk children. The national protection services aimed at
these vulnerable groups continue to be underdeveloped and underfunded.

12 R E F U G E E P O L I C Y R E V I E W F R A M E W O R K > **R E P U B L I C O F C H A D**