UNICEF commissioned REACH to conduct a household survey over the course of April 2014. The findings from this assessment provide an updated overview of the main vulnerabilities, needs and coping mechanisms of Syrian refugees residing in ITS across the governorates of Ajloun, Al Balqa, Al Karak, Al Mafraq and Irbid. As such, this report will present findings on demographics, livelihoods, shelter, Water, Sanitation and Hygiene (WASH), food security, health and education with a view to inform better targeted assistance and service provision across these sectors.

Priorities

With so many resource constraints and service gaps, the list of ITS needs and vulnerabilities that REACH has identified in Jordan thus far is extensive; from entrenched food insecurity, poor attendance rates for school-aged children to widespread open defecation, there are multiple and often overlapping areas where humanitarian assistance could be effectively targeted in a coordinated manner. In terms of human capital, the needs of minors should be integrated into any response; whilst humanitarian actors have already worked to establish informal education centres, for instance, the ever-increasing number of ITS residents means that this response may need to be scaled up to prevent further loss of schooling. This also holds true for health and where geographic remoteness or lack of travel options prevents access to life-saving healthcare services; mobile interventions or home visits may offer an effective solution to this problem. Overall, needs are evidently substantial and are growing steadily as the number of Syrian refugees being priced out of formal host communities and opting for ITS continues to grow.

Needs

With so many resource constraints and service gaps, the list of ITS needs and vulnerabilities that REACH has identified in Jordan thus far is extensive; from entrenched food insecurity, poor attendance rates for school-aged children to widespread open defecation, there are multiple and often overlapping areas where humanitarian assistance could be effectively targeted in a coordinated manner. In terms of human capital, the needs of minors should be integrated into any response; whilst humanitarian actors have already worked to establish informal education centres, for instance, the ever-increasing number of ITS residents means that this response may need to be scaled up to prevent further loss of schooling. This also holds true for health and where geographic remoteness or lack of travel options prevents access to life-saving healthcare services; mobile interventions or home visits may offer an effective solution to this problem. Overall, needs are evidently substantial and are growing steadily as the number of Syrian refugees being priced out of formal host communities and opting for ITS continues to grow.

Main Findings

Food insecurity appeared to be widespread, and given the financial resource constraints that have been outlined in this report, access to and consumption of high-nutrient food groups was severely inadequate. Although lack of access to WFP food assistance does not appear to be the major cause of food insecurity, its scope and size contributed greatly to it. This is compounded by the pervasive micronutrient deficiencies which ITS households face as a result of resource constraints and other access barriers, all of which have negative consequences for at-risk groups such as children and pregnant and lactating women. Ad hoc migration patterns are also an aggravating factor due to interruptions to food supplies which require time and resources to be re-established and which in turn may confront ITS residents with trade-offs for other basic services. The severe shortage in the provision and use of WASH infrastructure has had negative effects across the health and water sectors. Poor hygiene practices and inadequate capacities to store water properly strongly correlates with the prevalence of medical ailments such as diarrhea. Another issue is the open defecation which often leads to the spread of infectious diseases. Where water is mainly provided by private vendors, the provision of adequate water storage infrastructure could address many of the health and cost-related externalities that are generated as a result of this service. Similarly, infrastructure rehabilitation, hygiene promotion and facilitation of access to latrines could effectively address many of the entrenched health and hygiene issues that refugees in ITS face. Nevertheless, it is worth noting that this may often be limited by the land rights of the ITS tenants, thus requiring mobile or temporary solutions which are tailored to often ad hoc migration patterns. Minors, who comprise over half of ITS residents across the assessed governorates and who are by definition dependent on older population cohorts to facilitate access to basic services, appear to face substantial human capital deficits and challenges. In terms of their health status, children aged 0-59 months are afflicted by disproportionately higher rates of fever and diarrhea than the remaining demographic groups combined. Equally, 36% of all at-risk children aged 0-59 months have reportedly yet to be vaccinated against polio. These findings also tie in with the 2014 Syria Regional Response Plan's sectoral priorities for health, which specify that increasing and expanding routine vaccination coverage are priorities for Jordan. Likewise, resource constraints, geographic remoteness and cyclical migration patterns all appear to deter school enrolment and as such, the majority of school-aged children are reportedly not attending school. Whilst the resilience of ITS households is strengthened by communal sharing of scarce available local resources through informal lending, borrowing, and other coping mechanisms, when an exogenous shock affects the whole ITS – for instance, when an income source is exhausted or when eviction occurs – this coping mechanism becomes insufficient. Conversely, whilst this pooling of private resources may offer short-term relief, vulnerability is further compounded in the long-term by the accumulation of debt and the opportunity costs that trade-offs forced by resource scarcity entail across the sectors of food security and education in particular. This is clearly evident once we consider that 42.1% of households are insecure and 59.4% of households had a poor FCS.