Are IDPs Satisfied With the Quality of Public Health and Education Services They Receive? A Long-term Perspective from Urban Areas in the Post-Socialist Countries

Artjoms Ivlevs

Background paper for the Global Report on Internal Displacement 2019


In most displacement contexts IDPs incur losses to their material assets (housing, land and livestock), leading them to invest in mobile human capital (education) in an attempt to reduce the socio-economic disadvantage that they or their children are likely to experience as a result of displacement. Consequently it may be expected that IDPs actively seek and obtain adequate public education services and, as a result, be no less satisfied with the quality of education services compared to people not affected by conflict. This paper analyses IDPs’ self-reported satisfaction with public health and education services in urban areas of post-socialist countries of Central and Eastern Europe that experienced violent conflict in 1990s and 2000s. The analysis draws on the Life in Transition-II survey, conducted by EBRD and the Bank in 30 post-socialist countries, focusing on the former Yugoslavia (Bosnia-Herzegovina, Croatia, North Macedonia, Kosovo, Serbia) and the former Soviet Union (Armenia, Azerbaijan, Russia, Tajikistan). In the sample of nine countries, approximately nine percent of respondents are former IDPs, 60 percent of whom live in urban areas. Key findings include:

  • IDPs are disproportionately more likely to be dissatisfied with the quality of public health services 10 to 15 years after displacement. IDPs are more likely to report disrespectful treatment by staff, lack of medication, long waiting lists/lines, unclean facilities, and requests for unauthorized payment for services that should be free. Some of these findings can be explained by the concentration of IDPs in areas where health services are underfunded or were damaged by conflict, while others point to discrimination and prejudice against IDPs. Overall, these results point to the long lasting vulnerability and disadvantage of IDPs in terms of access to and satisfaction with public health services.
  • There is no difference in satisfaction with public education services between IDPs and non-IDPs. Greater satisfaction with education but not health services is consistent with the hypothesis that forcibly displaced are more likely to invest in education to compensate for the loss of material possessions.
  • Relative to people who were not affected by conflict, IDPs are 4.2 percentage more likely to file a complaint if dissatisfied with public education services. There are no differences between IDPs and non-IDPs in relation to the likelihood of filing a complaint about public health services. This further supports the conjecture that the forcibly displaced are particularly keen to invest in education.