Context Matters: The Implications of the Mode of Service Provision for Structural and Relational Integration of Refugees in Ghana and Ethiopia

Samuel K M Agblorti, Abis Getachew, Jana Kuhnt, Abdirahman A Muhumad

Journal of Refugee Studies (2023) 


This article examines how variations in the form of service provision to refugees and host communities in Ethiopia and Ghana affects access and quality of services, the integration outcomes of refugees, and social cohesion 

Ethiopia hosts more than 890,000 refugees and asylum seekers living in camps situated in five of its nine regions as well as in the capital, Addis Ababa. Ghana hosts almost 14,000 refugees and asylum seekers, 60 percent of whom live in one of five camps in the country. Both countries have encampment policies, and the remote rural location of refugee camps in less developed regions means refugees (and hosts) have limited economic opportunities. There are also an increasing number of refugees who have self-settled in urban areas in both countries. 

In both countries the quality of services is poor and poverty levels are high. In Ghana, social services for refugees and host communities are integrated, with the national government responsible for the delivery of services to both groups in both camps and urban areas. In Ethiopia, services for refugees are coordinated by the Refugee and Returnee Services (RRS) and delivered by UNHCR and NGOs in camps and urban areas, while government at federal, regional, and local levels are responsible for services for host communities. In Ethiopia, services provided to refugees are open to host communities and vice versa, even though they are not integrated. 

The comparative analysis is based on qualitative data collected in Ghana in 2020, and qualitative and quantitative data collected in Ethiopia in 2020. In Ghana this included unstructured interviews with key informants in the administration of refugee services and refugee leaders in each of the five camps in the country. In Ethiopia, data collection included semi-structured interviews with stakeholders and experts, focus group discussions with the Refugee Central Committee and host community representatives of Awbare and Sheder camps in the Somali regional state of Ethiopia, and a quantitative survey in the Awbare and Sheder refugee camps and adjacent host communities. More than 2,000 individuals (almost 950 households) were surveyed, 40 percent of whom were from the host communities and 60 percent were refugees.  

Main findings: 

  • Overall, access to social services—irrespective of how and where they are provided—is possible for both hosts and refugees. Basic social services including education, health, and water are accessible to refugees in both countries. In Ethiopia the majority of host and refugee members are satisfied with their access to education. In both countries, access to schools and health facilities inside and outside the camps is generally open to both refugee and host communities, and both communities feel comfortable accessing the services provided to the other group. However, in some cases there are obstacles to access, for example due to language barriers (for French speaking refugees in Ghana). Financial constraints affect access to services mainly for the host community, as refugees can access some services free of charge. Access to services for refugees is easier in terms of distance to reach the service and amounts and capacities available. 
  • Overall, the quality of services differs between Ghana and Ethiopia, and this is directly related to the form of service provision. In Ethiopia, service quality in refugee camps is better than local services provided to host communities due to higher capacity, better funding, and continuous monitoring of refugee service providers. For example, health facilities in camps are better equipped, schools in the camps pay higher salaries and attract better teachers, and schools in camps are more likely to meet government standards for teacher-student ratios. In Ghana, where services are integrated, both refugees and hosts receive the same quality of services, and quality is usually lower compared to services provided to refugees in Ethiopia. Additionally, UNHCR continues to provide additional teaching and learning materials to camp schools in Ghana, which results in better quality schooling in camps.  
  • Perceptions of unfairness arise when refugees receive better quality services than hosts. In Ethiopia, differences in the quality of services provided to refugees and hosts is perceived by host communities as unfair, whereas variations in access (e.g., distance to services) were less important for perceptions of unfairness. In Ghana there were less perceptions of inequality and little mention of experienced unfairness. 

Regardless of whether services are already integrated within one agency (Ghana) or still provided by separate actors (Ethiopian), both refugees and hosts can access services. However, there are obstacles to access (mainly for hosts) due to financial constraints and distance to services. When services are provided to refugees by humanitarian organizations in parallel to national systems, this leads to a divergence in the quality of services due to higher level of capacity of non-governmental service providers. This is likely to lead to perceptions by host communities of unfairness, increasing the potential for social tensions over resources. Integrating services reduces imbalances in service quality and offers more opportunities for interaction, more likely fostering positive relations between refugees and hosts. However, integrating services is likely to result in poorer service quality overall due to the lower capacity of national actors. Additionally, any supplementary financial support provided to refugee facilities would perpetuate imbalances in the quality of services and perceptions of unfairness. The authors also note that the full integration of services is challenging, takes time, and is highly context specific.