Knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources in Somali IDP camps: a cross-sectional study

Jude Alawa, Samir Al-Ali, Lucas Walz, Eleanor Wiles, Nikhil Harle, Mohamed Abdullahi Awale, Deqo Mohamed, and Kaveh Khoshnood


This paper investigates knowledge and perceptions of COVID-19, prevalence of pre-existing conditions, and access to essential resources among residents of IDP camps in Somalia. There are over 3 million IDPs in Somalia living in over 2,100 settlements.

The analysis is based on a survey administered in Somali to 401 adults in 12 IDP camps in the Lower Shabelle region of Somalia. The survey covered: (1) demographic information, including sex, age, displacement status, household characteristics, education and employment; (2) participants’ health profiles, including current health status, existing conditions and symptoms, and concerns precipitated by COVID-19; (3) knowledge of COVID-19, most commonly used sources of information, trusted sources of COVID-19 information and perceptions of community efforts against COVID-19; and (4) access to water, sanitation and hygiene (WASH) facilities, COVID-19 screening and health services.

Main findings:

  • The majority of respondents were female (86 percent) and had received no formal education (89 percent).
  • 58 percent of respondents reported being in ‘good’ health, however 50 percent of participants reported having one or more pre-existing conditions. Health staff administering surveys reported that many participants did not know what the surveyed conditions were, had little recollection of previous diagnoses and had rarely visited a health professional.
  • A considerable proportion of the sample reported experiencing symptoms that could potentially be attributed to COVID-19, including headache, fever, or muscle or body aches.
  • When asked how COVID-19 has changed their daily lives, 59 percent of respondents indicated that lockdowns had decreased their income or caused them to lose their job
  • There is very poor knowledge among IDPs related to COVID-19. In response to questions assessing knowledge surrounding COVID-19 prevention and treatment, 50 percent of responses responded ‘I don’t know’.
  • 49 percent and 57 percent of respondents reported that they trusted religious officials and the radio, respectively, to provide information about COVID-19, while only 37 percent and 5 percent said that they trusted health officials and humanitarian aid workers, respectively.
  • Respondents reported a lack of access to adequate sanitation facilities (washing facilities, soap, disinfectants, and face masks) and an inability to practice social distancing protocols. Nevertheless, 77 percent of respondents reported taking at least one COVID-19 preventative measure.
  • More than a third of respondents reported not being able to buy essential food items in the week preceding the survey, which forced them to skip meals, eat smaller portions or buy lower quality food.
  • There is a significant lack of access to treatment and preventative services for COVID-19 among IDPs. Respondents’ self-reported access to COVID-19 screening and medical services was low, with 97 percent saying that they could not access screening and only 20 percent saying that they were confident that they could receive medical services if infected.
  • 47 percent of respondents indicated that camp living conditions needed to change to prevent the spread of COVID-19.

Overall, this study reveals very low levels of COVID-19 knowledge and limited access to essential prevention and treatment resources among IDPs in Somali camps.