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INTRODUCTION

Entering its 7th year, the armed conflict in Eastern Ukraine is still active with 3.4 million people in need of humanitarian assistance. The COVID-19 pandemic has further compounded the ongoing crisis; as of December 8th the number of confirmed cases of COVID-19 had surpassed 800,000 in the country. Actors including the World Health Organization (WHO) and oblast administrations expect that this is an underrepresentation of the situation, with levels of testing roughly equivalent to one confirmed case for every 14 tests completed, substantially higher than the WHO-recommended 5% positive samples. The population in Ukraine is particularly vulnerable to the COVID-19 outbreak, due to both an ageing population and high rates of chronic illness such as multidrug-resistant tuberculosis, heart disease, diabetes5 . Between the Government and Non-Government Controlled Areas (GCA and NGCA) of Donetsk and Luhansk Oblasts, elderly individuals account for almost one third (32%) of people in need the highest proportion among humanitarian crises worldwide.

With the fastest-growing domestic number of COVID-19 cases during the month of November, community engagement in infection prevention and control (IPC) practices is essential to stemming the spread of the virus. To inform humanitarian partners responding to the COVID-19 outbreak, the Knowledge, Attitudes, and Practices Assessment (KAPA) was launched to evaluate the degree to which populations have access to and use information on COVID-19 and the recommended actions for reducing the risk of infection and transmission. It also seeks to understand household attitudes towards COVID-19 messaging, uptake of recommended preventative practices, as well as access to essential healthcare services and water and hygiene materials required to observe IPC measures. This third round focused on GCA residents, and data collection and analysis were completed in partnership with the Kyiv International Institute of Sociology (KIIS) between 16 October and 1 November 2020. A total of 1.601 household surveys were completed via Computer-Assisted Telephone Interviews (CATI) using stratified simple random sampling of non-comprehensive resident lists. Findings are therefore representative with a 95% confidence level and a 5% margin of error, but may not be generalisable to all households in Donetsk and Luhansk oblasts in GCA. Settlements for the randomly selected respondents can be seen on the assessment coverage map on page 2. Findings presented in this factsheet may not include answers such as "Don't know" or "Decline to answer" and total percentages may therefore not sum to 100%. The full activity terms of reference can be accessed at this link.

Throughout this factsheet, findings for round 1 (July-August 2020) are displayed for comparison purposes (advisory only). Round 2 of the KAPA (September-October 2020) was conducted in NGCA and can be accessed on the REACH Resource Centre or following the clickable link.

KEY FINDINGS

TRENDS IN COVID-19 KNOWLEDGE

The perception of epidemiological trends in COVID-19 in Ukraine has changed considerably, with the majority of respondents in GCA now believing that COVID-19 is increasing in Ukraine (76% compared to 36% in round 1).

The proportion of respondents who suspect someone they know to have contracted COVID-19 is also on the rise (from 3% to 19%). This may be in line with the slight increase in the proportion of respondents who believe that COVID-19 is a contagious disease (from 79% to 84%).

Reported knowledge on other COVID-19 transmission dynamics remained similar across rounds, with the only exception being a shift towards shorter reported time periods (2-10 days) before an infected individual would begin showing symptoms.

TRENDS IN COVID-19 ATTITUDES

Despite the acknowledgement of increasing COVID-19 cases nationwide, the degree to which COVID-19 is perceived as an important issue has significantly reduced. From 46% of respondends who considered it to be either "very" or "extremely important" in July-August 2020, only 7% still think so. Instead, almost half (48%) of respondents now consider COVID-19 to be "not important at all".Similarly, there is a noticeable shift from a "more" fearful perception of COVID-19 in round 1 towards a "less" fearful one in round 3.

However, respondents have also increasingly reported greater levels of likelihood of developing the disease as compared with round 1. Particularly, the proportion of respondents who believe it is "very" or "extremely likely" to contract COVID-19 has nearly doubled from 12% to 23%.

CHANGES IN PRACTICES

A net downtrend can be observed for all reportedly adopted preventative measures against COVID-19, with in particular handwashing and avoiding crowded areas with the largest drop in values. This suggests that, on average, respondents were reporting fewer of these measures.

The mandatory wearing of masks in public is the sole public health measure implemented by the Government of Ukraine which achieves growing support, from 53% to 67% of respondents. All other measures did not experience any change in the reported level of support / opposition they had previously received.

Also, an overall decrease in the level of confidence granted to formal sources of information (local and national authorities, healthcare workers) can be noted between the two rounds.

Other notable trends include a general decrease in the proportion of respondents who have reportedly seen or heard public health advertisements between the two rounds, which could coincide with the slight rise in the share of respondents who have never sought out information on COVID-19 in the two weeks prior to the assessment (from 43% to 49%). Generally speaking, respondents have reported to be seeking out information less regularly than during round 1.

Eventually, a net decline in the proportion of respondents who can recall measures implemented by the Government can be observed, with the main change for quarantine (from 54% to 20%).

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Ukraine: COVID-19 Knowledge, Attitudes, and Practices Assessment - Non-Government Controlled Areas of Donetsk and Luhansk, Round 3: November 2020 -...