The Vulnerability Assessment of Syrian Refugees in Lebanon (VASyR) analyzes a representative sample of Syrian refugee households in Lebanon to provide a multi-sectoral update of the situation of this population. Conducted annually, 2021 marks the ninth year of this assessment. The contents of this report, jointly issued by the United Nations High Commissioner for Refugees (UNHCR), the United Nations Children’s Fund (UNICEF), and the United Nations World Food Programme (WFP), show that the situation of Syrian refugees continues to worsen as Lebanon faces a compounded socio-economic and health crisis. With the currency depreciation, price spikes, and subsidy removals, nine out of 10 Syrian refugee households were not able to afford essential goods and services that ensure minimum living standards, despite increasing humanitarian support. Households continued to resort to negative coping strategies to survive, such as begging, borrowing money, not sending their children to school, reducing health expenses, or not paying rent. This survey indicates that, in 2021, more family members took poorly paid jobs, high-risk jobs, or extra shifts to make the same income that households made in 2020 while remaining heavily dependent on assistance. These coping strategies negatively affect resilience and the capacity to generate income in the future, making refugee families more vulnerable to food insecurity and more dependent on assistance.
Between June 7 and July 7, 2021, survey teams visited 5,035 randomly selected Syrian refugee households, covering all districts across Lebanon. The household questionnaire was designed based on that of the previous year to ensure comparability, and face-to-face interviews took between 45 and 60 minutes to complete. The analysis plan was developed with inputs from the sector working groups and with reference to global indicators.
A continuous decline in the rate of refugees with legal residency A continuous decline in the rate of Syrian refugees with legal residency was noted, with only 16% of individuals aged 15 years and above holding legal residency. Even though most Syrian children born in Lebanon have the minimum level of birth documentation issued by doctor’s or midwife’s certificate (98%) , only 31% have the birth registered at the Foreigner’s Registry.
Violence against children
Protecting Syrian refugee children from all forms of violence was still a concern in 2021. More than half (56%) of children between 1 and 14 years of age had experienced at least one form of physical or psychological aggression. Furthermore, since 2019, the phenomena of children between the ages of 5 and 17 who are engaged in child labor doubled, reaching 5% in 2021, with boys being at risk four times higher than girls. Additionally, the highest rate of child labor was among adolescents between the ages of 15 and 17. Violence against adolescents spans to girls getting married off at an early age. In 2021, one in five adolescent girls between the ages of 15 and 19 were married at the time of the survey.
Refugees continue to live in conditions below humanitarian standards with over half (57%) of Syrian refugee families living in overcrowded shelters, shelters below humanitarian standards, and/or shelters in danger of collapse. The distribution of Syrian refugee households across the main shelter types remained mostly stable with the majority (69%) living in residential structures, 22% in nonpermanent shelters, and 9% in non-residential structures. Thirty-three percent of female-headed households were living in informal settlements, an increase of 5 percentage points compared to 2020. Monthly rent costs for all shelter types combined increased by 18%, reaching an average of LBP 312,798 nationally, up from LBP 264,000 in 2020. Rent costs in non-permanent (LBP 133,304), residential (LBP 368,103), and non-residential (LBP 272,092) shelters increased by 43%, 17%, and 6% respectively compared to 2020.
Lebanon’s compounded socio-economic crisis has pushed almost the entire Syrian refugee population into a situation of severe economic vulnerability. Despite the increase in assistance, 88% of Syrian refugee households were still below the Survival Minimum Expenditure Basket (SMEB), the absolute minimum amount required to cover lifesaving needs, similar to 2020 (89%) but significantly higher than the 2019 level (55%). On average, the monthly expenditures per capita were two thirds the SMEB (down from 120% in 2019), implying that Syrian refugee households were not meeting the minimum living standards. With a 404% and 372% increase in food and non-food prices since October 2019, inflation has significantly impacted their capacity to afford essential needs. The levels of debt increased by 1.8 times compared to last year, indicating that Syrian refugee households are increasingly in need of more resources to cover their basic needs. Buying food was the main reason for borrowing money, followed by rent, essential non-food items, and medicines.
Assistance remained the main source of income for Syrian refugees, enabling households to meet their basic needs that could not be covered through employment alone. Even with more Syrian refugees working (33% in 2021 vs. 26% in 2020) and with the unemployment rate decreasing from 39% in 2020 to 30% in 2021, the income that households were able to gain from employment in 2021 was still one-fifth of the SMEB compared to one-third of the SMEB value in 2019 before the onset of the economic crisis, indicating that Syrian refugees are engaging in poorly paid and high-risk jobs. Syrian refugees were mostly employed in low skilled jobs in agriculture, construction, and other services (restaurants, hotels, etc..). The participation in the labor force was 47%, and 53% of the population was inactive. Fifty-nine percent of men were employed compared to only 9% of women.
In 2021, 94% of the Syrian refugee households faced challenges when accessing food and had to employ coping strategies to manage their food shortages. Forty percent of households had an rCSI (reduced Coping Strategy Index) category above 19, denoting significant constraints in accessing food. Reliance on coping strategies increased across the country, suggesting further pressure on household food budgets. Overall, the rCSI increased by two points (from 16 in 2020 to 18 in 2021), with the most significant increases registered in Beirut and the North, indicating that households adopted more strategies to deal with the lack of access to food in the previous week and adopted severe strategies more frequently. The use of livelihood-based coping strategies, that negatively affect resilience and the capacity to generate income in the future, was also widespread among the Syrian refugee population. The most applied livelihoodbased coping strategies were taking on new debts (92%), purchasing food on credit (75%), and reducing health (54%) and education expenditures (29%). Households that sold off goods and spent savings were at 25%, and those who reported they had to withdraw children from school or send children to work were at 7% each.
Similar to 2020, around half of Syrian refugee households were food insecure, (46% moderately food insecure, 3% severely food insecure) in 2021. More than 90% of the food insecure (moderate and severe) households were living below the SMEB. Nearly half (46%) had inadequate diets, down by 4 percentage points compared to 2020. Syrian refugee households continued to consume less variety of food. The share of households with poor daily dietary diversity (<4.5 food groups per day) almost tripled from 8% in 2019 to 21% in 2020 and 22% in 2021. Only one fifth (21%) of households had a rich daily diet diversity (consuming 6.5 or more food groups per day), similar to 2020 (23%), and down by 12 percentage points compared to 2019 (33%). There was a significant decrease in iron consumption with 82% of households never consuming iron, up by 19 percentage points compared to 2020.
The proportion of respondents that reported having access to primary health care was the same in 2021 compared to 2020 despite a slight increase of those who reported needing primary health care. Access to hospital care decreased, despite the need reported being similar to 2020, with more than 80% reporting to access the hospital care they needed. For both primary health care and hospital care, the greatest obstacle to accessing care remained financial, and households in the lowest expenditure quintile reported having the least access to care. There were also significant differences in reported access between governorates, and particularly residents in Mount Lebanon and Beirut reported having less access to care. A quarter of children under the age of 2 suffered from at least one disease, with the majority (60%) suffering from diarrhea, and an increase from 2020 of 23 percentage points in children who suffered from a cough (56%). Access to medication was a challenge, with less than half of the respondents reporting to be able to access all their needed medication. There was a marked increase in knowledge of how to access health care for COVID-19 compared to the previous year. There was no increase in the proportion of women reporting having delivered at home Children not in education In the past two years, the field of education has witnessed a shock that did not exist before. The COVID-19 pandemic forced school closures, resulting in thousands of children and youths staying home and learning at distance, leading to the education status deteriorating since 2020. There was a 14-percentage points drop in primary school attendance, reaching 53% for the scholastic year 2020-2021. Similarly, the share of pre-primary attendance (children between 3 and 5 years) dropped by 5 percentage points, with only 11% attending early childhood education. About half (47%) of school-aged children (6 to 17 years) attended any school 2020/2021, with the majority (47%) attending school both physically and remotely, 30% only remotely, and 23% only physically. The costs of education material and transportation remained the most prominent reasons for why refugee children did not attend the school year 2020-2021, with an increase in 10 and 14 percentage points respectively.
Youth and adolescents
As in 2020, the percentage of youth (15 to 24 years of age) who were attending school or university was only 13%. Yet, there was a considerable disparity between age groups, with those aged between 15 and 19 attending at a higher rate than the 20 to 24 years group, at 24% and 4% respectively. Among the youth, costs were still reported as a prominent reason for not attending school, however, the two main reasons were either due to marriage or due to work. Moreover, seven out of 10 youth were not in education, employment, or training (NEET), with boys (78%) reporting a higher rate than girls (54%). Similar to education attendance, the NEET increased with age. The NEET share among youth aged 15 to 18 years was 57% compared to 75% for those aged between 19 to 24 years.
Safe and clean environment
The water, sanitation, and hygiene (WASH) situation among Syrian refugees in Lebanon was marked by a scarcity of water for drinking and household use and improper sanitation, with conditions varying depending on the type of shelter. Household members with access to an improved drinking water source (89%) was similar to last year. Bottled mineral water remained the main source of drinking water at 38%. The reliance on bottled mineral water varied across regions and was highest in the South (74%) and lowest in Baalbek-El Hermel (8%). Additionally, 48% of households reported paying for drinking water, spending an average of LBP 63,505 per month. The majority (85%) had access to an improved drinking water source within their dwelling or a 30-minute roundtrip.
The share of household members with access to an improved sanitation facility remained similar to previous years at 91%, with flush toilet (69%) as the main source, though with a 14 percentage points difference in access to flush toilets between male-headed households (71%) and female-headed households (57%). Regional differences were also notable, with the ratio of access to an improved sanitation facility decreasing from 89% in 2020 to 74% 2021 in Bekaa. Household members with access to a basic sanitation facility was 76%, similar to 2020, but decreased to 52% for non-permanent shelters.
Access to improved sanitation in non-permanent shelters also dropped significantly from 79% in 2020 to 67% in 2021. For both access to an improved water source and improved sanitation facility, households in non-permanent shelters were found to be the most vulnerable. Trucked water provided by the UN or NGOs was the most prominent drinking water source at 28%, while bottled mineral water was at 11%. Moreover, only 12% of individuals living in non-permanent shelters had access to a flush toilet with the majority (55%) using an improved pit latrine with cement slab