KAP Assessment Report On COVID-19

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KNOWLEDGE, ATTITUDES AND

PRACTICES (KAP)
ASSESSMENT ON COVID-19
COMMUNITY BASED MIGRATION PROGRAMME
September 2020
KNOWLEDGE, ATTITUDES AND PRACTICES (KAP) ASSESSMENT ON COVID-19

Conducted by
TRCS Community Centre staff
Tenadi Gölemerz
Mehmet Akdaş
Semih Paslı
Sayeeda Farhana
Klaudia Jankowska

Graphic Design
Engin Aygün

Turkish Red Crescent Society (TRCS)


Community Based Migration Programme
KNOWLEDGE, ATTITUDES AND
PRACTICES (KAP)
ASSESSMENT ON COVID-19
COMMUNITY BASED MIGRATION PROGRAMME
September 2020
Executive Summary
To understand communities’ knowledge, attitudes and practices (KAP), along with their information needs on COVID-19,
this KAP assessment was conducted by the Turkish Red Crescent Society (TRCS), with support from IFRC, under the
Community Based Migration Programme (CBMP) from 20 July to 12 August 2020. The assessment has been conducted
via TRCS’ social media platforms, phone interviews and online consultations/focus group discussions (FGDs) with refugees
and local people in 16 TRCS Community Centre locations. Comprising both qualitative and quantitative data, a total of
3,840 individuals have been interviewed over the phone in 16 Community Centre locations, with a total of 320 refugees and
local people participating in 32 FGDs. The findings of the assessment are intended to inform understanding of community
perceptions of, and knowledge about, COVID-19 and, in turn, shape risk communication, behaviour change and community
engagement activities.
Although the KAP survey questionnaire was posted in TRCS social media, the total number of responses submitted was too
low to consider the analysis meaningful and the findings statistically significant and therefore was not used in the analysis
for this assessment. This report presents the survey results of the phone interviews and the outcome of the FGDs in 16
Community Centre locations.
Findings show that community members in all locations are well aware (96.5%) of the COVID-19 outbreak, including the
symptoms of the infection, how it spreads, and how to reduce the risks of becoming infected. This indicates a high exposure
to information related to this topic.
The most popular sources of information about COVID-19 were TV (66.4%), followed by government officials (38.7%),
Facebook (34.8%), health workers (31.4%), websites (23.8%) and family and friends (43.3%). Other sources mentioned
were social media channels including that of TRCS and its website, TRCS staff and volunteers, Ministry of Health, doctors,
mosques, newspaper, radio and NGOs. While the use of Facebook (24.5%) and WhatsApp (11.1%) is slightly higher among
refugees, TV is more accessible by people from host communities (35.8%) as TV shows are mostly in Turkish and there
is no language barrier for them. The majority (95.6%) of respondents reported that they did not encounter any challenges
in receiving information about COVID-19. However, refugees identified language as one the of the key barriers and other
challenges, such as, being unable to afford internet, or being unable to read or write in Arabic, which prevented people from
accessing written information.
Communities’ most trusted sources of information are Government officials (46.9%), TV (44.3%), health workers (34.8%)
and doctors (22.3%). Other channels include Facebook, family and friends, community leaders, Muhtars, websites, Ministry
of Health, TRCS, World Health Organisation (WHO) and NGOs. In many locations, religious leaders are identified as one of
the most trusted channels through which to receive information. Live sessions on TRCS Facebook or other social media
channels featuring doctors or physicians are suggested to talk about COVID-19, raise awareness, and answer questions
from the audience.
A majority of the respondents identified older people (85.8%) and people with chronic disease (74.1%) as being at the
highest risk of COVID-19 infection. Others considered pregnant women, health workers or people working in factories and
public areas, those using public transport, and people who do not follow the preventive measures as also being particularly
at risk of COVID-19 infection. Although young people and children were recognised as being at relatively low risk, it was
understood that they can be carriers of the disease.
There are various rumours spreading within the community both among refugees and local people about COVID-19. These
rumours are spread mostly via word-of-mouth and social media. Misperceptions and rumours in a community can create
social tension or lead to the practising of harmful behaviours and should be responded to by swiftly providing communities
with the right information.
A majority of the survey respondents view COVID-19 as very dangerous (84.0%). Some respondents said that a minority of
people in their community believed COVID-19 was a political problem or that it did not really exist.
When asked if a person who is infected or has recovered from COVID-19 is faced with discrimination, 21.7% of the host
population answered “Yes” compared to 8.7% of the refugee respondents. This indicates that stigmatisation on COVID-19
is higher amongst the host population than in refugee communities. Among those (1,548 respondents) who are faced with
discrimination are people who are or have been infected (60.1%) as well as those suspected of having COVID-19 (55.2%).
Two-thirds (67.1%) of the respondents are worried that they might become infected with COVID-19. Among other responses,
the fear of losing employment (9%) or having lost employment (9.1%), paying rents/bills (9.4%), or being unable to afford
food for the household (6.4%) or hygiene products (3.9%) was slightly higher among refugees than local people. These
concerns are also higher for men compared to women.

4 Community Based Migration Programme


Almost all - 94.3% - of survey respondents are taking some measures in their daily life to prevent the risk of COVID-19
infection, including frequently washing hands with soap, practicing personal hygiene, staying indoors and avoiding going out
unless necessary, sterilizing surfaces and cleaning homes with disinfectant, using masks, and maintaining physical distance
whenever outside. Those who said they were not taking any measures (64 respondents) highlight various reasons, including
not knowing how to take preventive measures (50%), not believing these practices will prevent the risk (20.3%), and being
unable to afford soap or disinfectants (14.1%).
Despite the high levels of awareness, community members in many locations now are becoming less inclined to follow the
preventive measures compared to the early stages of the outbreak. Some believe that healthier people will not be infected
and cannot spread the disease, while a few thinks that COVID-19 does not really exist. People find discomfort wearing
masks in the hot weather or are not wearing the masks appropriately. After months of social isolation and staying indoors,
more people are now beginning to go out to public places without heeding physical distancing or wearing masks. As people
begin to attend their workplaces again, there is a growing need to encourage and motivate people to maintain safety and
cleanliness measures at their places of employment.
Although around 55% of the respondents reported not needing any additional information on COVID-19, the remaining
45% requested information on various topics relating to COVID-19. While communities may have information about
preventive measures, awareness raising activities need to be reinforced to inform people how to protect themselves in this
post-lockdown1 situation. Information materials for children and young people, should be further developed to help them
understand the risks and the necessary measures to avoid infection. Online trainings/seminars on COVID-19 and hygiene
promotion are suggested to encourage community members, children and young people to practice healthy behaviours.
Well over half of respondents said they preferred to receive information from TRCS by phone (58.6%), followed by SMS
(29.6%), TRCS Facebook (23.8%), and WhatsApp (20.3%). Turkish (59.6%) and Arabic (51.1%) were the main preferred
languages, with English, Farsi, and Kurdish also reported, but in much lower numbers.
While a good percentage of refugee respondents reported following TRCS social media channels, most of the respondents
from the local community were not aware about these platforms, or the TRCS website, or that these channels were a source
of COVID-19 information. Of all respondents following TRCS social media (1,752 respondents), refugees are more likely
to visit the TRCS Facebook and Community Centre Facebook pages (62.1%) than the local people (25.6%). For the host
population, TRCS Instagram and Twitter, both the general and Community Centre accounts, were more popular, with more
than half (52.4%) of host-community respondents reporting visiting them, compared to less than a third (28.3%) of refugees.
Around 72.4% of respondents said they would prefer to contact TRCS by phone to ask questions or share feedback.
Respondents also said they preferred face-to-face interaction by visiting TRCS Community Centres or meeting staff/
volunteers in person. Online meetings via Zoom/Skype were recognised as useful to ask questions and share key concerns
from their community. It is suggested that TRCS conduct more surveys, similar to this KAP assessment in which communities
can participate to discuss their situation and concerns about COVID-19.
Under the current situation, many people have lost employment. At the same time, the need for masks, hygiene kits, food
parcels and psychosocial support (PSS) in the community is growing. Relevant services including mental health support are
increasingly requested from TRCS to help communities respond to the COVID-19 outbreak. While this assessment shows
there is a broad foundation of understanding of the direct risks posed by the virus and the steps to prevent its spread, there
is a growing need to respond to its knock-on impacts, and to ensure organisations, and the information and services they
provide, remain agile in responding to the swiftly changing situation.

1
COVID-19 pandemic lockdown are extreme precautions or restrictions to prevent the spread of COVID-19. In Turkey shortly after the first COVID-19
case was reported in mid-March 2020, strict measures were introduced by the Turkish government to curb the spread of the pandemic in the country.
Lockdown was introduced for those above 65 years and under 20 years old and inter-city travel restrictions and weekend curfews were imposed. Other
containment measures included closing of schools, provisioning flexible working arrangements, recommending people to stay at home and banning
public gatherings. Beginning of June 2020, restrictions have been eased in Turkey by lifting curfews and reopening businesses, government offices
and other services which have been shut during the lockdown, with targeted restrictions depending on the COVID-19 situation in different cities. On
26 August 2020, the government has issued a new presidential decree on flexible working modalities for all state institutions to minimize the spread of
COVID-19.

Community Based Migration Programme 5


Table of Contents
Executive Summary.................................................................................................................................................... 4
List of Maps................................................................................................................................................................ 8
List of Tables.............................................................................................................................................................. 8
List of Figures............................................................................................................................................................. 8
Abbreviations ............................................................................................................................................................. 9

Introduction.............................................................................................................................. 10
Background............................................................................................................................................................... 11
Why KAP assessment?............................................................................................................................................ 11
Goal and Objectives................................................................................................................................................. 12
Method...................................................................................................................................................................... 12
TRCS Community Centre social media ............................................................................................................. 12
Phone interviews by TRCS Community Centre staff........................................................................................... 12
Online consultation/Focus Group Discussion (FGDs)......................................................................................... 12
Limitations......................................................................................................................................................... 14
Demographic Profile................................................................................................................................................ 14
Gender.............................................................................................................................................................. 14
Age................................................................................................................................................................... 14
Nationality......................................................................................................................................................... 15
Status in Turkey................................................................................................................................................. 15
Highest level of education.................................................................................................................................. 15
Language spoken and understood.................................................................................................................... 16

Knowledge................................................................................................................................. 17
What do you know about the new Coronavirus?............................................................................................... 18
What kind of information have you received about the new Coronavirus?.......................................................... 18
How does the Coronavirus spread?.................................................................................................................. 19
What are the main symptoms of the Coronavirus infection?............................................................................... 19
Do you know how to prevent the Coronavirus contraction? .............................................................................. 20
Where do you get information about the new Coronavirus from?....................................................................... 20
Is there anything preventing you or making it difficult to receive information about the new Coronavirus?........... 21
If yes, what are the barriers?.............................................................................................................................. 21
Which channel/who do you trust the most for information related to the new Coronavirus?............................... 22
Do you know who is at the highest risk of the infection?.................................................................................... 23
Have you heard anything about the Coronavirus that you are not sure is true or not?........................................ 23

Attitudes....................................................................................................................................26
How dangerous do you think the new Coronavirus is?...................................................................................... 27
If a person gets infected with Coronavirus or has recovered in your community,
are they treated differently or discriminated because of it?................................................................................. 27
If yes or to some extent, which of the following groups are being discriminated in your community
because of the Coronavirus?............................................................................................................................. 28
What worries or concerns you the most about the Coronavirus?....................................................................... 29

Practices.....................................................................................................................................30
Are you taking any measures in your daily life to prevent the risk of infection?.................................................... 31
If not, why?....................................................................................................................................................... 31
If yes or sometimes, what have you and your family done to prevent becoming sick with the Coronavirus
in the recent days?............................................................................................................................................ 32
Are you facing any challenges in taking such preventive measures?.................................................................. 33
What would you do if you or someone from your family has symptoms of this disease?.................................... 34

6 Community Based Migration Programme


Information needs & communication channels................................................................35
What information do you need right now about the new Coronavirus?.............................................................. 36
How would you prefer to receive information about the Coronavirus from TRCS?.............................................. 37
What language would you prefer to receive the information in?.......................................................................... 38
Do you follow TRCS social media platforms (Facebook, Twitter, Instagram, YouTube) and website
to get information about the Coronavirus?......................................................................................................... 39
If yes, which platforms do you follow?............................................................................................................... 39
If not or sometimes, what are the reasons?....................................................................................................... 39
If you wanted to ask questions or share feedback with TRCS on the Coronavirus,
how would you prefer to do so?........................................................................................................................ 40
Do you have any comments or feedback about COVID-19 that you would like to share with us?...................... 42

Recommendations...................................................................................................................43

Community Based Migration Programme 7


List of Maps
Map 1 Turkey: Provinces with an active TRCS Community Centre............................................................................... 14

List of Tables
Table 1 Number and composition of FGD participants................................................................................................. 13
Table 2 Rumours and places where they are heard...................................................................................................... 25

List of Figures
Figure 1 Gender-Age structure of respondents............................................................................................................ 14
Figure 2 Nationality-Status of respondents................................................................................................................... 15
Figure 3 Highest level of education of respondents by status and gender.................................................................... 15
Figure 4 Language spoken and understood by status................................................................................................. 16
Figure 5 Awareness about COVID-19.......................................................................................................................... 18
Figure 6 Types of COVID-19 information received........................................................................................................ 18
Figure 7 Understanding how COVID-19 spreads......................................................................................................... 19
Figure 8 Understanding COVID-19 symptoms............................................................................................................. 19
Figure 9 Understanding how to prevent COVID-19...................................................................................................... 20
Figure 10 Sources of COVID-19 information by status................................................................................................. 20
Figure 11 Barriers to receive information...................................................................................................................... 21
Figure 11a Barriers to receive information (follow up question)..................................................................................... 21
Figure 12 Trusted sources of information..................................................................................................................... 22
Figure 13 People with COVID-19 risk........................................................................................................................... 23
Figure 14 Attitudes towards COVID-19........................................................................................................................ 27
Figure 15 Likelihood of people to face discrimination in relation to COVID-19.............................................................. 27
Figure 16 People reported to face discrimination in relation to COVID-19..................................................................... 28
Figure 17 Worries and concerns in relation to COVID-19............................................................................................. 29
Figure 18 Likelihood of practicing preventive measures............................................................................................... 31
Figure 19 Reasons for not taking preventive measures................................................................................................ 31
Figure 20 Measures undertaken to prevent COVID-19................................................................................................. 32
Figure 21 Challenges in taking preventive measures.................................................................................................... 33
Figure 22 Actions taken if COVID-19 symptoms show................................................................................................. 34
Figure 23 What information communities need now..................................................................................................... 36
Figure 24 Preferred communication channels to receive information............................................................................ 37
Figure 25 Preferred language to receive information..................................................................................................... 38
Figure 26 Use of TRCS social media to receive COVID-19 information......................................................................... 39
Figure 26a Use of TRCS social media to receive COVID-19 information (follow up question)........................................ 39
Figure 27 Reasons for not using or sometimes using TRCS social media.................................................................... 39
Figure 28 Preferred channel to ask questions or share feedback with TRCS................................................................ 40

8 Community Based Migration Programme


Abbreviations

CBHFA Community Based Health and First Aid


CC Community Centre
CEA Community Engagement and Accountability
FGD Focus Group Discussion
IEC Information Education and Communication
IFRC International Federation of Red Cross and Red Crescent Societies
IM Information Management
KAP Knowledge, Attitudes and Practices
NGO Non-Governmental Organization
PMER Planning Monitoring Evaluation Reporting
PPE Personal Protective Equipment
PSS Psychosocial support
RCCE Risk Communication and Community Engagement
TRCS Turkish Red Crescent Society
WHO World Health Organisation

Community Based Migration Programme 9


Data collection process, Şanlıurfa

INTRODUCTION
Community Centre, 27 July 2020
Credit: TRCS

10 Community Based Migration Programme


Background
The COVID-19 pandemic has resulted in both a public health crisis, and a humanitarian crisis, affecting the lives, health and
livelihoods of people around the world. With the impact on socio-economic conditions, vulnerable people, already affected
by displacement and conflict, are at greater risk in the face of COVID-19 outbreak. Given the disruption of daily routines
and social isolation, the outbreak affects mental health and psychosocial wellbeing causing fear and anxiety among people
about their own health and the health of their loved ones.
In Turkey, as of 7 September 2020, 279,806 cases have been confirmed with 6,673 deaths reported. Survival rates
have been encouraging however, with 251,105 people recovering from the virus. While the country continues to observe
some containment measures, beginning of June 2020, restrictions have been eased by lifting curfews and reopening
businesses including restaurants, cafes, shopping malls, hairdressing salons, barbershops, and other similar venues as
well as government offices and other services which have been shut during the lockdown. Citizens above the age of 65 are
allowed outside between 10am to 8pm while those under 18 can go out anytime with their parents. Both these groups were
previously prohibited from leaving their homes, apart from on certain days of the week.
The Turkish government has issued a new presidential decree on 26 August 2020 on flexible working modalities for state
institutions. This decree published in the Official Gazette orders new working schemes to minimize the spread of COVID-19
outbreak. To continue providing services during the outbreak, all state institutions will provide remote working modalities or
new shifts for employees.
As part of the Community Based Migration Programme (CBMP), the Turkish Red Crescent Society (TRCS) has been
responding to COVID-19 related needs in the country by conducting risk communications and community engagement
(RCCE) activities. These include dissemination of information among refugee and host communities by phone, online social
media and conferencing platforms, at households, and in public community spaces. Based on community information
needs and in coordination with the TRCS public health department, the TRCS communications team has been updating and
developing new content and information materials on various topics related to COVID-19, including factual information to
address rumours. To date, TRCS has reached over 88,711 refugee and host communities through Community Centre (CC)
RCCE and hygiene promotion activities in relation to COVID-19. Also being conducted by TRCS are health interventions,
including symptom screening by phone, referring potential COVID-19 cases to hospitals, and various online psychosocial
support (PSS) activities.
TRCS operates 16 Community Centres in 15 cities across Turkey, of which 15 Community Centres are supported by IFRC,
providing integrated community level support including protection assistance, social cohesion, health and psychosocial
services, language training, vocational training for employability and livelihoods support, all of which aim to increase the
resilience and well-being of both refugee and host communities. Recognizing that listening and working with communities
to support them and address their vulnerabilities leads to better quality programming, TRCS has been using the Red Cross
Red Crescent Movement’s Community Engagement and Accountability (CEA) approach within its work at the Community
Centres to ensure services provided are relevant and effective for the needs of the community.

Why KAP assessment?


Given that understanding about COVID-19 and the ongoing outbreak is rapidly evolving, any information gaps among
people can potentially lead to misperceptions, rumours, and panic. It is critical to capture and act on the feedback and
concerns of the communities we work with, to provide relevant life-saving information, adjust response operation, and build
long-term trust.
To understand refugee and local communities’ knowledge, attitudes, and practices (KAP), along with their information needs
on COVID-19, this KAP assessment was conducted by TRCS, with support from IFRC, between 20 July and 12 August
2020. The assessment helps us understand what people know, what they believe, and what they do in relation to COVID-19,
and is a community engagement tool to help us listen to people and improve our work. Knowing what information people
have heard already, how they reacted to it, and why they might be resistant to change can help us develop effective,
targeted information, engage in dialogue with communities, and promote positive behaviour. The assessment also provides
an understanding of the context for refugees and local people in the current outbreak to help ensure RCCE activities
communicate with all groups, and do not unintentionally create or exacerbate existing tensions and inequalities.

Community Based Migration Programme 11


Goal and Objectives
The goal of the KAP assessment is to understand communities’ knowledge, attitudes and practices, along with their
information needs on COVID-19, and inform risk communication, behaviour change and community engagement activities.
Key objectives are to understand communities’:
• knowledge about COVID-19
• attitudes and feelings towards COVID-19, as well as their perceptions, beliefs, or any preconceived ideas
• practices and what people do to protect themselves and their families from the disease
• information needs and their preferred channels through which to receive information and share feedback with TRCS 

Method
This KAP assessment has been conducted via TRCS’ social media platforms, phone interviews, and online consultations/
focus group discussions (FGDs) with refugees and local people in 16 TRCS Community Centre (CC) locations. Comprising
both qualitative and quantitative data, a total of 3,840 individuals have been interviewed over the phone in 16 Community
Centre locations, while a further 320 refugees and local people have participated in 32 FGDs. Of these 320, 160 were men,
160 women, and 160 were refugees and 160 local community members. A KAP survey questionnaire, to be used on TRCS
social media platforms and phone interviews, and FGD questions have been developed through consultation with TRCS
CEA, Communication, and PMER departments as well as IFRC CEA, IM and PMER. KOBO toolbox - a free open-source
tool for mobile data collection - has been used to collect data for the survey. An online orientation on the KAP assessment
was held on 22 July 2020 for 25 TRCS staff from the Community Centres (CCs) to explain the objectives of the assessment,
how to use KOBO to collect data, and to go through the survey questionnaire and FGD questions.

TRCS Community Centre social media


The KAP survey questionnaire has been posted on TRCS Community Centre (CC) Facebook and LinkedIn pages and to
Twitter account in Turkish, English and Arabic. The survey was posted three times within the timeframe of the assessment.
This survey through social media does not target any specific group and has been kept open to any page visitors. A short
introduction about the purpose of the survey was included when the forms were posted to the social media platforms.

Phone interviews by TRCS Community Centre staff


TRCS staff in each of 16 Community Centre locations have conducted the KAP survey via phone interviews by calling
members of both the refugee and local community. A total of 240 individuals have been interviewed in each location totalling
3,840 individuals in 16 locations. Of these, 1,959 were female (51%), 1,877 male (48.9%) while 1,893 (49.3%) of the
respondents were Turkish, 1,848 (48.1%) Syrian, and 97 (2.6%) of other nationalities. An estimated 50% of the respondents
interviewed are involved in TRCS CC activities, with the other half of respondents not accessing any services at the CC. In
the phone survey, random sampling2 and snowball technique sampling3 have been used.

Online consultation/Focus Group Discussion (FGDs)


Two separate online consultations/FGDs with refugees and local people, have been conducted in each of 16 CC locations.
In total 32 FGDs have been conducted reaching 320 refugees and local people. The participants of the FGDs also included
members of TRCS’ existing community forum, the Advisory Committee4. The Advisory Committee members have been
previously part of a qualitative assessment on COVID-19 in March 2020, hence any changes or improvement in their lives
can be reflected in these FGDs. Since the consultations have been done online, a maximum of 10 participants attended
each FGD session.

2
Random sampling consists of a sample that is meant to be an unbiased representation of the total population. For the phone survey, the respondents
involved in CC activities, are randomly selected from the TRCS beneficiary database which records information of community members receiving or
accessing various services at the CC such as language courses, vocational training, PSS counselling, etc.
3
Snowball technique sampling is a nonprobability sampling technique where existing study subjects recruit future subjects from among their acqua-
intances. For the phone survey, the respondents not involved in CC activities are selected through snowball technique sampling, where the surveyed
respondents involved in CC activities select other individuals near their residence, who are not receiving or accessing any services at the CC.
4
The Advisory Committee comprises of community representatives (locals and refugees) and functions as a platform to share with TRCS, along with
other stakeholders, their feedback or concerns about the Community Centre activities and other issues affecting them. With a maximum of 15 mem-
bers, the committee comprises of both men and women from various profession and age.

12 Community Based Migration Programme


Apart from the Advisory Committee members, other participants attending the FGDs were identified prioritising older
people, people with disabilities, and single heads of households including those who are involved in CC activities and others
that are not accessing any services at the CC. The reason for conducting separate FGDs for refugees and local people was
to ensure that people could discuss openly, and avoid influence from either party in responding.
The number and composition of the community members who participated in the FGDs are outlined in the table below. In
total, 320 community members participated in the discussion, of which 160 were men, 160 women, and 160 refugees and
160 local community members.

Number and composition of FGD participants


Sl No Community Centre Local Refugee
Total
Men Women Men Women
1 Adana Community Centre 5 5 5 5 20
2 Ankara Community Centre 5 5 5 5 20
3 Bağcılar Community Centre 5 5 5 5 20
4 Bursa Community Centre 5 5 5 5 20
5 Hatay Community Centre 5 5 5 5 20
6 İzmir Community Centre 5 5 5 5 20
7 Gaziantep Community Centre 5 5 5 5 20
8 Kahramanmaraş Community Centre 5 5 5 5 20
9 Kayseri Community Centre 5 5 5 5 20
10 Kilis Community Centre 5 5 5 5 20
11 Konya Community Centre 5 5 5 5 20
12 Mardin Community Centre 5 5 5 5 20
13 Mersin Community Centre 5 5 5 5 20
14 Sultanbeyli Community Centre 5 5 5 5 20
15 Şanlıurfa Community Centre 5 5 5 5 20
16 Kocaeli Community Centre 5 5 5 5 20
Total 80 80 80 80 320

Table 1 Number and composition of FGD participants

Data collection process, Şanlıurfa


Community Centre, 29 July 2020
Credit: TRCS

Community Based Migration Programme 13


Limitations
Although the KAP survey questionnaire was posted in TRCS social media three times throughout the period of the
assessment, the total number of responses submitted was too low to consider the analysis meaningful and the findings
statistically significant and therefore not used in the analysis for this assessment. This report  presents only  the survey
results of the phone interviews and the outcome of the FGDs in 16 Community Centre locations. The findings are presented
separately in the knowledge, attitudes, practices, and information needs section.

İstanbul İstanbul
Bağcılar Sultanbeyl�
Ankara
Kocael� Kayser�
Kahramnamaraş

Şanlıurfa
Bursa

İzm�r

Mard�n
Konya Gaz�antep
K�l�s
Mers�n Adana
Hatay

Map 1 Turkey: Provinces with an active TRCS Community Centre

Demographic Profile
Analysis of this assessment is based on 3,840 phone survey responses and 32 FGDs with refugees and local community
members in 16 Community Centre locations. Out of 3,840 respondents, 1,959 are female (51%) and 1,877 male (48.9%).
The age distribution of the respondents is: 0.9% 14-17-year-olds, 39.6% 18-29, 56.6% 30-59-year olds and 2.9% over
the age of 60. The FGDs are conducted separately with refugees and host community members. In total, 320 community
members participated in the FGDs, of which 160 were men, 160 women, and 160 refugees and 160 local community
members.

Gender Age

Female 1,959 (51.0%) 30-59 2,172 (56.6%)


Male 1,877 (48.9%) 18-29 1,522 (39.6%)
Prefer not to answer
4 (0.1%) 60+ 112 (2.9%)
14-17 34 (0.9%)

Figure 1 Gender-Age structure of respondents

14 Community Based Migration Programme


Out of 3,840 survey respondents, 1,893 (49.3%) are Turkish, 1,848 (48.1%) Syrian, and 97 (2.6%) other nationalities: Iraq,
Iranian, Afghan and others such as, Palestinian, Algerian, Uzbek, etc. Out of 3,840 interviewed, 1,911 (49.8%) respondents
are refugees and 1,893 (49.3%) host population. 34 (0.9%) respondents selected “Other” nationality option and this group
could not be classified as either a refugee or a host community and 2 (0.1%) respondents preferred not to answer.

Nationality Status in Turkey


Nationality grouped
Turkish 1,893 (49.3%) Refugee 1,911 (49.8%)
Syrian 1,848 (48.1%) Host Population 1,893 (49.3%)
Prefer not to answer 2 (0.1%) Other 34 (0.9%)
Other 34 (0.9%) Prefer not to answer 2 (0.1%)
Iraqi 41 (1.1%)
Iranian 2 (0.1%)
Afghan 20 (0.5%)

Figure 2 Nationality-Status of respondents

The highest level of education: 20.3% of respondents from the host population had completed university while 14.3%
of the refugee respondents had completed secondary education. 14.2% of female and 15.8% of male respondents had
completed university.

Highest level of education


by status and gender
Prefer
Host population Refugee Other
not to answer
University 778 (20.3%) 358 (9.3%) 14 (0.4%) 1 (0.0%)
High School 449 (11.7%) 500 (13.0%) 6 (0.2%)
Secondary 177 (4.6%) 551 (14.3%) 3 (0.1%) 1 (0.0%)
Primary 275 (7.2%) 372 (9.7%) 6 (0.2%)
Vocational training 92 (2.4%) 36 (0.9%)
Masters/PhD 86 (2.2%) 18 (0.5%) 5 (0.1%)
No formal education 24 (0.6%) 65 (1.7%)
Other 12 (0.3%) 11 (0.3%)

Male Prefer
Female
not to answer
University 544 (14.2%) 605 (15.8%) 2 (0.1%)
High School 476 (12.4%) 479 (12.5%)
Secondary 353 (9.2%) 378 (9.8%) 1 (0.0%)
Primary 407 (10.6%) 246 (6.4%)
Vocational training 49 (1.3%) 79 (2.1%)
Masters/PhD 51 (1.3%) 58 (1.5%)
No formal education 64 (1.7%) 25 (0.7%)
Other 15 (0.4%) 7 (0.2%) 1 (0.0%)

Figure 3 Highest level of education of respondents by status and gender

Community Based Migration Programme 15


In regards to language, the host population spoke and understood Turkish (48.7%), followed by English (10%) and some
Arabic (8.6%). Refugees, on the other hand, spoke Arabic (48.5%), Turkish (17.3%) and some English (6.3%). Under the
“other” category: Kurdish was mentioned.

Language spoken and understood


more than one answer possible

Prefer
Host population Refugee Other
not to answer
Arabic 331 (8.6%) 1,861 (48.5%) 22 (0.6%) 1 (0.0%)
English 384 (10.0%) 241 (6.3%) 12 (0.3%) 2 (0.1%)
Farsi 5 (0.1%) 26 (0.7%) 1 (0.0%) 0 (0.0%)
Other 189 (4.9%) 65 (1.7%) 8 (0.2%) 0 (0.0%)
Turkish 1,870 (48.7%) 664 (17.3%) 26 (0.7%) 2 (0.1%)

Figure 4 Language spoken and understood by status

Data collection process, İzmir


Community Centre, 29 July 2020
Credit: TRCS

16 Community Based Migration Programme


Data collection process, İstanbul Sultanbeyli

KNOWLEDGE
Community Centre, 5 August 2020
Credit: TRCS

Community Based Migration Programme 17


Knowledge assesses a community’s understanding and what they know about a given topic, COVID-19 for this
KAP assessment. This helps to understand if people are aware about COVID-19, its risks or the groups that are at
risk of infection and the protective actions to prevent the disease.

Survey findings show about 96.5% of the respondents are aware about COVID-19. This number indicates a high
exposure to information about COVID-19 with these 96.5% of respondents reporting that COVID-19 is a virus that can cause
disease. However, the remaining 3.5% of respondents either did not know anything about it (1.6%), thought COVID-19 was
used as a TV/radio campaign (1.4%), or gave another response (0.5%).

What do you know about the new Coronavirus?


It’s a virus that can cause a disease 3,706 (96.5%)

I don’t know anything 60 (1.6%)

It’s a TV/radio campaign 54 (1.4%)

Other 20 (0.5%)

Figure 5 Awareness about COVID-19

Under “Other” the following responses were recorded: the new Coronavirus is a punishment sent by God, a virus originating
in China, a virus similar to what causes flu, a virus spread by bats. Two respondents said they did not know enough to
answer this question.
Respondents have received various information about COVID-19 including its symptoms (88.2%), how it is
transmitted (83.4%), how to prevent the disease (70.5%), and how to wear masks (55.3%) or wash hands (48.5%).
People also reported being informed about what to do if infected (42.5%), the risks involved for people with chronic disease
or pregnant women (31%) and who to ask questions on COVID-19 (22.1%).

What kind of information have you received about the new Coronavirus?
more than one answer possible

Symptoms of the new coronavirus disease 3,385 (88.2%)


How it is transmitted 3,203 (83.4%)
How to protect yourself from the disease 2,708 (70.5%)
How to use masks 2,123 (55.3%)
How to wash hands 1,861 (48.5%)
What to do if you have the symptoms 1,632 (42.5%)
Risks and complications for people with chronic disease or pregnant women 1,189 (31.0%)
Who to ask questions about coronavirus 848 (22.1%)
How to use bleach/disinfectant at home to prevent risks of infection 721 (18.8%)
Which hospitals to go if symptoms appear 716 (18.6%)
Other 88 (2.3%)

Figure 6 Types of COVID-19 information received

There were no significant differences in answers provided by refugees/host community members or women/men. Under
“Other” the following responses were recorded: the virus can cause an economic crisis, people should practice physical but
not social distancing, there is no cure for the disease, people should stay at home unless it is absolutely necessary to go
out. Nine respondents said they had not received any information.

18 Community Based Migration Programme


When asked how COVID-19 spreads, most respondents mentioned correctly that it can spread through droplets
from infected persons when coughing and sneezing (86.6%) or direct contact with infected people (70.9%),
touching contaminated objects or surfaces (64.6%) or touching nose, eyes and mouth with dirty hands (54.1%).
However, the remaining mentioned blood transfusion (4.1%) and close contact with animals and pets (7%) as sources of
infection with 2.1% of people providing other responses.

How does the Coronavirus spread?


more than one answer possible

Droplets from infected people when coughing and sneezing 3,325 (86.6%)
Direct contact with infected people 2,723 (70.9%)
Touching contaminated objects/surfaces 2,479 (64.6%)
Touching nose, eyes and mouth with contaminated hands 2,076 (54.1%)
Blood transfusion 157 (4.1%)
Contact with wild animals 139 (3.6%)
Contact with pets 129 (3.4%)
Other 79 (2.1%)
Drinking unclean water 69 (1.8%)
Do not know 51 (1.3%)
Through rainwater 14 (0.4%)

Figure 7 Understanding how COVID-19 spreads

Other answers not covered in the list: the virus spreads from/through people who are not careful enough and do not follow
the restrictions, through breathing (airborne), the main sources of the virus spread are hospitals.
Almost all respondents mentioned that the main symptoms of COVID-19 are fever (94.6%), cough (84.7%) and
shortness of breath (74.3%). Other symptoms mentioned were muscle pain (35.2%), headaches (35.1%), loss of taste or
smell (31.8%) and diarrhoea (30%).
These survey findings complement the FGDs which found that the vast majority of respondents in all locations are well
aware of the COVID-19 outbreak, the symptoms of infection, how it spreads, and how to reduce the risk of getting infected.
FGD participants explained that the common symptoms of infection include fever, dry cough, sore throat, lack of sense
of smell and taste, and breathing difficulties. The virus can spread through droplets during coughing and sneezing or by
touching eyes or mouth with dirty hands; and as well as being transmitted through air, physical contact with an infected
person can also spread the disease.
According to FGD respondents a lot more people are now aware about the disease and have sufficient information compared to
during the early stages of the outbreak. However, in certain locations such as Mersin, awareness of COVID-19 was lower among
refugees than amongst people from the local communities. The reason for this is mainly due to the language barrier, which can
negatively impact refugees’ access to information and motivation to practice healthier behaviours and adopt precautions.

What are the main symptoms of the Coronavirus infection?


more than one answer possible
Fever 3,632 (94.6%)
Cough 3,254 (84.7%)
Shortness of breath and breathing difficulties 2,854 (74.3%)
Muscle pain 1,351 (35.2%)
Headache 1,346 (35.1%)
Loss of taste or smell 1,222 (31.8%)
Diarrhoea 1,152 (30.0%)
Other 124 (3.2%)
Do not know 52 (1.4%)
No symptoms 35 (0.9%)

Figure 8 Understanding COVID-19 symptoms

Other mentioned symptoms: flu-like symptoms, general weakness.

Community Based Migration Programme 19


Regarding the measures to prevent COVID-19 infection, most respondents correctly identified washing hands
with soap (90.4%), wearing masks when going out (84.6%), maintaining physical distance (82.2%), using hand
sanitizer (57.8%) and maintaining good coughing etiquette (49.4%). Others mentioned wearing masks when taking
care of an infected person (31.3%) and using disinfectants to clean surfaces (15.9%).

Do you know how to prevent the Coronavirus contraction?


more than one answer possible

Wash your hands frequently using soap and water 3,473 (90.4%)
Wear masks when you go out 3,249 (84.6%)
Maintain physical distance (1 meter) whenever outside 3,157 (82.2%)
Use a hand sanitizer that contains at least 60% alcohol 2,220 (57.8%)
Cover your mouth and nose when coughing or sneezing 1,896 (49.4%)
Avoid touching mouth, nose, and eyes with contaminated hands 1,360 (35.4%)
Wear masks if you are sick or taking care of an infected person 1,201 (31.3%)
Use disinfectants to clean surfaces 611 (15.9%)
Other 79 (2.1%)
Do not know 41 (1.1%)

Figure 9 Understanding how to prevent COVID-19

Other recorded prevention methods: not going out unless absolutely necessary, taking care of personal hygiene, avoiding
meeting other people.
Survey findings complement FGD reports where participants reported being well aware of preventive measures to reduce the
risk of infection. Encouragingly, participants also said they shared information they receive about COVID-19 and necessary
precautions with their family members, friends, neighbours, and community forums, as well as with other employees at work
via WhatsApp groups or social media.
The most popular sources of information about COVID-19 reported by respondents were TV (66.4%), followed
by government officials (38.7%), Facebook (34.8%), health workers (31.4%), websites (23.8%) and family and
friends (43.3%). Other sources mentioned included social media channels - including those of TRCS and its website - and
TRCS staff and volunteers.

Where do you get information about the new Coronavirus from?


more than one answer possible

Host population Refugee Other Prefer not to answer


TV 1,374 (35.8%) 1,151 (30.0%) 25 (0.7%) 0 (0.0%)
Government officials 987 (25.7%) 487 (12.7%) 11 (0.3%) 1 (0.0%)
Facebook 383 (10.0%) 939 (24.5%) 16 (0.4%) 0 (0.0%)
Health workers 784 (20.4%) 415 (10.8%) 6 (0.2%) 0 (0.0%)
Website 387 (10.1%) 511 (13.3%) 14 (0.4%) 1 (0.0%)
Family/neighbours 377 (9.8%) 506 (13.2%) 1 (0.0%) 0 (0.0%)
Friends 314 (8.2%) 460 (12.0%) 7 (0.2%) 0 (0.0%)
WhatsApp 253 (6.6%) 428 (11.1%) 9 (0.2%) 0 (0.0%)
Instagram 426 (11.1%) 235 (6.1%) 8 (0.2%) 0 (0.0%)
Twitter 433 (11.3%) 120 (3.1%) 7 (0.2%) 1 (0.0%)
TRCS social media & web 184 (4.8%) 241 (6.3%) 2 (0.1%) 0 (0.0%)
TRCS staff/volunteers 155 (4.0%) 251 (6.5%) 1 (0.0%) 0 (0.0%)
Brochures/leaflets 251 (6.5%) 131 (3.4%) 2 (0.1%) 0 (0.0%)
Radio 104 (2.7%) 11 (0.3%) 0 (0.0%) 0 (0.0%)
Other 44 (1.1%) 43 (1.1%) 0 (0.0%) 0 (0.0%)
Community leaders 75 (2.0%) 12 (0.3%) 0 (0.0%) 0 (0.0%)
Religious leaders 19 (0.5%) 12 (0.3%) 0 (0.0%) 0 (0.0%)

Figure 10 Sources of COVID-19 information by status

20 Community Based Migration Programme


Participants in the FGDs reported receiving information about COVID-19 from similar sources to survey respondents,
including social media (Facebook, WhatsApp, Twitter, YouTube), TV, Ministry of Health, government institutions, newspapers,
websites, radio, NGOs and TRCS through its social media channels. They also mentioned other sources such as brochures,
friends and family, mosques, doctors, health workers, and TRCS staff or volunteers. In Kahramanmaraş and Kocaeli, local
people have also been using Hayat Eve Sığar (Life Fits into Home), a mobile application that provides information about
COVID-19 in Turkey.
In most areas, social media (Facebook, WhatsApp and Instagram) and TV are popular among both refugees and local
people. While the use of Facebook (24.5%) and WhatsApp (11.1%) is slightly higher among refugees, TV is more accessible
to host community members (35.8%) as TV shows are mostly in Turkish and there is no language barrier for them.
95.6% of the survey respondents said they did not encounter any challenges in receiving information about
COVID-19. However, among those who do (170 respondents) said they did have difficulties, such as not knowing the
trusted sources of information (65.3%), not having access to internet (20.6%), and social media channels having limited
information in their native languages (10.6%). For people from the host population, not knowing which are trusted sources
of information (45.3%) is identified as one of the main challenges, whereas for refugees access to internet (15.9%) and not
having information on social media in their native languages (7.6%) are the main obstacles. These responses were also
higher for female respondents than men.

Is there anything preventing you or making it difficult to receive information


about the new Coronavirus?
more than one answer possible

No 3,670 (95.6%)
Yes 170 (4.4%)

Figure 11 Barriers to receive information

If yes, what are the barriers?


more than one answer possible; 170 respondents
Refugee Prefer
Host population not to answer
I do not know which is the trusted source of infomation 77 (45.3%) 33 (19.4%) 1 (0.6%)
I do not have access to internet 8 (4.7%) 27 (15.9%) 0 (0.0%)
The social media channels I follow have limited information in my langugage about coronavirus 5 (2.9%) 13 (7.6%) 0 (0.0%)
I do not use social media 6 (3.5%) 9 (5.3%) 0 (0.0%)
I live far away from the Community Centre 7 (4.1%) 4 (2.4%) 0 (0.0%)
I do not have a phone 0 (0.0%) 4 (2.4%) 0 (0.0%)

Male Prefer
Female not to answer
I do not know which is the trusted source of infomation 56 (32.9%) 55 (32.4%) 0 (0.0%)
I do not have access to internet 20 (11.8%) 15 (8.8%) 0 (0.0%)
The social media channels I follow have limited information in my langugage about coronavirus 14 (8.2%) 4 (2.4%) 0 (0.0%)
I do not use social media 7 (4.1%) 8 (4.7%) 0 (0.0%)
I live far away from the Community Centre 9 (5.3%) 2 (1.2%) 0 (0.0%)
I do not have a phone 1 (0.6%) 3 (1.8%) 0 (0.0%)

Figure 11a Barriers to receive information (follow up question)

FGD participants from refugee communities in Ankara, Kahramanmaras, Kocaeli, Mardin and Urfa, identified language
as one of the key barriers in accessing information. In other locations, community members can receive information from
TRCS Community Centres or other institutions in both Arabic and Turkish languages. School-going children in many refugee
families support by translating and explaining COVID-19 related information from Turkish to Arabic. In Bursa, it is reported
that refugees with poor financial conditions have challenges to afford internet access, making it difficult for them to access
information from social media or websites. Some refugees are not able to read or write in Arabic, and this can prevent them
from accessing written information.

Community Based Migration Programme 21


Respondents’ most trusted sources of information were Government officials (46.9%), TV (44.3%), health
workers (34.8%) and doctors (22.3%). Other channels mentioned included Facebook (16.6%), family and friends (23.3%),
websites (13.2%) and TRCS (21.4%), all of which were also more trusted by refugees than people from host communities.

Which channel/who do you trust the most for information related to the new
Coronavirus?
more than one answer possible
Overall Host population Refugee
Government officials 1,801 (46.9%) 1,084 (28.2%) 704 (18.3%)
TV 1,702 (44.3%) 839 (21.8%) 839 (21.8%)
Health workers 1,336 (34.8%) 817 (21.3%) 512 (13.3%)
Doctors 855 (22.3%) 473 (12.3%) 373 (9.7%)
Facebook 636 (16.6%) 107 (2.8%) 525 (13.7%)
Family/neighbours 520 (13.5%) 196 (5.1%) 321 (8.4%)
Website 506 (13.2%) 177 (4.6%) 327 (8.5%)
TRCS social media & web 420 (10.9%) 160 (4.2%) 258 (6.7%)
TRCS staff/volunteers 403 (10.5%) 106 (2.8%) 296 (7.7%)
Friends 377 (9.8%) 121 (3.2%) 254 (6.6%)
WhatsApp 307 (8.0%) 72 (1.9%) 228 (5.9%)
Brochures/leaflets 286 (7.4%) 168 (4.4%) 115 (3.0%)
Twitter 281 (7.3%) 203 (5.3%) 74 (1.9%)
Instagram 207 (5.4%) 104 (2.7%) 101 (2.6%)
Other 122 (3.2%) 68 (1.8%) 52 (1.4%)
Community leaders 73 (1.9%) 51 (1.3%) 21 (0.5%)
Radio 63 (1.6%) 52 (1.4%) 10 (0.3%)
Religious leaders 19 (0.5%) 12 (0.3%) 6 (0.2%)

Figure 12 Trusted sources of information

In the FGDs, participants reported that their trusted sources of information were
family, friends, doctors or healthcare professionals, Ministry of Health and other People around me prefer to get
government institutions, TRCS and its Community Centres, community leaders, information from community
Muhtars5, World Health Organization (WHO) and NGOs. In Bursa, Bağcilar, leaders and Muhtars on
Kahramanmaraş, Mersin, Kayseri and Sultanbeyli, respondents also mentioned COVID-19.
religious leaders as one of the trusted channels to receive information. Religious
leaders should be involved and engaged in encouraging communities to Salih,
practice positive behaviours and explaining the importance of following Turkish man - 61, Adana
health advice. FGD participants suggested that the sharing of key messages
or announcements by the Muhtars could be quite effective in reinforcing the
importance of undertaking preventive measures to stop the spread of disease.
FGD participants also said that communities prefer to receive information through local or national TV channels (TRT1),
news channels (TRT News, A News) and Arabic TV channels as well as through SMS, online meetings, phones, social
media platforms and TRCS staff or volunteers. In Gaziantep and Kocaeli, participants recommended TRCS to conduct live
sessions together with doctors or physicians on Facebook or other social media channels to talk about COVID-19, raise
awareness among people to take precautionary measures, and answer questions from the audience.

5
Muhtar - Muhtar is the elected government representative who carries out management and executive roles in the city neighbourhoods and villages
in Turkey

22 Community Based Migration Programme


A majority of respondents identified older people (85.8%) and people with chronic diseases (74.1%) as being
at the highest risk of COVID-19 infection. Also mentioned were health workers (25.9%), pregnant women (22.1%), and
children under 5 years old (15.3%).

Do you know who is at the highest risk of the infection?


more than one answer possible

Elderly persons 3,293 (85.8%)

People with chronic disease 2,846 (74.1%)

Health workers 996 (25.9%)

Pregnant women 848 (22.1%)

Children under 5 years old 588 (15.3%)

Adolescents up to 15 years old 365 (9.5%)

Youth 334 (8.7%)

Adults (18+) 301 (7.8%)

Other 158 (4.1%)

Figure 13 People with COVID-19 risk

Other vulnerable groups mentioned in the survey were people with compromised immune systems, those working outside
(especially men), and people staying/working in crowded places. Twenty individuals said that everyone is at risk of contracting
the virus, while twelve could not indicate any vulnerable groups.
FGD participants recognized that everyone could be at risk of infection, but specifically mentioned, older people (above 60
years of age), those with chronic diseases and people with weak immune systems as being at a higher risk of becoming
infected. Many participants felt pregnant women, health workers, people working in factories and public areas, those using
public transport, and people not following the preventive measures (not wearing masks, not maintaining personal hygiene
or not paying attention to physical distancing) could be equally at risk of COVID-19 infection. Most participants recognised
that although young people and children are at relatively at low risk themselves, they can be carriers of the disease.

Have you heard anything about the Coronavirus that you are not sure is true or not?
Participants in the FGDs stressed that there are various rumours spreading within their communities about COVID-19.
These rumours are spread mostly via word of mouth and social media (Facebook, Twitter and Instagram). Misperceptions
and rumours in a community can create social tension or lead to practising harmful behaviours and should be responded
to swiftly by providing communities with the right information.
In most locations, participants said they checked official websites including those of the Ministry of Health and NGOs
to verify rumours. They suggested that audio, video, and visual information materials should be developed to provide
communities with accurate, reliable information. These could be published on official social media accounts and websites
including those of TRCS and Ministry of Health, as well as being shared by TV channels. Others said they would like to
receive factual information via phone, leaflets, information kiosks, SMS, WhatsApp groups and TRCS Community Centres.

Community Based Migration Programme 23


Examples of the different types of rumours and the locations where they were heard are listed below.

Sl No Rumours Location
Kahramanmaraş, Şanlıurfa,
1 There is no coronavirus.
Bağcilar, Mersin

Coronavirus will infect you anyways. So, you don’t need to pay
2 Mardin, Kahramanmaraş
attention to preventive measures.

3 Mask does not protect individuals. Bağcilar

4 The virus is not spread by air or physical contact. Kahramanmaraş

5 We can protect ourselves with onion, garlic and olive oil. Mardin

6 If you wear a mask, you will not be infected. Kilis

7 Coronavirus can contaminate meat. Do not buy meat. Kilis

8 Garlic, onion and coffee are protectors against the virus. Kayseri

9 The virus only affects older people. Gaziantep

10 Children are not infected by coronavirus. Bağcilar

11 Coronavirus does not infect pregnant women. Gaziantep

12 The virus does not infect young people. Kayseri

Those who have recovered from coronavirus have a high risk of


13 Izmir
getting Alzheimer’s disease in future.

14 The number of coronavirus cases are not accurate. Izmir, Kahramanmaraş

15 The virus is mostly spread during the winter season. Kocaeli

16 The virus disappears when the weather gets hot. Kocaeli, Mardin, Bursa

17 The virus dies when it rains. Kocaeli

18 The virus can stay in the air for 15 days. Kocaeli

19 The virus is spread by the rain. Kocaeli

20 The virus can be cured if we eat sumac plant. Mardin, Bursa, Kayseri, Şanlıurfa

Soup made with sheep’s head and foot is good to treat


21 Mardin, Bağcilar, Kilis
coronavirus.

22 The virus dies if it reaches the stomach. Mardin

23 If you eat fruits, you will not be infected. Şanlıurfa

24 The virus can spread from food. Sultanbeyli

Those who have recovered can be infected by coronavirus for a


25 Sultanbeyli
second time.

24 Community Based Migration Programme


We heard there are no vacant beds in Yüreğir State Hospital
26 because of the increase in the number of cases in Adana last Adana
week. The patients are sent to other cities for treatment.

A person can be infected with coronavirus through cigarette


27 Ankara
smoke.

28 There is no risk of getting coronavirus from swimming pools. Kahramanmaraş

29 Vinegar prevents coronavirus. Bursa, Şanlıurfa

30 A vaccine to treat coronavirus has been developed. Ankara, Bağcilar

31 Coronavirus will not infect you if you perform ablution.6 Bursa, Kilis, Mersin

32 The virus will go away if you read prayers. Kahramanmaraş

33 The foreigners brought the virus to Turkey. Bursa

34 Coronavirus is used as a biological weapon. Izmir, Mersin, Bağcilar

35 The virus does not infect the Muslims. Gaziantep, Kilis, Mersin

36 Local people are not infected by coronavirus. Bağcilar

We have seen and experienced the hardships of the war in Syria.


37 Bağcilar, Kayseri, Kilis, Mersin
This coronavirus cannot do anything to us.

People of certain nationality are infected very quickly because


38 Kayseri
they are less careful compared to others.

Table 2 Rumours and places where they are heard

Survey respondents also reported similar rumours in their communities. Below is a summary of their responses:
• Drinking alcohol/tea/water with lemon or eating garlic/onion/sumac/hot pepper can protect against COVID-19.
• The virus is a governmental programme/biological weapon.
• Antibiotics are a good cure for the virus.
• Unverified information about vaccination.
• Animals can get infected.
• It is very dangerous.
• Masks can protect from the virus.
• The infection rate will decrease in the summertime.

6
Ablution or “Wudu” is the Islamic procedure for cleansing parts of the body before prayers such as washing face, arms, wiping the head and washing
the feet.

Community Based Migration Programme 25


Data collection process, İzmir

ATTITUDES
Community Centre, 7 August 2020
Credit: TRCS

26 Community Based Migration Programme


Attitudes refer to communities’ feelings towards the subject, in this case COVID-19, as well as their perceptions,
beliefs, or any preconceived ideas that they may have towards the disease. It also helps to understand if certain
groups of people are at risk of or experience stigma and discrimination in the community because of people’s
attitude towards the disease.

The majority of survey respondents view COVID-19 as very dangerous (84.0%), while few think COVID-19 is
“more or less” dangerous (12.9%), or not dangerous at all (1.7%).

How dangerous do you think the new Coronavirus is?


Very dangerous 3,224 (84.0%)

More of less dangerous 496 (12.9%)

Is not dangerous 67 (1.7%)

Other 53 (1.4%)

Figure 14 Attitudes towards COVID-19

The following responses were reported under the “Other” category: it varies from one person to another, not very dangerous
if taking necessary precautions, dangerous only for those with compromised immune systems, dangerous only for those
over 65 years old and/or with chronic diseases. Seven “I don’t know” answers were also reported.
Almost all participants in the FGDs considered COVID-19 to be deadly and highly contagious, first transmitted from China and
then spread across other countries. A few respondents in Hatay and Izmir reported that some people in their communities
believed COVID-19 to be a political problem or that it did not really exist.
When asked if a person who is infected or has recovered from COVID-19 would face discrimination, 21.7% of the
host population answered “Yes” compared to 8.7% of the refugee respondents. This suggests that stigmatisation
of COVID-19 is higher among the host population than among refugee communities.
Of those who face discrimination (1,548 respondents), people who have, or have previously had, COVID -19
(60.1%) were the most recognised as being discriminated against, followed by people suspected of having
COVID-19 (55.2%). Again, these responses are significantly higher among the host population (39.9% and 38.2%
respectively) compared to refugees (19.9% and 16.7% respectively). Others recognised as being stigmatised were older
people, Syrians, health workers, refugees, and poor people.

If a person gets infected with Coronavirus or has recovered in your community,


are they treated differently or discriminated because of it?
Prefer
Host population Refugee Other
not to answer
No 744 (19.4%) 1,106 (28.8%) 16 (0.4%)
Yes 832 (21.7%) 335 (8.7%) 6 (0.2%) 1 (0.0%)
Do not know 156 (4.1%) 262 (6.8%) 7 (0.2%) 1 (0.0%)
To some extent 161 (4.2%) 208 (5.4%) 5 (0.1%)

Figure 15 Likelihood of people to face discrimination in relation to COVID-19

Community Based Migration Programme 27


If yes or to some extent, which of the following groups are being discriminated
in your community because of the Coronavirus?
More than one answer possible; 1548 respondents
Refugee Other Prefer
Host population not to answer
Anyone who is or have been infected with coronavirus 617 (39.9%) 308 (19.9%) 6 (0.4%) 0 (0.0%)
Persons suspected with coronavirus 592 (38.2%) 258 (16.7%) 5 (0.3%) 0 (0.0%)
Old people 258 (16.7%) 109 (7.0%) 3 (0.2%) 0 (0.0%)
Syrians 175 (11.3%) 104 (6.7%) 0 (0.0%) 1 (0.1%)
Health workers 232 (15.0%) 27 (1.7%) 0 (0.0%) 0 (0.0%)
Any refugee 138 (8.9%) 54 (3.5%) 0 (0.0%) 1 (0.1%)
Poor people 140 (9.0%) 32 (2.1%) 0 (0.0%) 0 (0.0%)
Those who work outside 144 (9.3%) 17 (1.1%) 0 (0.0%) 0 (0.0%)
Local people 92 (5.9%) 21 (1.4%) 3 (0.2%) 1 (0.1%)
Other 37 (2.4%) 11 (0.7%) 0 (0.0%) 0 (0.0%)
Figure 16 People reported to face discrimination in relation to COVID-19

These findings complement FGDs where participants, particularly those from the host community, said that in general
people who are infected or who have recovered from COVID-19 experience discrimination in the community. People would
stay away from the infected or recovered person for fear of also becoming infected. People who have already recovered
from COVID-19 are still considered to be potential carriers of the disease. Participants also gave examples where not only
was the person infected treated differently but their families were also stigmatised.
“One of our neighbours was infected, and his whole family was discriminated against in the neighbourhood,” said one
respondent from the host community in Gaziantep.
In Izmir, it was reported that healthcare professionals found it difficult to find day care or babysitters for their children because
people were afraid that their children might pass on the virus. Participants also reported that people on low-incomes – both
refugees and local people - were bound to go to workplaces because they needed the money for their livelihoods, and so
could be at risk of infection.
People in local communities also reported rumours that foreigners had brought the virus into Turkey, creating some negative
attitudes towards people from other countries. In Sanliurfa, Mersin, Kocaeli and Kayseri, participants from host communities
said that people believe refugees cannot maintain proper hygiene due to lack of money to buy hygiene products or to live
in good housing conditions, and so are at higher risk of infection. As a result, they said, local people avoid interacting with
refugees and discriminate against refugees who have, or have had, COVID-19.
A participant from the host community in Kayseri said, “If the infected person is a refugee, the local community do not want
to meet him or her at all, even if they recover.”
Refugee participants in Konya, Kocaeli, Kayseri, Bursa and Gaziantep said that refugees encounter difficulties accessing
hospitals, especially if they do not have ID cards. Language is also an added barrier to communicating with doctors at the
hospitals. Many refugees tend to think that they will not be admitted or provided treatment if they go there.
Almost all participants recommended that TRCS organise seminars or meetings online for people to discuss this topic and
build a non-discriminatory attitude to support those who have been infected or recovered from COVID-19.

28 Community Based Migration Programme


Just over two-thirds of survey respondents (67.1%) reported being worried that they might become infected
with COVID-19. This was one of the major concerns among both refugees (33.2%) and local people (33.3%). Fears of
losing employment (9%) or having lost employment (9.1%), paying rent/bills (9.4%), being unable to afford food for the
household (6.4%) and hygiene products (3.9%) were all slightly higher among refugees than local people. These concerns
were also higher for men than women.

What worries or concerns you the most about the Coronavirus?


More than one answer possible Prefer
Host population Refugee Other not to answer
Fear to get infected with coronavirus 1,278 (33.3%) 1,274 (33.2%) 23 (0.6%) 0 (0.0%)
Fear to lose employment due to coronavirus 312 (8.1%) 345 (9.0%) 2 (0.1%) 0 (0.0%)
Afraid to go to hospitals in case we catch the virus 348 (9.1%) 294 (7.7%) 5 (0.1%) 0 (0.0%)
Lost employment due to coronavirus 231 (6.0%) 349 (9.1%) 2 (0.1%) 1 (0.0%)
Paying house rents/bills 204 (5.3%) 360 (9.4%) 1 (0.0%) 0 (0.0%)
I do not have any worries or concerns 239 (6.2%) 264 (6.9%) 3 (0.1%) 1 (0.0%)
Unable to afford enough food for family 183 (4.8%) 244 (6.4%) 1 (0.0%) 0 (0.0%)
Accessing medical care because hospitals will not admi. 218 (5.7%) 163 (4.2%) 5 (0.1%) 1 (0.0%)
Accessing online education for children 155 (4.0%) 138 (3.6%) 2 (0.1%) 0 (0.0%)
Other 211 (5.5%) 80 (2.1%) 2 (0.1%) 1 (0.0%)
Children unable to benefit from the online education 168 (4.4%) 114 (3.0%) 2 (0.1%) 0 (0.0%)
Unable to afford hygiene products to maintain hygiene 129 (3.4%) 150 (3.9%) 0 (0.0%) 0 (0.0%)
Finding new jobs/daily or weekly jobs 95 (2.5%) 136 (3.5%) 1 (0.0%) 0 (0.0%)
Do not have enough money to go to hospitals 104 (2.7%) 94 (2.4%) 0 (0.0%) 0 (0.0%)

Figure 17 Worries and concerns in relation to COVID-19

Survey respondents also mentioned that they were concerned about their family members getting sick, their children
becoming ill, death of a family member, and that the disease is/will become more widely spread.
These findings are similar to the fears aired in the FGDs. Respondents in all locations said that their greatest fear was that
they or their family members would become infected with COVID-19, particularly for people whose family members have
chronic diseases or are older. While some were concerned about losing current employment, others worried about not
finding employment due to COVID-19. For households with low incomes and poor financial conditions, many are already
unable to afford adequate hygiene materials or food for their families and children.
“I may become unemployed if I get infected,” said a respondent from the local community in Kocaeli.
Respondents also reported fear of going to hospitals, the re-opening of schools in the future, of becoming infected through
contact with people who do not show symptoms, or hearing about the death of a family member due to the disease.
Others said they were afraid they could become infected or infect one of their family members, because they were regularly
going to their workplaces. Many parents were concerned that their children cannot access the online and distance-learning
programmes which is being organised to make up for lost school time.
People are also worried about how long the pandemic will last, when the situation will improve, and when vaccines or
effective treatments will be available. “I am worried about the uncertainty”, is how one respondent from the local community
in Mardin expressed his fears about the future.

Community Based Migration Programme 29


Data collection process,Şanlıurfa

PRACTICES
Community Centre, 5 August 2020
Credit: TRCS

30 Community Based Migration Programme


Practices  refer to the ways in which the community demonstrates their knowledge and attitudes through their
actions. This KAP assessment identifies how people have used their knowledge on COVID-19 to take measures
and what people do to protect themselves and their families to prevent the disease. This section also helps to
understand what the community would do if they or a member of their family became infected.

Overwhelmingly, survey respondents (94.3%) said they were taking some measures in their daily life to prevent
the risk of COVID-19 infection. While 4% said they only sometimes take measures, just 1.7% of the respondents said
they are not doing anything about it.

Are you taking any measures in your daily life to prevent the risk of infection?
Yes 3,621 (94.3%)
Sometimes 155 (4.0%)
No 64 (1.7%)

Figure 18 Likelihood of practicing preventive measures

Those who said they were not taking any measures (64 respondents) highlighted various reasons, for example,
not knowing how to take preventive measures (50%), not believing these practices will be effective in preventing
the risk (20.3%), and being unable to afford soap or disinfectants (14.1%). Others said there was too much conflicting
information (12.5%), or that family members were compelled to go out for work (12.5%) and as a result not able to follow
safety measures.

If not, why?
More than one answer possible; 64 respondents

I do not know how to take preventive measures 32 (50.0%)


I do not believe these practises will prevent the risk of infection 13 (20.3%)
I cannot use soap or disinfectants because I cannot afford them 9 (14.1%)
There is too much conflicting information so it is hard to know what is correct 8 (12.5%)
Members in my family need to go out for work or find work 8 (12.5%)
Other 6 (9.4%)
I do not understand the information on preventive measures 6 (9.4%)

Figure 19 Reasons for not taking preventive measures

Community Based Migration Programme 31


Those who said they were taking measures (3,776 respondents) identified several different actions they took
to protect themselves and their families: washing hands with soap (90%), wearing masks when going out (87%),
maintaining physical distance (78.7%), using hand sanitizers (56.1%), and covering their mouth and nose when coughing
or sneezing (48.6%).

If yes or sometimes, what have you and your family done to prevent becoming
sick with the Coronavirus in the recent days?
More than one answer possible; 3776 respondents
Wash hands frequently using soap and water 3,399 (90.0%)
Wear mask when going out 3,286 (87.0%)
Maintain physical distance (1 meter) whenever outside 2,971 (78.7%)
Use a hand sanitizer that contains at least 60% alcohol 2,117 (56.1%)
Cover mouth and nose when coughing or sneezing 1,836 (48.6%)
Wear mask if I am sick or taking care of an infected person 957 (25.3%)
Avoid touching mouth, nose, and eyes with contaminated hands 955 (25.3%)
Wear gloves 710 (18.8%)
Use disinfectants to clean surfaces 629 (16.7%)
Other 97 (2.6%)

Figure 20 Measures undertaken to prevent COVID-19

These survey results align well with the FGD findings. To prevent the risks of becoming infected, FGD participants said they
were taking necessary precautions in their daily lives, such as, frequently washing hands with soap or using hand sanitizers,
practicing personal hygiene, staying indoors and avoiding going out unless necessary, sterilizing surfaces and cleaning
homes with disinfectant, using masks, and maintaining physical distance whenever outside.
Participants stressed that the most important actions to reduce the risks of COVID-19 infection were to wash hands with
soap frequently and for at least 20 seconds, to eat healthy food, wear masks, maintain personal hygiene, and keep physical
distance when outside. Avoiding crowds and practicing good coughing etiquette were also given as ways to reduce the
chances of COVID-19 infection.
Participants in Kayseri, Kilis and Mersin said that they avoided going to hospital unless they had a major illness, and that
they had also cut down on visiting their relatives’ homes. However, they also recognised that there were people in their
communities living in poor economic conditions who were compelled to go out for work and unable to undertake these
precautions. People in poor economic conditions often could not afford to buy hygiene products such as masks, gloves,
and disinfectants increasing their risks of infection, the participants said.

Data collection process, Hatay


Community Centre, 27 July 2020
Credit: TRCS

32 Community Based Migration Programme


Almost three-quarters of survey respondents, 74.2%, said that they do not face any challenges to take preventive
measures. Those who said they did face challenges gave examples that their family members were forced to go out to
work, particularly the men (7.9%), or that they needed to overcome social pressures of people around who didn’t want to
them take action- this was particularly the case amongst the host population (9.2%). Refugees (8.1%) mentioned difficulties
affording soap and disinfectants.

Are you facing any challenges in taking such preventive measures?


More than one answer possible
Host population Refugee Other

I don’t face any challenges or difficulties in taking action 1,409 (36.7%) 1,412 (36.8%) 27 (0.7%)
Difficult to stay at home as I/member of my family needs to go out for work 256 (6.7%) 256 (6.7%) 6 (0.2%)
I had to overcome people around me who didn’t want me to take action 353 (9.2%) 153 (4.0%) 1 (0.0%)
Difficult to afford soap or disinfectants 114 (3.0%) 312 (8.1%) 4 (0.1%)
Other 120 (3.1%) 101 (2.6%) 2 (0.1%)

Prefer
Female Male not to answer
I don’t face any challenges or difficulties in taking action 1,462 (38.1%) 1,387 (36.1%) 1 (0.0%)
Difficult to stay at home as I/member of my family needs to go out for work 214 (5.6%) 302 (7.9%) 2 (0.1%)
I had to overcome people around me who didn’t want me to take action 248 (6.5%) 257 (6.7%) 2 (0.1%)
Difficult to afford soap or disinfectants 221 (5.8%) 209 (5.4%) 0 (0.0%)
Other 131 (3.4%) 91 (2.4%) 1 (0.0%)

Figure 21 Challenges in taking preventive measures

The following challenges were recorded under the “Other” category: difficulty in wearing a mask (either general or due to
asthma), not having enough money to purchase masks, other people not taking the necessary precautions (e.g. not wearing
masks, washing hands, keeping physical distance).
FGD participants reported that despite the high levels of awareness, community members in many locations are now
becoming less inclined to follow the preventive measures compared to in the early stages of the outbreak. In Hatay, for
example, following the withdrawal of curfew, people felt that the risk of infection has reduced and so the health advice is
less relevant for them. In Gaziantep, Mardin, Mersin, Kilis and Kayseri, participants tended to feel that healthier people
would not be infected and could not spread the disease. A few people also reported beliefs that COVID-19 does not
really exist. Discomfort wearing masks in the hot weather was also reported, as well as observations that people do not
wear the masks appropriately. After months of social isolation and staying indoors, more people are now beginning to go
out to public places. As a result, public transport is becoming crowded, and physical distance cannot be maintained in
all locations. In Kahramanmaraş and Kayseri, it was suggested that young people are less willing to follow health advise,
and so risked becoming infected and further spreading the disease. In Adana and Kahramanmaraş, refugee participants
explained that it can be difficult to maintain physical distancing due to cultural norms, such as greeting people by shaking
hands or hosting guests at home. In addition, misinformation and rumours on social media were undermining accurate
health information. Rumours, such as that COVID-19 decreases in hot weather, impact people’s beliefs and behaviour to
adopt healthy practices. As more people return to their workplaces, there is a growing need to raise awareness and re-
energise people’s motivation to maintain safety and cleanliness in the office.
FGD participants in Bursa, Kahramanmaraş, Sultanbeyli and Hatay felt that women were more attentive than men in
following the health advice, maintaining personal hygiene and undertaking preventive measure. In Mersin and Şanlıurfa,
people from the host community said that more men use public transport and go out to work than women, increasing their
chances of becoming infected. Refugees from amongst the FGD participants in Adana inform that there are some refugees
in the community who rely in fatalism, hence undertake poor precautions. Refugees are also perceived to be at higher risk
of infection by the host community due to their poor economic conditions, lacking affordability to buy hygiene products and
language barriers.

Community Based Migration Programme 33


When asked what they would do if they or someone in their family showed symptoms, majority of the respondents
answered that they would go to the hospital (78.4%). Others mentioned they would contact a doctor to get
advice (40.5%), isolate themselves (31.6%) or ask friends and relatives for advice (10.1%). These responses were
consistently higher for people from the host population than for refugees.

What would you do if you or someone from your family has symptoms of this
disease?
More than one answer possible
I will go to the hospital 3,009 (78.4%)
I will contact a doctor or hospital to get advice 1,554 (40.5%)
I would stay at home to isolate myself from others 1,213 (31.6%)
I will ask my relative/friends to advise me on what to do 388 (10.1%)
Other 71 (1.8%)
I will buy medicines from the market 34 (0.9%)
Continue life as normal 32 (0.8%)
I will go to a religious leader 23 (0.6%)
Do nothing 13 (0.3%)

Figure 22 Actions taken if COVID-19 symptoms show

Other responses given included: call 112, call 184, call an ambulance, self-isolate. Three people did not know what they
would do in such a situation.

Data collection process, Gaziantep


Community Centre, 29 July 2020
Credit: TRCS

34 Community Based Migration Programme


INFORMATION NEEDS
& COMMUNICATION Data collection process, Konya

CHANNELS
Community Centre, 6 August 2020
Credit: TRCS

Community Based Migration Programme 35


Information needs & communities’ preferred channels to receive information and share feedback with TRCS 
This is to assess what information communities want or need to know about COVID-19 and their preferred channels
to receive that information. This section also aims to understand how well TRCS social media channels are being
used by the communities, what can be improved, and how communities would prefer to contact TRCS to ask
questions or share feedback.

Although just over half, 55% (2,113), of respondents said they do not need any more information about COVID-19,
that still leaves 45% (1,727) of people who do recognise that they need information. Out of those who requested
for information (1,727 respondents), subjects included: symptoms of COVID-19 infection (31.7%), trusted sources of
information (26.5%), how COVID-19 is transmitted (25.1%), and how to protect oneself from the disease (20.7%).

What information do you need right now about the new Coronavirus?
More than one answer possible

I do not need any information 2,113 (55.0%)


Symptoms of the new coronavirus disease 547 (14.2%)
Trusted sources of information 458 (11.9%)
How it is transmitted 434 (11.3%)
How to protect yourself from the disease 357 (9.3%)
How to take care of an infected person at home 339 (8.8%)
Precautions for people with chronic disease 314 (8.2%)
What to do if you have the symptoms 231 (6.0%)
Which hospital to go to if symptoms appear 225 (5.9%)
Who to ask questions about coronavirus 195 (5.1%)
Precautions for pregnant women 191 (5.0%)
Other 189 (4.9%)
Where to get free psychosocial support? 168 (4.4%)
How/when to use masks 165 (4.3%)
How to get Vefa social support services 149 (3.9%)
How to wash hands 123 (3.2%)
How to contact TRCS 87 (2.3%)
How to access distance education programme 73 (1.9%)
How to use bleach/disinfectant at home 52 (1.4%)

Figure 23 What information communities need now

Other information needed: if there is going to be second/third wave of the Coronavirus, if COVID-19 is real, what are the test
and treatment procedures, numbers of cases in each city, when the pandemic will end, information about curfews.
FGD participants in all locations said people need information about any new symptoms of COVID-19 infection, how to
maintain personal hygiene, how and when to use masks, and what should be done after a person has recovered from
the disease. They stressed that while communities may have information about preventive measures, awareness needs
to be raised about protective behaviours people can adopt themselves in post lockdown, and that people needed further
encouragement to adopt safe and healthy practices. Dissemination of information about the presence of COVID-19, its
risks, how it can spread, as well as the importance of wearing masks in public areas and physical distancing, should
be reinforced to ensure people are taking care of themselves, participants said. They felt this was particularly important
for people at increased risk such as older people, and people with chronic diseases, as well as for young people in the
community. FGD participants suggested TRCS collaborate with public institutions to maximise the impact of dissemination
of key information and highlight the importance of preventive measures.
Given the evolving situation, communities were also interested in information on the number of COVID-19 cases in each
city in Turkey, where and which hospitals are available to treat infected patients, how to get admitted to these hospitals,
information about TRCS blood support, and any updated information on COVID-19 including vaccines or drugs to treat
patients. Information materials on COVID-19 with visuals for children should be developed and disseminated to help young
people understand the risks and the necessary steps to protect against infection, participants said.

36 Community Based Migration Programme


FGD participants also suggested that online trainings or seminars should be organised by TRCS to encourage community
members and children to practice healthy behaviours. At the same time, the number of psychosocial support (PSS) sessions
should be increased by TRCS or other NGOs to address community needs.
Other information people said they would like to know included how to disinfect clothes, clean homes adequately, and
how to keep the environment clean and safe. People were also interested to hear the experiences of recovered COVID-19
patients to understand their experience more and take lessons that they could apply to their own lives.
Significantly over half of survey respondents said they would prefer to receive information on COVID-19 from
TRCS by phone (58.6%), but other channels that would also support are SMS (29.6%), TRCS Facebook (23.8%)
and WhatsApp (20.3%). Refugees showed a stronger preference for phone (29.6%), TRCS Facebook (15.4%), WhatsApp
(12.5%) and TRCS staff and volunteers (5.8%) than respondents from the host population. People from host communities
however, showed a stronger preference for SMS (15%), TV (9.6%) and TRCS Instagram, Twitter and website (23.5%).

How would you prefer to receive information about the Coronavirus from TRCS?
More than one answer possible

Refugee Other Prefer


Host population not to answer
Phone 1,099 (28.6%) 1,137 (29.6%) 15 (0.4%) 1 (0.0%)
SMS 576 (15.0%) 550 (14.3%) 10 (0.3%) 2 (0.1%)
TRCS Facebook 310 (8.1%) 590 (15.4%) 15 (0.4%) 0 (0.0%)
WhatsApp 289 (7.5%) 481 (12.5%) 7 (0.2%) 1 (0.0%)
TV 370 (9.6%) 208 (5.4%) 9 (0.2%) 0 (0.0%)
TRCS lnstagram 306 (8.0%) 184 (4.8%) 6 (0.2%) 0 (0.0%)
TRCS website 301 (7.8%) 185 (4.8%) 6 (0.2%) 0 (0.0%)
TRCS staff/volunteers 207 (5.4%) 221 (5.8%) 0 (0.0%) 0 (0.0%)
TRCS Twitter 297 (7.7%) 95 (2.5%) 5 (0.1%) 1 (0.0%)
Doctors 203 (5.3%) 146 (3.8%) 3 (0.1%) 0 (0.0%)
TRCS YouTube 170 (4.4%) 157 (4.1%) 5 (0.1%) 0 (0.0%)
Ministry of Health/Public official websites 210 (5.5%) 95 (2.5%) 2 (0.1%) 0 (0.0%)
Brochures/leaflets 170 (4.4%) 113 (2.9%) 3 (0.1%) 0 (0.0%)
Online meetings/seminars 64 (1.7%) 60 (1.6%) 1 (0.0%) 0 (0.0%)
Other 43 (1.1%) 21 (0.5%) 0 (0.0%) 0 (0.0%)
Radio 25 (0.7%) 0 (0.0%) 0 (0.0%) 0 (0.0%)
Community leaders 18 (0.5%) 7 (0.2%) 0 (0.0%) 0 (0.0%)
Religious leaders 6 (0.2%) 5 (0.1%) 1 (0.0%) 0 (0.0%)

Figure 24 Preferred communication channels to receive information

Other methods of communication people mentioned included: email, e-government, public places (e.g. metro). Eleven
people said they did not want to receive any information from TRCS.
FGD participants suggested several ways they would like to receive information about COVID-19, including social media
platforms (WhatsApp, Facebook, Instagram and YouTube), where audio, video and visual information materials can be
posted in different languages. Other preferred channels were TV (mainly news channels and TRT Arabic), SMS, phone
calls, radio, information kiosks, brochures and official websites of public institutions, Ministry of Health and TRCS. Online
trainings, seminars or live sessions on social media organized by TRCS were also mentioned as ways to raise awareness
among people.
In Kilis, Kayseri and Gaziantep, many participants said they would prefer face-to-face interaction at the TRCS Community
Centre while others suggested household visits, which would be particularly helpful to share information with older people.
In Şanlıurfa, Kocaeli and Konya, participants suggested creating WhatsApp groups to share information about COVID-19.
While social media is quite popular among young people, it was recognised that television is more accessible for older
people. Participants stressed that audio, video, and visual information was more effective than written information, especially
for children, older people and those who cannot read or write. In Şanlıurfa, respondents said that sign language can be quite
useful in videos for those with hearing impairment. It is recommended that the use of social media platforms is maximized
to disseminate information about COVID-19.

Community Based Migration Programme 37


Visual information, either in the form of videos or infographics, could be displayed in screens near public transportation or
various institutions, such as mosques, schools or markets, and billboards in the streets. It is recommended that posters and
leaflets on COVID-19 should be put up on the walls or distributed near workplaces and factories, public spaces, and areas
where communities are living. In Adana, refugees suggested that information on COVID-19 and the “14 rules’’ 7 of COVID-19
prevention could be disseminated using megaphones in the neighbourhoods where refugees are living.
More information materials about COVID-19 with visuals or videos for children to help them understand the risks and the
necessary measures to avoid infection were recommended, and some participants suggested that TV channels such as
TRT Kid could be useful for communicating with children on this topic.
Regarding the preference of language to receive information from TRCS Community Centre was
TRCS, respondents were fairly divided in roughly half, with 48.5% of the only institution that shared
respondents (those from host communities) preferring Turkish and information about COVID-19 in
47.4% (those who are refugees) preferring Arabic. Around 4.8% of the Arabic and Turkish at first. Later,
respondents mentioned other languages including English, Kurdish and Farsi. other institutions started to share
information in these two languages.
In the FGDs, the majority of participants said they would prefer to receive
information in Turkish, Arabic and English. In Mersin and Mardin, some preferred Fevzi,
Kurdish while in Bursa, a few people mentioned Russian. Refugee man - 37, Bursa

What language would you prefer to receive the information in?


More than one answer possible

Host population Refugee Other Prefer


not to answer
Turkish 1,862 (48.5%) 399 (10.4%) 24 (0.6%) 2 (0.1%)
Arabic 119 (3.1%) 1,822 (47.4%) 21 (0.5%) 1 (0.0%)
English 50 (1.3%) 50 (1.3%) 9 (0.2%) 2 (0.1%)
Other 28 (0.7%) 16 (0.4%) 3 (0.1%) 0 (0.0%)
Farsi 2 (0.1%) 24 (0.6%) 1 (0.0%) 0 (0.0%)

Figure 25 Preferred language to receive information

Kurdish was reported as the “Other” preferred language.

7
“14 rules’’ - These are the precautionary measures that the Ministry of Health in Turkey has underlined for people to prevent COVID-19. The 14 rules
are explained in this link here.

38 Community Based Migration Programme


When asked if respondents follow TRCS social media channels or visit the website, 26.6% of the host population
answered “No” compared to 19.3% of the refugees. Just over a quarter of refugees, 26.3%, said they did follow
TRCS social media channels or had visited the website compared to 19% of people from host communities.
Among those who follow the TRCS social media platforms (1,752 respondents), a greater proportion of refugees visit the
TRCS Facebook and Community Centre Facebook pages (62.1%) than people from host communities (25.6%). The TRCS
Instagram and Twitter accounts both the general account and the Community Centre account, are more popular with
people from the host communities (52.4%) than with refugees (28.3%).

Do you follow TRCS social media platforms (Facebook, Twitter, Instagram,


YouTube) and website to get information about the Coronavirus?
Host population Refugee Other Prefer
not to answer
No 1,021 (26.6%) 741 (19.3%) 16 (0.4%) 1 (0.0%)
Sometimes 141 (3.7%) 160 (4.2%) 8 (0.2%)
Yes 731 (19.0%) 1,010 (26.3%) 10 (0.3%) 1 (0.0%)

Figure 26 Use of TRCS social media to receive COVID-19 information

If yes, which platforms do you follow?


More than one answer possible;1752 respondents
Host population Refugee Other Prefer
not to answer
TRCS Community Centre Facebook page 239 (13.6%) 635 (36.2%) 5 (0.3%) 0 (0.0%)
TRCS Facebook page 210 (12.0%) 453 (25.9%) 3 (0.2%) 0 (0.0%)
TRCS Instagram 294 (16.8%) 129 (7.4%) 3 (0.2%) 0 (0.0%)
TRCS Community Centre Instagram 218 (12.4%) 187 (10.7%) 2 (0.1%) 1 (0.1%)
TRCS Twitter 233 (13.3%) 66 (3.8%) 1 (0.1%) 0 (0.0%)
TRCS Community Centre Twitter 174 (9.9%) 112 (6.4%) 1 (0.1%) 1 (0.1%)
TRCS Youtube 77 (4.4%) 108 (6.2%) 1 (0.1%) 0 (0.0%)
Other 16 (0.9%) 22 (1.3%) 2 (0.1%) 0 (0.0%)

Figure 26a Use of TRCS social media to receive COVID-19 information (follow up question)

The main reason people (2,088 respondents) gave for not following these social media channels was that they
did not know about them. This lack of awareness was higher amongst people from the host population (37.9%) than
amongst refugees (26.8%). For refugees, the main reasons given were not having internet (3.4%) or that the content was
not in Arabic or in their native languages (5.3%).

If not or sometimes, what are the reasons?


More than one answer possible; 2088 respondents

Host population Prefer


Refugee Other not to answer
I do not know about TRCS social media platforms/Website 791 (37.9%) 559 (26.8%) 21 (1.0%) 1 (0.0%)
Other 245 (11.7%) 135 (6.5%) 0 (0.0%) 0 (0.0%)
The contents are not relevant to my needs 98 (4.7%) 61 (2.9%) 1 (0.0%) 0 (0.0%)
I do not have internet to access TRCS social media 50 (2.4%) 72 (3.4%) 0 (0.0%) 0 (0.0%)
The contents are not in Arabic 2 (0.1%) 70 (3.4%) 0 (0.0%) 0 (0.0%)
The contents are not in my language (other than Arabic and Farsi) 4 (0.2%) 39 (1.9%) 2 (0.1%) 0 (0.0%)
The contents are not easy or clear to understand 7 (0.3%) 17 (0.8%) 0 (0.0%) 0 (0.0%)
The words/language is not easy to understand 1 (0.0%) 9 (0.4%) 1 (0.0%) 0 (0.0%)
The contents are not in Farsi 0 (0.0%) 3 (0.1%) 0 (0.0%) 0 (0.0%)
The photo/illustrations are not clear to understand 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)

Figure 27 Reasons for not using or sometimes using TRCS social media

Community Based Migration Programme 39


Under the “Other” category the following responses were recorded: following other platforms and Ministry of Health website,
did not think about it, rarely use social media, do not have internet, don’t have smartphone.
The survey findings were broadly confirmed by FGD participants. While several
refugee respondents said that they follow TRCS social media channels, the I receive useful information from the
majority of participants from the host community said they were not aware of videos published by the Turkish Red
the platforms or TRCS website, or that they had been providing COVID-19 Crescent on COVID-19.
information. Participants suggested that these TRCS channels should be Ammar,
promoted more widely to inform communities and enable people to access Refugee man - 41, Kahramanmaraş
information about COVID-19.
Participants suggested that updated or improved information on COVID-19 should be shared on TRCS social media
channels, and that the Arabic content should be increased. Among refugee participants who followed the TRCS social
media platforms, Facebook was most popular, followed by Instagram, Twitter and YouTube. As with the surveys, Instagram
and Twitter were more widely used by the host community members.
Most of the refugee participants mentioned they encountered various challenges in accessing social media platforms, such
as lacking internet facilities, not having social media accounts, or not having a smartphone, and not knowing if TRCS social
media accounts are available in Arabic. Respondents in Konya, Kilis, Mersin and Şanlıurfa said they were unaware of the
TRCS Community Centre website or that information on the website was available in Arabic. A few participants in Kocaeli
and Izmir said they had received information from the Ministry of Health or that they followed the news channels and so did
not need more information from TRCS social media.
Almost three-quarters of survey respondents said they would prefer to contact TRCS over the phone (72.4%) to
ask questions or share feedback. This preference was similar for people from host communities (36.5%) and refugees
(35.3%), while women (37.5%) showed a slightly stronger preference than men (34.8%). Compared to the host population,
refugees preferred WhatsApp (15.4%), SMS (8.2%), the TRCS Facebook page (8.6%), and face-to-face interaction at TRCS
Community Centre (6.2%).

If you wanted to ask questions or share feedback with TRCS on the Coronavirus,
how would you prefer to do so?
More than one answer possible
Host population Refugee Other Prefer
not to answer
Phone 1,403 (36.5%) 1,356 (35.3%) 20 (0.5%) 1 (0.0%)
WhatsApp 395 (10.3%) 590 (15.4%) 14 (0.4%) 1 (0.0%)
SMS 293 (7.6%) 315 (8.2%) 10 (0.3%) 1 (0.0%)
TRCS website 375 (9.8%) 144 (3.8%) 5 (0.1%) 1 (0.0%)
TRCS Facebook page 147 (3.8%) 332 (8.6%) 5 (0.1%) 0 (0.0%)
Face to face TRCS Community Centre 228 (5.9%) 237 (6.2%) 2 (0.1%) 0 (0.0%)
Face to face with TRCS staff/volunteers 250 (6.5%) 212 (5.5%) 1 (0.0%) 0 (0.0%)
Feedback and Complaint Box at TRCS CC 76 (2.0%) 77 (2.0%) 1 (0.0%) 0 (0.0%)
Online meetings through Zoom/Skype 63 (1.6%) 49 (1.3%) 1 (0.0%) 0 (0.0%)
Other 62 (1.6%) 15 (0.4%) 2 (0.1%) 1 (0.0%)

Female Male Prefer


not to answer
Phone 1,441 (37.5%) 1,336 (34.8%) 3 (0.1%)
WhatsApp 518 (13.5%) 481 (12.5%) 1 (0.0%)
SMS 303 (7.9%) 316 (8.2%) 0 (0.0%)
TRCS website 259 (6.7%) 266 (6.9%) 0 (0.0%)
TRCS Facebook page 205 (5.3%) 278 (7.2%) 1 (0.0%)
Face to face TRCS Community Centre 232 (6.0%) 235 (6.1%) 0 (0.0%)
Face to face with TRCS staff/volunteers 244 (6.4%) 219 (5.7%) 0 (0.0%)
Feedback and Complaint Box at TRCS CC 72 (1.9%) 81 (2.1%) 1 (0.0%)
Online meetings through Zoom/Skype 57 (1.5%) 56 (1.5%) 0 (0.0%)
Other 35 (0.9%) 45 (1.2%) 0 (0.0%)

Figure 28 Preferred channel to ask questions or share feedback with TRCS

40 Community Based Migration Programme


As with the survey findings, FGD participants said they would prefer to contact TRCS by phone or WhatsApp to ask
questions or share feedback about COVID-19. Other channels mentioned included the 168 call centre 8 number or a
dedicated COVID-19 hotline, SMS or e-mail, TRCS Facebook or other social media pages, or a separate TRCS webpage
on COVID-19.
Participants in many locations including Ankara, Bursa, Hatay, Gaziantep, Mardin and Konya said they would prefer to
share feedback face-to-face by visiting TRCS Community Centres or meeting its staff/volunteers. Face-to-face interaction
at the Community Centres or speaking over the phone could be beneficial for refugees in particular, participants said, as this
enabled them to make use of TRCS interpreters. Online meetings via Zoom or Skype could also be useful to ask questions
and share key concerns, participants added. Respondents in Şanlıurfa, Kilis, Mersin, Konya and Bursa also suggested that
TRCS should conduct more surveys, similar to this KAP assessment, or set up a mobile application to support communities
with information and enable them to ask questions about COVID-19.

Data collection process, Şanlıurfa


Community Centre, 10 August 2020
Credit: TRCS

8
TRCS’ 168 call centre provides a free of charge helpline for beneficiaries on the Emergency Social Safety Net (ESSN) cash assistance programme. It
aims to provide information on the ESSN application processes; receive feedback and complaints and ensure that specific issues are followed up on
and resolved.

Community Based Migration Programme 41


Do you have any comments or feedback about COVID-19 that you would like to
share with us?
FGD participants said they appreciated TRCS’ effort in addressing the COVID-19 outbreak. They particularly highlighted the
online consultations/FGDs carried out as part of this KAP assessment, as being useful and requested more to be done to
enable others to openly discuss about their situation and concerns on COVID-19.
Under the current situation, many people have lost employment and participants
We would like to ask TRCS to suggested TRCS provide more relevant services for people who have become
conduct more online discussions or unemployed, along with information about institutions or employers where
assessments like this one. Through they can seek support. In Kocaeli it was suggested that more support should
these discussions we are able to be provided to refugees in the Kizilaykart (ESSN9 ) programme given their job
voice our concerns and understand uncertainty.
what we all lack. Participants also suggested that TRCS organise more monthly or weekly online
Fatma, Refugees woman – 39, Kilis trainings about COVID-19, preventive measures, and hygiene promotion for
communities. Participants felt the need for masks, hygiene kits, food parcels
and psychosocial support in the community was increasing and that relevant services, including mental health support, was
necessary to help prevent the spread of the disease and mitigate its impact. They recommend TRCS collaborate with local
NGOs, particularly those run by refugees, and implement joint projects or activities to respond to the outbreak.
It was felt that people, especially Syrian children, need support to be able to access and benefit from the distance education
programme (EBA), and that information materials on COVID-19 and other online activities for children should be developed
and organised to explain the risks and preventive measures. FGD participants also suggested TRCS organise social and
recreational activities for people, either online or outdoors, while also expressing interest in volunteering to support TRCS
activities if requested.
With the summer heat and humidity, along with the easing of restrictions through the gradual opening of restaurants, cafes,
markets, shopping malls, hairdressing salons and intercity travel, FGD participants recognised that many people are now
going outside without paying attention to physical distancing or wearing masks. Although people have information about
COVID-19, public awareness activities about the presence and risks of COVID-19 still need to be reinforced, they said.
Misperceptions and rumours about the disease which impact people’s beliefs, creating social tension, and leading to the
practising of harmful behaviours, were also raised. Participants suggested more information materials about COVID-19,
including those addressing rumours, should be developed in Turkish and Arabic, and in physically printed and online
formats, for dissemination to communities or to be posted on social media. With many voicing concerns over a second
wave of the outbreak, participants emphasised that stringent measures by local authorities should be undertaken to ensure
people follow the recommended healthy behaviours.

9
Through European Union funding, and a partnership between the IFRC and TRCS, Emergency Social Safety Net (ESSN) programme provides hu-
manitarian support to more than 1.7 million refugees in Turkey through monthly cash assistance enabling them to cover essential needs like food, rent
and utilities.

42 Community Based Migration Programme


Data collection process, Adana

RECOMMENDATIONS
Community Centre, 29 July 2020
Credit: TRCS

Community Based Migration Programme 43


Sl No Activities IEC products/ Channels

Disseminate key information to communities to encourage people to


adopt positive behaviours. Some of the topics identified are:
• How to protect ourselves in post lockdown
• Any new symptoms of COVID-19
• How to maintain personal hygiene
E-brochures and videos (with sign
• How and when to use masks
language if feasible) in different
• Importance of masks and physical distancing languages (e.g. Turkish, Arabic,
• Who are at risk? Kurdish and English) to be
• What to do after a person recovered from COVID-19 used in TRCS CC social media,
TRCS webpage on COVID-19;
• The presence of coronavirus, its risks and how it can spread
1 IEC materials to be shared with
• Information on the number of COVID-19 cases in the cities Advisory Committee, Youth Club10
in Turkey members and CBHFA volunteers via
• Where and which hospitals to go to WhatsApp/Facebook groups in CC.
• How to get admitted in these hospitals
• Information about vaccine or drugs
• Information on COVID-19 for children
• How to disinfect clothes and homes
• How to maintain cleanliness and safety at workplace
• Information about TRCS blood support
• Information about TRCS social media channels and website

E-Bulletin specific to each


location, E-Brochure and videos;
in different languages (e.g. Turkish,
Arabic, Kurdish and English) to be
used in TRCS CC social media,
2 Respond to rumours/misperceptions identified in each location
TRCS webpage on COVID-19;
IEC materials to be shared with
Advisory Committee, Youth Club
members and CBHFA volunteers via
WhatsApp/Facebook groups in CC.

Conduct online seminars by CBHFA volunteers and/or TRCS staff on


3 Through Zoom/Skype calls
the prevention of COVID-19 disease and hygiene promotion

Organise online information seminars for community members


using public influencers (e.g. community/religious leaders/Muhtar)
4 Through Zoom/Skype calls
to encourage promotion of general healthy behaviours and address
misinformation and rumours with actionable and verified information

10
Youth Club - Like the advisory committee, a youth club has been formed in each of the TRCS Community Centres comprising members from local
and refugee children. The youth club acts as a platform where TRCS can share information about its services and provide opportunity to the members
to voice issues affecting them and participate in the designing of youth activities at the centre.

44 Community Based Migration Programme


E-brochures and videos (with sign
language if feasible) in different
languages (e.g. Turkish, Arabic,
Kurdish and English) to be
Develop information materials (visuals and/or videos) with key
used in TRCS CC social media,
5 influencers, e.g. community leader, doctors, religious leaders,
TRCS webpage on COVID-19;
community volunteers, etc
IEC materials to be shared with
Advisory Committee, Youth Club
members and CBHFA volunteers via
WhatsApp/Facebook groups in CC.

Conduct online meetings with existing community forums, the


Monthly reports from TRCS
6 Advisory Committee and Youth Club at the CCs, to disseminate key
Community Centres
information, share IEC materials and understand information gaps

Promote local dialogue and social cohesion with focus on addressing


7 Through Zoom/Skype calls
stigma and xenophobia related to COVID-19

E-brochures and videos in


different languages (e.g. Turkish,
Arabic, Kurdish and English) to be
used in TRCS CC social media,
Develop information materials (visuals and/or videos) on stigma and
8 TRCS webpage on COVID-19;
xenophobia related to COVID-19
IEC materials to be shared with
Advisory Committee, Youth Club
members and CBHFA volunteers via
WhatsApp/Facebook groups in CC.

Use existing tools to collect and respond to community feedback,


9 questions, complaints and rumours and adapt new communication Reports on Community Feedback
channels as appropriate

Conduct Knowledge, Attitudes and Practices (KAP) assessment


at regular intervals to identify those most at risk, barriers to healthy Extract and detailed assessment
10
behaviours, information needs, preferred/trusted channels of report
engagement and community perception about the risks

Community Based Migration Programme 45


TRCS – The Turkish Red Crescent Society (TRCS), founded IFRC – The International Federation of Red Cross and Red
in 1868, is the largest humanitarian organization in Turkey. Crescent Societies (IFRC) is the world’s largest volunteer -
based humanitarian network. With its 190 member National
TRCS has a country-wide network with 258 Branches and
Red Cross and Red Crescent Societies worldwide, IFRC is
provides support to vulnerable people living in Turkey and
reaching 160. 7 million people annually through long-term
overseas. TRCS has nine regional and 25 local disaster
services and development programmes, as well as 110 mil-
management and logistics centres. The mission of TRCS is
lion people through disaster response and early recovery
“Providing aid for needy and defenceless people in disasters
programmes. IFRC acts before, during and after disasters
and usual periods as a proactive organization, developing
and health emergencies to meet the needs and improve
cooperation in the society, providing safe blood and
the lives of vulnerable people. The Federation does so with
decreasing vulnerability”.
impartiality as to nationality, race, gender, religious beliefs,
Besides contributing to the development of social welfare, class and political opinions.
TRCS has been providing services on shelter, nutrition
and health, psychosocial support, blood service, disaster
response operations, international aids, social services,
livelihood and protection for displaced populations.

For more information, please contact us:


Turkish Red Crescent Society (TRCS) International Federation of Red Cross and Red
Community Based Migration Programme Crescent Societies (IFRC)

Kamil Erdem Güler Shafiquzzaman Rabbani


Programme Coordinator Programme Coordinator,
[email protected] IFRC Turkey
[email protected]
Semih Paslı
Social Cohesion Officer and
Sayeeda Farhana
CEA Focal Point
Community Engagement and Accountability
[email protected]
(CEA) Delegate,
Mehmet Akdaş IFRC Turkey
Social Cohesion Officer and [email protected]
CEA Focal Point
[email protected]

KNOWLEDGE, ATTITUDES AND PRACTICES (KAP)


ASSESSMENT ON COVID-19
KNOWLEDGE, ATTITUDES AND PRACTICES (KAP)
ASSESSMENT ON COVID-19

/ KizilayTM / KizilayTM / KizilayTM

/ KizilayTM / KizilayTM

www.kizilaytoplummerkezleri.org

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