Health services for refugees and the host community will deteriorate: Some 1,000 health workers will not be maintained and at least 50,000 daily patient contacts (consultations, prescriptions, treatments, and dispensing) will not be provided. The well-established and highly functional model referral systems for healthcare will begin to fail and 52 vehicle ambulances will not be fuelled or staffed.
Deforestation in and around settlements will continue: This will further expose women and girls to Gender Based Violence and damage relations between refugees and host communities. The provision of household cooking energy for 14,400 households will be de-prioritized, and 1,600 hectares of woodlots for firewood will not be re-planted. In addition, three million trees will no longer be planted annually to mitigate the impact of refugee use of firewood.
Dependency on humanitarian assistance will remain: Some 28,000 households currently engaged in short-term employment will no longer receive a wage and 12,000 newly arrived households will not receive emergency assistance to help them stabilize and engage in long-term livelihoods.
Inability to protect those at increased risk of vulnerability: There will continue to be 295,000 refugees who experience poor mental health that are not being supported, and 28,000 refugees with heightened protection risks will miss out on the special support they require.
Decreased funding to the Inter-Agency refugee Feedback, Referral and Resolution Mechanisms (FRRM), a 2-way communication channel that allows refugees throughout the country to report urgent protection issues and receive guidance in the language of their choices, will led to 10,000 calls going unaddressed in 2023.
Water and Sanitation (WASH): Underfunding in the sanitation sub-sector will result into over 50 per cent of refugees in new arrival settlements without safe excreta disposal facilities. In addition, a gap of 80,000 household latrines needs to be addressed, to prevent disease outbreaks and flooding.
There is insufficient capacity and funding to cover the multiplicity of needs. The Uganda Country Refugee Response partners have therefore identified the most pressing needs in each sector, and calculated USD 128.5 million required in January 2023, to provide critical and minimal services for the first three months, that will help reduce the negative impact of underfunding.

There is a multiplicity of needs that have overstretched Refugee Response partners in Uganda. The country continues to host refugees at an unprecedented scale, keeping its borders open to over 1.4 million refugees, including more than 860,000 children. Uganda has received over 146,000 new arrivals from South Sudan and the Democratic Republic of the Congo, and they continue to arrive each day. There are more than 86,000 new arrivals that have been settled into areas without basic infrastructure and often with partial support, lacking poles and tools to establish shelters, mats to sleep
Due to underfunding, soap and hygiene kits have not been provided since 1 July 2022. Recent findings have identified that, 62 per cent and 49 per cent of households in Southwest and West Nile respectively, are food insecure. There are insufficient cereals and pulses in stock to distribute the planned food basket during the January 2023 cycle and only 42% of households have access to land for food production. Ugandans and refugees are feeling the strain of land, food, and resources.
Poverty remains high and inflation is on the rise which will increase economic vulnerability and tensions amongst refugees and the host community will increase as social services provided by humanitarian actors are reduced in 2023.
Refugee children are facing an uphill battle for education and safety. Malnutrition rates among children are increasing with four in every ten children being anaemic and seven out of every 100 children aged six months to five years, identified as having Global Acute Malnutrition (GAM). For each classroom there is an average of 131 children, one teacher is available for every 73 children, and they are sitting on the floor or sharing desks with up to six other pupils. 51 per cent of children who have been exposed to violence, abuse, neglected, and exploited are not receiving support due to staffing gaps in case management services and alternative care services.
Basic services and facilities are already overstretched and barely able to manage the existing needs.
In some locations, health workers each provide consultation for an average of 80 patients a day. There were 277 attempted suicide cases in refugee settlements in, with 49 resulting in death. Latrine coverage has critically plummeted in settlements receiving new arrivals from over 75 per cent in January 2022 to below 50 per cent.
Contributions from donors have enable partners in the Uganda Country Refugee Response to respond, still increased support in 2023 is needed. By September 2022 $360 million USD had been raised for partners in the Uganda Country Refugee Response. Despite this support, less than 50% of the total needs have been covered leaving a gap of $440 million USD. This lack of funding has led to constant reprioritization of budgets by partners to cover emergency needs and maintain critical services. The inability for partners to meet the growing needs is having a negative impact.
Impact of underfunding in 2023: Without additional funding, further service reductions and operational cuts are expected. These cuts would have severe implications for refugees and the communities hosting them. Here are some examples:
Food security will reduce further: Maternal, Child Health and Nutrition (MCHN) program beneficiaries will start receiving 50 per cent of their ration entitlement.
Less access to quality education for all children: There will be 50% less teachers, bigger class sizes and no support for students with disabilities. The decrease in teachers will affect 501,000 learners amongst the refugee and host communities. The average class size will increase to 1 teacher for every 90 students. Some 10,000 learners with disabilities, who are especially vulnerable to exclusion from school environments, will not receive the support they need.

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