The Refugee Coalition of East Africa (RefCEA) is a refugee-led community organization based in Nairobi, Kenya to advocate for and improve the livelihoods of LGBTQI refugees who have fled their home countries due to homophobic violence. Although recognized by international law, this community still faces intersecting stigmas of being a refugee and being a sexual and/or gender minority in their host country of Kenya. Like all refugees, they have significant barriers to stable employment and receive little if any financial support which results in extreme poverty, and frequent food or housing insecurity. Furthermore, as members of a highly stigmatized group living in the slum areas on the outskirts of Nairobi, violence, harassment, and discrimination from the surrounding community is commonplace. These factors contribute to very poor mental health as well as feelings of despair and hopelessness. 
 

With over 650 known  LGBTQI  refugees in Kenya, with several hundred more in other East African countries, and due to prevalent homophobia in East and Central Africa, many  LGBTQI  individuals are forced to flee their homes, seeking safety and anonymity. According to a 2017 study out of Oxford University of MSM cis men and transgender women, the unemployment rate for recent migrants and refugees in this population is greater than 50%, while the average number of dependents of these same individuals is nearly 14 per person (Smith & Clark, 2017). In 2014, a local civil society organization launched Utunzi, a web-based tool, to report and view experiences of violence and discrimination by sexual and/or gender minorities, including refugees. Reports have increased sharply in recent years, from 17 to 136 per 1000 monthly (NGLHRC, 2020). HOYMAS, a health clinic geared towards LGBTQI and sex workers, has noted extreme disparities in depression reported by refugees they serve (Gathiawa, 2019). 
 

In response to these findings, RefCEA conducted an experiment in 2018 called the SPARK  Fund (Sustainable Programs for Autonomous Refugees in Kenya). This fund provided financial support of refugees struggling with economic insecurity within LGBTQI communities in East Africa to facilitate sustainable, autonomous sources of income.  The aim is to help these individuals get out of the cycle of poverty through their own direction and ingenuity. Funding will be delivered through online promotion of these business ventur es to RefCEA's global supporter base under the auspices of All Out, a UK-based human rights organization. 
 

Successful applicants were paired with experienced local business and tribal leaders who will provide guidance and support to further develop their business. Furthermore, participants received training on business development and personal goal setting. Through these small cash grants, paired with training and mentorship, RefCEA hoped to foster self-reliance, alleviate poverty, reduce stigma, and ultimately improve mental health of participants. 

THEORY OF CHANGE

The intersecting stigmas of being refugee and LGBTQI in a homophobic foreign land leaves few opportunities for employment, resulting in poverty, depression, and despair. By providing small cash grants of $2000 to start a small business, in addition to goal setting workshops and mentor guidance, participants will be able to form relationships with tribal leaders and elevate their community respect, which, in turn, reduces stigma. With focus on defined business and personal goals, a modest income can be generated which reduces food/housing insecurity, contributing to improved mental health. Entrepreneur skills further enhance mental health by suggesting a more positive future.

This theory of change is loosely based on Bourdieu’s Social Capital Theory (1979). He conceptualized social capital as ‘‘the aggregate of the actual or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance and recognition’’. Economic (money), cultural (education, taste) and social (networks, power) are forms of capital that are transferable and interchangeable. Elevating one form of capital can influence acquisition of others. Elevated capital increases opportunities for improved health outcomes (Link & Phalen, 1995).

SIMILAR APPROACHES

Although this model has been successfully demonstrated in the arena of international development, the use of behavioral economics and microenterprise initiatives are relatively new to public health. Jennings Mayo-Wilson (2020) has shown microenterprise development is an effective tool for HIV prevention among Black urban youth in Baltimore. Tingey, et al (2020) found significant reductions in depression and reported violence for participants of an entrepreneurship intervention RCT among Native American Youth. In Uganda, Bermudez (2018) showed interventions addressing economic insecurity bolstered health outcomes, such as HIV viral suppression, among vulnerable young adults living in low resource environments. Finally, the SPARK Fund is very similar to Project Come-up, a program based on cash grants for young adults of color. 

STAKEHOLDERS

The stakeholders for this intervention are LGBTQI refugees in Nairobi, RefCEA and their refugee leadership, community and tribal leaders, civil society organizations in Nairobi advocating for the LGBTQI or refugee community (such as HOYMAS and Utunzi), fiscal sponsor All Out, and funders who primarily consist of individual donors from around the world.

PROGRAM OBJECTIVES

Specific programmatic activities and indicators are detailed in the attached Appendices. Following successful completion of the program, RefCEA hopes to show reduced depression, reduced hunger and homelessness, and reduced community harassment and violence. Success of the program will be gauged on the following questions:

1. Compared to groups that did not receive cash grants, does owning a small business improve food/housing security?
2. Does owning a small business ease relationships with surrounding community as measured by reduced incidents of discrimination or police contact?
3. Does the program improve mental health as measured by pre/post mental health assessments?

TARGET POPULATION

The target population for this group is young sexual and/or gender minority refugees or asylum seekers who have been living within 50km of Nairobi for at least 6 months and show moderate to severe clinical depression. Participants must be registered and mandated by UNHCR and not receiving stipends more than 5,000 Kenyan shillings (approximately $50 USD) monthly, nor can they be scheduled for resettlement within the next 12 months. Qualification to participate is open to anymore meeting the aforementioned criteria and have prepared a suitable business idea covering points defined in the Call for Proposals posted on the RefCEA website.