Trends and Drivers of Refugees in Africa

1 College of Medicine, University of Ibadan, Ibadan, NIGERIA 2 Slum and Rural Health Initiative Research Academy, Ibadan, NIGERIA 3 Universal Care for Africa Foundation, St Louis, USA 4 College of Biomedical Engineering, Taipei Medical University, Taipei. TAIWAN 5 Bluegate Public Health Initiative, Ibadan, NIGERIA 6 College of Health Sciences, Obafemi Awolowo University, Ile-Ife, NIGERIA 7 Pan African University of Life and Earth Sciences Institute, Ibadan, NIGERIA 8 Faculty of Veterinary Medicine, University of Ibadan, Ibadan, NIGERIA *Corresponding Author: mayadesina@gmail.com


INTRODUCTION
Since the end of World War II, there has been a constant rise in the number of refugees globally (UN, 2019). Fraogmen (1970) explained that this may be due to the constant turbulence in various nations after this era. The global population of refugees rose steadily from 2.8 million in 1976 to about 21.3 million in 2017, including adults and children (UNHCR, 2019). Over 26% of the global population of refugees is found in Sub-Saharan Africa are found in the Sub-Saharan Africa, the highest population found in any region (UNHCR, 2019). According to the 1951 Refugee convention, a refugee is "someone who is unable or unwilling to return to their country of origin owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion" (UNHCR, 2017). However, practically, it is quite difficult to give a definite definition of a refugee (Fraogmen, 1970).
The population of refugees of African origin has been on the rise. This is because of the rise in conflict and violence in Africa (OECD, 2017). This increase in refugee population poses great problems to the continent and the globe at large. These may include health problems in varying diversities (Castaneda et al., 2017), bans on refugee as experienced by the Trump-led administration when he blocked refugees from all countries including three in Africa (Libya, Somalia, Sudan) (Pfortmueller et al., 2012;Whitaker, 2017) and other varying forms of antiimmigrant hostility (Balakian, 2016;Salehyan, 2008;Whitaker, 2016). Examples are the Xenophobia rise in South Africa resulting in violence against Somalis amongst others, the Tanzania government expelling more than half of its Rwandans refugee and the case of the Botswana government refusal to grant refugee status to asylum seekers (Charman, 2012;Kamanga, 2005;Nyamnjoh, 2002;Whitaker, 2017). However, the Sustainable Development Goals (SDGs) allows that forced displacement, as well as the welfare of internally displaced persons and refugees, be considered as development challenges that need greater investment and efforts from the international community (OECD, 2017).
There are 54 countries in the African continent (Figure 1). This study seeks to discuss the population trends of refugees in Africa based on their origin, using secondary data from 1990 to 2017. The outcome of this study may guide governments, policy makers, health advocates, human right activities, nongovernment organisations, etc, in combating issues responsible for the increase in population of refugees in Africa and also in catering for the needs of these refugees. Additionally, this study presents the major drivers for refugee migration in Africa.

METHODOLOGY
This study utilized secondary data from the World Bank database on the population of refugees in 54 countries in Africa based on their countries of origin from 1990-2017.

Statistical Analysis
The data from Africa region were extracted into a Microsoft Excel 2019 document and analysed descriptively using SPSS version 25. Adobe Photoshop CS6 was utilized in developing the data visualization (charts and maps). Ethical approval was not required as the data used is publicly available and accessible.

RESULTS
From 1990 to 2017, there were 118,374,355 refugees from the different regions in Africa as shown in Table 1. The highest population of refugees during this period was from Somalia (19,217,481) and the lowest, from Lesotho (238). Table 1 also categorises nations into different regions viz. North, South, East, West and Central and lists the nations in each region based on decreasing population of refugees.  Eritrea (8,495,249) and Liberia (8,433,832) respectively. It is of note that 5 out of these 7 countries are in East Africa and account for 77% of the population of refugees from these groups.
The trend of all 54 countries during the period of 28 years (1990-2017) is presented in Figure 5. Important trends in this chart include; the sharp drop in refugee population from Rwanda between 1994 and 1995, from a staggering 2,257,573 to 574, 617. Also, there was an acute decline in the population of Ethiopian refuges between 1990 and 1991 from 1,316, 636 to 196,242. However, there was a very rapid rise in the number of Sudanese refugees from 778, 718 to a vast 2,439, 868 between 2015 and 2017. Figure 6 presents the population of refugee in the 54 African countries based on the 2017 data.

DISCUSSION
According to the Office of the United Nations High Commissioner for Refugees (UNHCR, 2019) the world is currently facing the highest levels of displacement ever in history, with an unprecedented 65.3 million people forced to leave their homes as a result of war, conflicts, drought or poor economies. Among these are 21.3 million refugees, over half of  There was a total of 118,374,355 refugees from the different parts of Africa within the year 1990 to 2017. Somalia accounted for the highest number of refugees under this period. The Somali two decades-long civil war, political instability and the severe droughts in the region resulting in deteriorating humanitarian situation, have forced a great number of Somalis to be refugees, seeking help in neighbouring countries (Polonsky et al., 2014). As of 2017, Somalia alongside Syria, Afghanistan, South Sudan and Myanmar accounted for two-thirds of the world's refugees (UNHCR, 2018). These countries mentioned are all plagued by war and political instability which is responsible for the high number of refugee's population (UNHCR, 2017). East Africa has the highest population of refugees of all the regions in Africa. This high number could be due to climate change and environmental degradation, armed conflict and political and economic crisis (Kumssa et al., 2014).
The year 2017 has been the year with the highest number of refugees from Africa within the time range studied. Probable reasons are mainly due to the South Sudan crisis, the recognition of some number of refugees on a group or prima facie basis, and also the granting of refugee status to quite a number of people (Rutinwa, 2002). The low number of African refugees in 2008 can be attributed to successful voluntary repatriation of a great number of refugees (UNHCR, 2019). This repatriation also occurred in the Asia and East Pacific region leading to a decline in refugee population (UNHCR, 2019). The sharp decline in refugee population from 1990 to 1992 and 1994 to 1997 can be due to certain factors. During this period, certain countries, for example, Tanzania and Zaire closed their borders against refugees (Rutinwa, 2002). Countries, such as Kenya and Tanzania also ordered forceful repatriation of refugees on the grounds that their presence was compromising the security of the country (Rutinwa, 2002). Also, the sharp rise from 2011 to 2017 can be because of rise in conflict and violence, political crisis and economic instability brewing in some African countries (UNHCR, 2017).
The notable trends presented are the sharp drop in refugee population in Rwanda between 1994and 1995and Ethiopia between 1990and 1991 and also the sharp rise in population of refugees from Sudan between 2015 and 2017. In the 1994 and 1995 periods, there was forced repatriation of millions of Rwandese refugees from Tanzania and the then Zaire. This may have accounted for the sharp decline in refugee population during that period (Rutinwa, 2002) while the probable reasons for the sharp rise in Sudan during the periods of 2015-2017 may be due to the peak experienced in the South Sudan crisis (UNHCR, 2017).

Climate change
Climate change has become one of the major causes of human displacement in Africa (UNHCR, 2019) as it has caused a rapid increase in the population of refugees (Environmental migration, 2020) because of its devastating effects on human existence. Such effects include; limitation in natural resources, food insecurity, poor nutrition and hygiene, lack of healthcare facilities, amongst others (UNHCR, 2019).
In a bid to survive, people tend to fight over the few available resources resulting in violent attacks among communities, forcing people to get displaced across international borders (UNHCR, 2019). Also, people who have been formerly displaced (primary displacement) because of other reasons, migrate to climate change affected areas and this can further force them into a secondary migration (UNHCR, 2019). Though, the refugees hardly contribute to the generators of climate change, they are mostly impacted by its consequences (Ahmed, 2019).

Natural disasters
Natural disasters have also been an impetus for human migration across borders in many African countries (UN, 2020). Disasters such as famines, floods, droughts, cyclones, mudslides and landslide, which may or may not be due to climate change, have affected different parts of the continent (Basher, 2008;UN, 2020). It has also caused negative socioeconomic impacts on the affected regions leading to poor quality of life of the inhabitants, subsequently forcing them to leave their homelands in pursuit of survival. The eastern part of the continent has been mostly hit by the effects of natural disasters as it experienced persistent drought for several years (Basher, 2008). This resulted in a higher number of refugee population in this region as revealed by this study.

Economic hardship
Most African countries declared independence from colonial empires in the post-World War II era, with little or no infrastructure available for manufacturing, education or healthcare, nor did they have much experience with running a modern state apparatus (Easterly, 2002). The World Bank stated in its 2019 report that 24 of the 30 countries in the world with annual per capita incomes (GDP per capita, current international USD) less than 3000 USD are in Africa, and these figures do not even include the conflict-ridden countries like Somalia and South Sudan (World Bank, 2019). The role of economic hardship in African refugee migration is impossible to disregard. Zelinsky (1971), in his Hypothesis of the Mobility Transition, argued that processes of modernisation and economic development historically resulted in increasing rural-to-urban migration followed by a subsequent increase in emigration. The wealth of a society has an inverse relationship to its emigration rate and a linear relationship with its immigration rate. However, as seen in most African countries, the presence of refugees places a demand on an already overstretched economy. Economic development of African societies would not only encourage citizens to imagine a future in their home countries, but would also foster conditions that will spur refugees to return to their homes at their own will.

Violence and tensions
Violent conflicts have been figured as one of the predominant causes of African refugee migration. The Office of the United Nations High Commissioner for Refugees (UNHCR) stated that the world is currently facing the highest levels of displacement ever in history, with an unprecedented 65.3 million people forced from their homes by war and internal conflict (UN, 2019). It was further revealed that the rate of human displacement is 34,000 per day due to conflict or persecution. In the Central African Republic, clashes among rival groups have forced thousands to flee their homes. Likewise in Nigeria, over 2 million people have been forcibly displaced, including the 1.87 million who have fled from the militant group Boko Haram's violence since 2014 (Momodu, 2017). Although the UN General Assembly High-Level Meeting on Refugees and Migrants addressed large movements of refugees and migrants, critics, however, say that the UN summits spent little time addressing the root causes of forced displacement and insecurities that force people to flee (Momodu, 2017). Poverty, poor education, unemployment, tribalism/racism and gross inequality of incomes can be identified as the causative factors for violence and tensions.

Limitations
This study may have been limited by under-reporting of data in many African countries.

Recommendations
A lot still needs to be done especially by the destination states in offering international protection for the rights of people displaced by climate change and natural disasters as most destination states do not recognise refugees in such context (Thompson, 2019). Also, the health status of the refugees should be of utmost importance as they are at risk of communicable diseases such as HIV/AIDS, sexually transmitted diseases, etc . Some of these diseases can be prevented by availablility of healthcare services and proper education on sexual health, contraceptive use, and so on . Mental health and psychosocial supports should be provided for the refugees (Adesina et al., 2020a(Adesina et al., , 2020b. It is recommended that further studies should be conducted on the effect of migration and displacement on the health status of refugees in Africa .

CONCLUSION
The refugee population over three decades has been on the rise with occasional periods of decline. This poses great socioeconomic and health problems to the refugees as well as the host countries themselves. It is therefore necessary that the government and other concerned stakeholders create lasting solutions to the causes of this increase in refugee population by tackling the drivers of the migration.