From Protection to Wellbeing: Quasi-Experimental Evidence from Cash & Voucher Assistance with Displaced Children
Principal Investigator: Jillian J. Foster
Research Team: Leena Adawiya, Faizah Alkhatheri, Jennifer C. Chen, Gilbert El Elkoury, Diala Hajal
Location: Akkar, Bekaa Valley, Mount Lebanon, Lebanon
Partner: Lebanon Cash Consortium, UNHCR, ECHO
Cash is a vital resource for vulnerable refugee populations to meet their basic needs effectively and with dignity, forming an important part of the humanitarian toolbox. Nevertheless, in complex humanitarian settings, there is a lack of rigorous evidence around the causal relationship between cash assistance and addressing household vulnerability, particularly in regard to the impact of cash assistance on vulnerabilities specific to children, or what practitioners and policymakers refer to ask “child protection outcomes”. This study examines the effect of multi-purpose cash assistance on children’s wellbeing and protection from violence and exploitation in Syrian refugee communities in Lebanon. Using a quasi-experimental design, this study examines shelter quality and consistency, access to education, economic exploitation of children, negative coping strategies, exposure to violence, psychosocial wellbeing, and family separation. Findings suggest that CVA small size relative to cost of living offers only marginal improvements and limited sustainability given. Focus group discussions expose underlying violence against children, oftentimes as a result of insufficient cash within the household. This study was conducted in partnership with the Lebanon Cash Consortium (LCC) multi-purpose cash assistance (MPCA) program.
Background
In September 2015, Lebanon was home to 1,078,338 UNHCR registered refugees from the Syrian conflict, which began in 2011. Both academic and grey literature have shown, the chaotic nature of refugee legal status, insecure livelihoods, and lack of resources places families, especially children, in dire situations where they often cannot access to basic and essential goods and services. This includes lack of access to adequate food, shelter, and medical treatment. The United Nations reports that more than half of all Syrian refugees are under the age of 18 and over 75% are not enrolled in school. Many children bear the burden of heading households and contributing to family income. The important relationship between CVA and children’s economic, physical, social, and emotional wellbeing was explored in partnership with a MPCA program in Lebanon. The Lebanon Cash Consortium—a group consisting of ACTED, CARE, IRC, Save the Children International, Solidarités International, and World Vision International—implemented this MPCA program in camp and informally-housed communities to meet the needs of vulnerable Syrian refugees, adults and children.
Research Design
Using a rigorous quasi-experimental design, the sample included primary data from household surveys (N: 433; 381 adults; 52 children), 117 semi-structured interviews (87 adults; 30 children), and 18 focus group discussions (6 groups with adults; 12 children) in the Akkar, Bekaa Valley, and Mount Lebanon. Average treatment effect was measured comparing those receiving CVA for at least three months (treatment group) with those previously qualified but having not received CVA up to that point (control group).
Results & Findings
Data suggests the relatively small size of CVA assistance (174 USD/month for three months in this case) compared to the cost of living in Lebanon minimized the size and sustainability of effects. This is especially true for severely vulnerable households. That said, there were meaningful results in psychosocial wellbeing, relative low intensity of protection issues, school enrollment and attendance, and food security. Receiving CVA correlates with both reduced psychosocial and protection issues for caretakers. In turn, children experience greater wellbeing themselves and a lower upper-bound (or magnitude) of protection issues. A clear gendered pattern emerged with women and girls being nearly twice as likely to express isolation and disempowerment as men and boys. Those receiving cash found the cost of schooling less of a barrier to enrollment and attendance, and CVA offered greater resources to cover the cost of food.
The relationship between CVA and child labor was ambiguous. Data on child labor was muddled by conceptual confusion. Both caretakers and children inconsistently identified “child labor”. While there were no reports of child trafficking or prostitution, there were many ‘grey areas’ identified around child labor, such as children receiving money for occasional tasks or errands and children trading labor in exchange for private tutoring when language barriers prohibited their access to local schools. Finally, there were no clear improvements in shelter quality nor negative coping strategies for those households in the treatment group.
Policy Implications
While CVA does offer vital support to vulnerable households, the magnitude and sustainability of any impact is mediated by the size and duration of assistance. Modest cash and voucher assistance relative to cost of living yields marginal and narrow benefit in the lives of children and their caretakers. Results from this study suggest child wellbeing is meaningfully improved and safety from the most negative protection outcomes is supported by CVA, even if not sustained beyond program implementation.
Cash and voucher assistance programs must be scaled relative to cost of living to maximize the magnitude and sustainability of benefit. Additionally, disability considerations should receive special and explicit integration into cash assistance programming, a point largely missed in the LCC MCPA program at the time. Finally, cash assistance is a poor instrument for changing broader societal problems, such as a lack of understanding and awareness around child labor. Additional programming is needed to raise awareness around child exploitation and the marginalization of women and girls.