Attachments
Executive Summary
Background
Humanitarian actors have a responsibility to ensure that assistance is provided in a way that minimizes risks and maximizes benefits to people affected by crisis. However, there are many challenges in evaluating ‘what works’ in addressing the needs of crisis-affected populations, and translating research evidence into practice in complex environments with limited resources.
Humanitarian assistance has traditionally been provided in the form of in-kind goods and services: temporary shelters, food and non-food items, water and medical care. However, as the nature of humanitarian crises has shifted over the last few decades, cash-based approaches have become an increasingly common strategy for the provision of humanitarian assistance and are widely considered an appropriate, and sometimes preferable, substitute for in-kind assistance when conditions permit.
Increasing use of cash-based approaches has been accompanied by efforts to evaluate cash-based interventions and develop recommendations for implementation in a range of settings. Systematic reviews of evidence in humanitarian settings are, however, relatively rare, and, to the best of our knowledge, this is the first systematic review of the effects of cash-based approaches in emergencies to date.
Objectives
The primary objective of this review was to assess and synthesize existing evidence on the effects of cash-based approaches on individual and household outcomes in humanitarian emergencies. The secondary objective was to assess the efficiency of different cash-based approaches and identify factors that hinder and facilitate programme implementation.
Review Methods
We followed standard methodological procedures for review of experimental and quasiexperimental studies to assess the effects of unconditional cash transfer, conditional cash transfer and voucher programmes for crisis-affected populations. We also adapted these procedures to review economic studies assessing the efficiency of cash-based approaches and observational, qualitative and mixed method studies assessing the factors that facilitate or hinder the implementation of cash-based approaches in different settings.
We conducted comprehensive searches of published and unpublished literature in November 2014. Two independent research assistants screened all identified studies to determine eligibility for inclusion in the review. We then extracted data from all included studies using a standardized coding tool and critically appraised the studies using existing tools appropriate for the different study designs.
Due to the heterogeneity of the comparisons and outcomes reported in the included studies, we were not able to synthesize the studies using meta-analysis. Instead, we have presented the results in tables and synthesised the findings narratively. We used narrative and thematic synthesis to address the secondary objective. We conducted these analyses in parallel, and have reported on each separately in subsequent chapters of this review.