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Impact Evaluation of the Multipurpose Cash Assistance Programme

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Impact Evaluation of the Multipurpose Cash Assistance Programme Lebanon Cash Consortium (LCC) Impact Evaluation of the Multipurpose Cash Assistance Programme January 26, 2016 Francesca Battistin, American University of Beirut (Lebanon) The Lebanon Cash Consortium (LCC) brings together six leading international NGOs to deliver multi-purpose cash assistance to socio-economically vulnerable refugee households living in Lebanon. Members of the LCC are Save the Children (Consortium Lead), the International Rescue Committee (Monitoring and Evaluation and Research Lead), ACTED, CARE, Solidarités International and World Vision International. Executive Summary Introduction The Syrian crisis is currently in its sixth year, with over one million Syrians still living in Lebanon as refugees. Nearly 60% of all financial resources pledged by UN agencies and INGOs were to secure basic assistance for Syrian refugees, mainly to support them in meeting food and healthcare needs. In the context of this protracted crisis, humanitarian actors continuously face resource shortages to help affected populations meet their basic needs. Therefore, donors look for cost-efficient yet effective solutions, and rely on the available evidence to make their funding decisions. In the Lebanese context, multipurpose cash assistance (MCA) has been used extensively to meet refugees’ basic needs, ranging from food, shelter, health and hygiene and other items, in a manner that allows refugees’ choice of spending priorities. The Lebanon Cash Consortium (LCC) brings together six international NGOs, including Save the Children (Consortium Lead), the International Rescue Committee (Monitoring, Evaluation, and Research Lead), Solidarités International, CARE, ACTED, and World Vision International. The mandate of the Consortium is to provide MCA to economically vulnerable Syrian households, whose eligibility is determined based on the inter-agency Proxy Means Test (PMT) score that seeks to measure economic vulnerability. During 2015, 20,000 household had been assisted with MCA out of 25,000 that were found eligible for MCA. The remaining 5,000 were not enrolled in the MCA program reportedly due to lack of funding. This study aims to measure the impact of the MCA delivered by LCC at a six-month midline of assistance on several proxies of physical and material wellbeing, encompassing food security, health, hygiene and housing. Methodology The study uses a quasi-experimental design called Regression Discontinuity Design (RDD) to compare indicators of the physical and material wellbeing of households that receive cash assistance versus households who do not. The RDD shares similarities to Randomized Controlled Trials (RCT) and can establish the causal effect of an intervention. The key difference between RDD and RCT lays in the modality of forming the two groups to be compared. Without having to randomize those who will receive or not receive cash assistance, which is considered unethical in humanitarian programs, in this RDD study the intervention and control households have been chosen in proximity of the PMT cutoff point. Hence, they are supposedly similar from a socio-economic and demographic perspective, as if they were randomly chosen. The only difference that is assumed between them is in the receipt of cash assistance. In turn, this allows establishing and measuring the causal effect of LCC intervention. The study compared a group of 247 recipient- and 261 non-recipient households, most of which are male-headed households (76% recipient and 77% non-recipient), with an average age of around 39 years old. Households in the two groups were found very similar, except for the fact that non-recipient households possessed a greater variety of basic household assets, had smaller size and received a lower amount of cash assistance from sources other than the LCC. Key Findings LCC cash aid increases refugees’ consumption of living essentials, including food and gas for cooking. Their total monthly expenditures, which includes food, water, health, hygiene, and other consumables, are on average, 21% higher than those of non-beneficiaries. In particular, LCC beneficiaries spend around 32% more on food and 12% more on gas for cooking compared to non-beneficiary households. Regarding food, LCC beneficiaries have a higher intake of dairy products and lower engagement in several coping strategies related to a previous lack of money to buy food. More specifically, they resort less frequently to borrowing food or to sending household members to eat elsewhere in order to meet food consumption needs. LCC beneficiaries are better off also because they are less reliant on debt for paying their rent. More precisely, non-beneficiary households are 1.8 times more likely than beneficiary households to borrow money in order to rent the place where they live. LCC cash transfers make households’ economies “healthier”; in fact, recipients are more likely to count on work as their main source of income as opposed to negative and unsustainable coping strategies, such as debt, remittances, gifts and sale of assets or food. Overall, LCC beneficiaries were found to be four times happier than non-beneficiaries as a result of being able to meet their households’ basic needs. However, they are also under greater stress for financial issues, which may be a consequence of the sense of precariousness and dependency on cash aid, and of the awareness that assistance may be discontinued. From a social cohesion perspective, LCC beneficiaries feel eight times more secure, as compared to non-beneficiaries. In addition, LCC cash assistance appears to increase by five times their sense of trust of the community hosting them. Limitations When considering the findings of this study, two major methodological limitations should be kept in mind. Information collected at baseline and midline was self-reported, hence of limited accuracy and reliability. In addition, the two groups were not entirely similar, which violates a core RDD assumption; although the analysis addressed this issue, some degree of bias should be expected. Conclusion In absence of more durable alternatives for Syrians in displacement, such as access to income-generation opportunities, and despite the variety in assistance, the LCC multipurpose cash assistance continues to be a necessary and appropriate aid modality for helping refugees in meeting their basic needs, in accordance with households’ priorities. Furthermore, the LCC Multipurpose cash aid appears to be effective as a modality to deliver supplementary assistance because it is versatile. In turn, the support the LCC provides is reducing beneficiaries’ vulnerability, on different levels. Nevertheless, no evidence from this study would support using it to replace specialized assistance, such as food aid and health services. The LCC MCA is particularly effective to address access barriers in situations where markets are functioning and are more elastic to demand increase, such as that of food items. Specific interventions are needed, aimed at strengthening services and expanding delivery capacity and outreach, in order to not create disparities in the status of affected peoples. Acknowledgments This project has been possible thanks to all agencies composing the Lebanon Cash Consortium (LCC), who believed in the importance of measuring the impact of their action and collected the baseline and midline data. They have been adventurous enough to entrust me this study and to allow its submission as an MS thesis at the American University of Beirut (AUB). Within the International Rescue Committee (IRC), which led the surveys and commissioned the research, I am particularly thankful to Jarrett Basedow, Philip Blue, Jamil El Khoury and Maria Cremona. They patiently reviewed the multiple versions of findings, and offered invaluable support for this research. In the initial stages, Malcolm Johnstone has been key to the realization of the study, as he conceived and encouraged the effort, led the midline survey, and handed over the data. I also benefitted from the guidance of Dr. Christian Lehmann, from the University of Brasilia, who reviewed the research proposal and provided guidance on Regression Discontinuity Design (RDD). A very special thanks goes to Daniel T.R. Masterson, of Yale University, who lent precious advice throughout data analysis. Dr. Pierre Mouganie from the AUB Department of Economics has been available to give feedback, even during holidays. Last but not least, I am extremely thankful to my Thesis Committee at AUB, composed of my Advisor, Dr. Hala Ghattas, and its three members, Khalil El Asmar and Dr. Monique Chaaya, from the Department of Epidemiology and Population Health, and Dr. Nisreen Salti of the Department of Economics; they reviewed the research proposal and findings, and helped me improve the analysis methods and the presentation of findings. In particular, Khalil El Asmar has been of invaluable technical and moral support when analyzing the data; he conceived the RDD design for this research, generated the sample and shared the findings of his pre-post intervention study, which offered many ideas for the conclusions section. The research was funded by the UK Department for International Development (DFID), and commissioned by the LCC. Contents Executive Summary ............................................................................................................................................ i Introduction .........................................................................................................................................................
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