Can we do more with humanitarian cash assistance?
Unpacking the available evidence and identifying areas for further study
Co-authored by Sana Khan, Senior Research Advisor - Economic Recovery, and Elizabeth Tromans, Senior Technical Advisor - Cash and Emergencies
At the International Rescue Committee, we’ve heard a number of questions relating to our cash programming, such as what is the evidence that supports it and why we take a “cash first” approach to humanitarian basic needs programming. Cash first for the IRC means that we commit to using cash assistance in programming designed to meet basic needs and food security outcomes for people in need where it is appropriate and feasible.
There is strong evidence that cash does what it’s supposed to in humanitarian contexts: enabling clients to meet their basic needs like food, water and shelter, and helping them to avoid negative coping mechanisms like taking kids out of school or selling assets like livestock. The IRC commissioned one of the very first pieces of rigorous evidence in a humanitarian context showing how effective cash can be in meeting basic needs. But there are still areas we could explore to see if cash can work to achieve other economic outcomes, like generating an income, accumulating assets and household decision-making, or other outcome areas like use of health services or school attendance.
The evidence is strong around how cash helps meet basic needs
The primary, if not the sole, objective of most humanitarian cash assistance programs is to enable clients to meet their basic needs and to avoid negative coping mechanisms. Humanitarian cash and voucher assistance programs are typically short-term in nature (12 months or less, and often only 3–6 months), are delivered in regular monthly intervals, and the dollar amount is determined by calculating a minimum expenditure basket. This amount is calculated by assigning a monetary value to basic needs items and services that households are likely to prioritize and that can be purchased through local markets. Calculations take into account the fact that other organizations might also help meet households’ needs for items like food or shelter. Humanitarian cash assistance programs are typically not intended to achieve longer-term outcomes, like income generation, and are mostly targeted at the household and not any one individual member.
The evidence supporting the use of cash for meeting basic needs is strong. We know that cash increases the purchasing power of households and that households primarily prioritize spending on food items and other non-food essentials. We know households don’t spend on temptation goods, such as alcohol and tobacco. We know that cash sometimes decreases child labor and increases school attendance for children. We also know that cash assistance can be a cost-efficient way of delivering assistance and offers clients dignity and choice.
But can cash do more?
Though we know that humanitarian cash assistance programs meet their objective, we’re less certain on how to leverage cash assistance to make it an even more powerful intervention to support vulnerable people. We would like to see more evidence that:
- Unpacks how to deliver cash better, faster, cheaper, and at scale.
- Aims to understand how cash assistance programs interact with their environment. For example, how do cash assistance programs affect markets or community members not receiving services.
- Identifies how to extend the benefits of cash beyond the intervention period, or amplify its impact to support other economic wellbeing outcomes, such as income and asset generation.
Answering these types of questions is unlikely to call into question the core case for humanitarian cash meeting basic needs. However, it may strengthen or weaken the case for cash relative to other programs (for example, if it proves to be more or less efficient, or if the unit of analysis is changed from the individual or household to the community). Alternatively, it may just call for a revised design of humanitarian cash assistance to ensure adherence to the Do No Harm principle.
Two recent IRC studies, What Works for Women & Girls (Syria) and Safer Cash (Afghanistan and Cameroon) illustrate this point. These studies indicate that while the humanitarian cash assistance met its goal of enabling households to meet their basic needs and avoid negative coping mechanisms, clients across the board also valued and appreciated the cash assistance. But we need to do more to make cash as safe as possible for all members of the client household. This is also corroborated by logic that an injection of cash into a household is likely to affect household dynamics in some way (either positively or negatively).
While acknowledging that it is likely not feasible for short-term humanitarian cash assistance programs to affect major changes in the systemic issues that often affect our clients in the places we work, this points to the need to redesign our cash programs with a protection lens to ensure we Do No Harm in our programming.
As another example, recent research on a social protection program in the Philippines suggests that in places where cash assistance social protection programs reach a significant percent of the population, nutrition outcomes improve for children in households that receive cash, while worsening for children in households that did not receive cash, likely due to price increases for certain food items. Humanitarian cash assistance does not typically reach the same scale as social protection programs, but the research does suggest that, perhaps even in humanitarian settings, we should consider looking at the effects on households that do not receive services or should re-consider our targeting when the vast majority of people are being reached in a given area.
Finally, the IRC is also designing a study to understand whether modifying the program design in humanitarian basic needs cash assistance can extend the benefits of cash beyond the intervention period. In Yemen, we will be launching a small-scale pilot to compare a lump sum cash approach to the more standard model of monthly deliveries of cash assistance. More on this soon.
Let’s not conflate the core case for cash with the conversation on how cash impacts across outcomes.
Insights like those listed above will help improve how we design programs and our overall impact, but they are not likely to make us debate the core case for humanitarian cash assistance programs and whether they should exist at all.
Overall, the case for using cash assistance to meet basic needs in humanitarian emergencies is strong, both in terms of what logic suggests and in terms of what the evidence shows. Increasingly, however, other sectors are considering using cash assistance for achieving outcomes beyond enabling clients to meet their basic needs. The evidence in this space for humanitarian settings is largely absent or mixed and the theory of change is not as straightforward for these other outcomes as it is for cash for basic needs. We think there is a role for cash to play in helping achieve other outcomes or amplifying the impact of other interventions aimed at achieving other outcomes, but whether cash alone can move the needle is unclear.
There are two risks of conflating these two conversations: first, we risk calling into question the use of humanitarian cash assistance for basic needs, and secondly, we risk taking away from one of the very appealing aspects about cash: cost-efficiency. We risk piling on many additional program activities to the core humanitarian cash assistance model that it becomes costly to deliver, while both internally and with donors it is still held to very high cost-efficiency standards.
Where do we begin? The IRC is starting with what we know about different sectors
Our starting point is to go back to our theory of change for these other outcome areas and to identify where cash might have a role to play. We are doing this by firstly refreshing our evidence reviews to ensure we have up-to-date information on the best use of cash in each of our outcome areas. Next, we’re working through nominated Cash Champions across sectors to identify program models where we’re already using cash, as well as where there are opportunities we have not yet explored.
At the same time, global clusters are developing guidelines for their sectors, which will also inform IRC programming decisions. After the mapping exercise, we’ll develop both new program models and sector-specific cash training packages to ensure that we can deliver on our quality commitments. And lastly, we’ll test out some of these models on a small scale and build in measurement to understand whether there is evidence to suggest that these models are helping us achieve our objectives. The IRC will also continue to explore opportunities to conduct rigorous research to help fill gaps in evidence.
In order to enable clients to meet basic needs, we remain committed to delivering cash better, faster, and cheaper while being responsive to client feedback and ensuring adherence to the Do No Harm principle.
