Cash‐based approaches in humanitarian emergencies: a systematic review
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This Campbell systematic review examines the effectiveness, efficiency and implementation of cash transfers in humanitarian settings. The review summarises evidence from five studies of effects, 10 studies of efficiency and 108 studies of barriers and facilitators to implementation of cash‐based humanitarian assistance. Studies assessing effectiveness of cash‐based approaches were experimental and quasiexperimental studies. Studies analyzing efficiency were experimental, quasi‐experimental or observational studies with a cost analysis or economic evaluation component. Studies examining barriers and facilitators included these study types as well as other qualitative and mixed methods studies. Unconditional cash transfers and vouchers may improve household food security among conflict‐affected populations and maintain household food security among food insecure and drought‐affected populations. Unconditional cash transfers led to greater improvements in dietary diversity and quality than food transfers, but food transfers are more successful in increasing per capita caloric intake than unconditional cash transfers and vouchers. Unconditional cash transfers may be more effective than vouchers in increasing household savings, and equally effective in increasing household asset ownership. Mobile transfers may be a more successful asset protection mechanism than physical cash transfers. Cash transfers can be an efficient strategy for providing humanitarian assistance. Unconditional cash transfer programmes have a lower cost per beneficiary than vouchers which, in turn, have a lower cost per beneficiary than in‐kind food distribution. Cash transfer programs can also benefit the local economy. Voucher programmes generated up to $1.50 of indirect market benefits for each $1 equivalent provided to beneficiaries and unconditional cash transfer programmes generated more than $2 of indirect market benefits for each $1 provided to beneficiaries. Intervention design and implementation play a greater role in determining effectiveness and efficiency of cash‐based approaches than the emergency context or humanitarian sector. Factors which influence implementation include resources available and technical capacity of implementing agencies, resilience of crisis‐affected populations, beneficiary selection methods, use of new technologies, and setting‐specific security issues, none of which are necessarily unique to cash‐based interventions.