Impact evaluation of multi-purpose cash assistance on unmet need for primary health care access among Syrian Refugees in Lebanon : the role of proximity to health care

Abstract

Syrian refugees displaced to Lebanon face severe economic vulnerability that prevents them from meeting their basic needs, including primary health care. A multipurpose cash (MPC) program was implemented beginning in October 2017, distributing $175 per household per month. The program targets vulnerable Syrian refugee households in Lebanon with the intent of helping households cover their basic needs and improve overall well-being. A cross-sectional survey of 4421 households, some of whom received MPC and some of whom did not, was conducted in July and August 2018 as part of the larger CAMEALEON consortium project. Using a quasi-experimental regression discontinuity design, this study compares unmet need for primary health care between MPC recipients and non-recipients, while accounting for the effect of distance to primary health care (PHC) facilities using geospatial analysis. MPC significantly reduced unmet need for PHC among individuals in households receiving the grants, while individuals living further from facilities were significantly more likely to have unmet need for PHC. Distance to facilities had a minor moderating effect on the relationship between MPC and unmet need for PHC. MPC has the greatest impact on young males aged 18-44 and individuals living in non-permanent shelters and did not have an impact on refugees with chronic illnesses. Further research is needed on the relationship between health care access, MPC programming, and proximity to health care. Efforts to improve health outcomes visa MPC should explicitly address chronic illness.