The impact of cash transfers on Syrian refugee children in Lebanon

Wael Moussa, Nisreen Salt, Alexandra Irani, Rima Al Mokdad, Zeina Jamaluddine, Jad Chaaban, and Hala Ghattas

World Development, Volume 150, Article number 105711 (2022)


This paper evaluates the impact of a large-scale multi-purpose cash (MPC) transfer program on a sample of Syrian refugee children in Lebanon. Lebanon hosts an estimated 1.5 million Syrian refugees, over half of whom are children 18 years and younger.

Since 2017, UNHCR and WFP have provided direct cash assistance to eligible refugee households over a 12-month period, amounting to US$175 per household per month. Households are selected for the program on a yearly basis based on their score on a proxy means testing (PMT) formula that predicts household expenditures using a set of socio-demographic characteristics from UNHCR registration data.

The research covers two cash cycles beginning in November 2017 and November 2018 to determine whether the MPC benefits children in recipient households. The analysis is based on data from two waves of household survey data collected in 2019 from Syrian refugee households, matched to UNHCR registration data (including households’ PMT scores in 2017 and 2018 and household access to other assistance programs). The sample was restricted to individuals under the age of 19 years and their households.

The analysis distinguishes between four groups of households: (1) households who did not receive MPC in either of the two cash cycles; (2) households who received MPC in the first period but not in the second period; (3) households who did not receive MPC in the first period but did in the second period; and (4) households who maintained eligibility for MPC benefits throughout both cycles. The analysis controls for child’s age and gender, and at the household level, controls for household size, and the gender, age, marital status, and educational attainment of the household head.

Main results:

  • Cash transfers improved health outcomes for pre-primary and school-aged children. Households receiving MPC reported a reduced incidence of acute illness in children (under 5 years of age) by 10 percentage points in the short run compared to children in non-recipient households, and by 8 percentage points in the long run compared to children in discontinued households. Consistent with the lower incidence of acute illness, all treatment groups reported a decreased need for primary health care (PHC) for young children compared to non-recipient households. Among households who report requiring PHC for children aged 0 to 5 years, MPC improved access to PHC across all treatment groups, but especially for households that receive long-run assistance. The results are qualitatively similar for children aged 6 to 14.
  • MPC led to improved educational outcomes compared to children in non-recipient households, including transitioning from non-formal to formal schooling. Compared to children in non-recipient households, MPC assistance increased enrolment rates in formal education by 7.6 percentage points for children in discontinued households and children in long-run recipient households and 8.8 percentage points for children in short-run recipient households. There were also significant decreases in enrolment in non-formal education among MPC recipients in the discontinued and long-run groups, indicating that MPC assistance is associated with a shift from nonformal to formal education.
  • MPC led to decreases in child labor. Higher enrolment rates for MPC beneficiaries where also coupled with significant decreases in child labor among all treatment groups, by 3.3 percentage points in the discontinued group and 3.7 percentage points in the long-run group.
  • Cash transfers reduced the likelihood of early marriage for girls aged 15–19 years. The estimated effect of MPC is negative for all treatment groups, ranging between 2.4 and 6.6 percentage points (but only significant for girls in discontinued households compared to non-recipients).

The authors conclude that the barriers to educational access are not necessarily a result of learning deficiencies but are also economic in nature. While favorable health effects of MPC on pre-primary children tend to diminish in the absence of continued or sustained cash assistance, MPC effects on health, education, child labor, and early marriage tend to persist even after MPC has been discontinued.