Women’s status and qualitative perceptions of a cash assistance programme in Raqqa Governorate, Syria

Abstract

Cash and voucher assistance is an efficient way to deliver assistance in emergency settings, and evidence demonstrates that cash programmes have consistent positive impacts on food security and other health and economic outcomes in these contexts. Nevertheless, while evidence from development settings shows that cash has the potential to reduce intimate partner violence and increase empowerment for women and girls, there is a dearth of rigorous evidence from acute humanitarian settings. In response to this evidence gap, the International Rescue Committee conducted an evaluation of a cash programme in Raqqa Governorate, Syria. The aim was to examine the effect of a cash for basic needs programme on outcomes of violence against women, and women's empowerment. This article draws on qualitative data from interviews with 40 women at the end of the cash programme. It offers evidence of potential increased tension and abuse within both the community and the household for some women whose families received cash, as well as potential increased social protection through repayment of debts and economic independence for others. Both negative and positive effects could be seen. While the objective of the cash programme was not to influence underlying power dynamics, this research shows it is necessary to integrate gender-sensitive approaches into programme design and monitoring to reduce risk to women of diverse identities.

Conflict-related health research in Syria, 2011–2019: a scoping review for The Lancet - AUB Commission on Syria

“… Damascus, Aleppo, Lattakia, Tartous, Dara’a, Rural Damascus, Hama, Homs Not funded (self-funded) Alhaffar (2019) [ 72 ] First: Syria Last: Syria First: academic Last: academic Examines the prevalence of caries and oral health status among school children in Damascus, and associations with socio-economic status Health status; Health determinants and risks September–November 2017 School-based survey (questionnaire and clinical examination) Seventh-grade school children in 10 randomly selected schools covering Damascus city Damascus Not funded (self-funded) Alhammoud (2019) [ 73 ] First: Qatar Last: UK First: clinical Last: clinical Reports the experience of one field hospital in Aleppo providing treatment of open shaft fractures Health system (service provision) July 2011–July 2016 Retrospective medical record review Patients with open long bone fractures managed with external fixation Aleppo Not reported Alothman (2019) [ 74 ] First: Syria Last: India First: academic Last: academic Reports on war injury presentations to Hama National Hospital Health system (service provision) 2017 Retrospective medical record review War injured patients received by Hama National Hospital Hama Not reported Ballouk (2019) [ 75 ] First: Syria Last: Syria First: academic Last: academic, government Examines prevalence of dental caries among school-aged children in Damascus city Health status September 2016–January 2017. School based oral health survey (clinical examination) School children aged 8–12 years and resident in Damascus city during the study period Damascus Not funded (self-funded) d Blackwell (2019) [ 76 ] First: USA Last: not stated First: humanitarian Last: humanitarian Examines the impact of a cash-based assistance program on women’s empowerment and violence against women Humanitarian assessment, response or needs;...…”

“…Health status is the most frequently researched theme, examined in 38 research papers covering nutrition [ 10 , 94 ], communicable diseases and/or vaccination status [ 8 , 18 , 23 , 26 , 28 , 30 , 38 , 41 , 47 , 54 , 61 , 88 , 94 , 95 ], mental health [ 20 , 27 , 39 , 55 , 56 , 60 , 79 , 83 , 91 , 94 ], child [ 22 , 41 , 57 , 92 ] and maternal [ 93 ] health, oral health [ 44 , 72 , 75 , 83 ], gender-based violence [ 76 ], anaemia [ 43 ] and non-communicable diseases [ 39 , 84 , 94 ]. Of studies examining injuries, three are studies of hospital patients [ 29 , 46 , 89 ], one examines injury burden among children surveyed at home and in camps for internally displaced persons (IDPs) [ 41 ] and one reports injury counts among children and the general population as provided by key informants [ 32 ].…”

“…Review of humanitarian programmatic data and operations included middle-upper arm circumference screening, survey of living conditions and food security, and nutritional programming administered by Medecins Sans Frontiers (MSF) in Al-Raqqa in 2013 [ 10 ], MSF vaccine-preventable disease risk assessment, pre- and post-vaccine coverage surveys and immunization activity in Aleppo in 2015 [ 47 ], 2012–2014 surgical data from an MSF field hospital in Northwest Syria [ 19 ], blast injuries managed at an MSF-supported facility in Raqqa in 2017–18 [ 89 ], MSF paediatric consultations in Aleppo and Raqqa in 2013–16 [ 57 ], MSF assessment of health status of recently arrived IDPs in Al-Raqqa in 2017 [ 94 ], primary care services delivered by 10 Union of Medical Care and Relief Organisations (UOSSM) centres in opposition-controlled territories in 2014–2015 [ 28 ], and analysis of data from the humanitarian health response in contested and opposition-controlled areas in 2013–14 [ 32 ]. Additional interventions and program evaluations included delivery and evaluation of an intervention through provision of information and follow-up questionnaire in bread packages being distributed by a humanitarian organization in Northern Syria [ 21 ], evaluation of three modes of food assistance programming in Idlib in 2014–15 [ 34 ], evaluation of an International Rescue Committee cash assistance program on violence against women in Raqqa [ 76 ], evaluation of effectiveness of multi-level WASH risk reduction interventions in southern Syria in 2018 [ 64 ] and examination of the impact of a psychosocial support program on the wellbeing of a control and intervention group of farmers [ 96 ]. Several papers interviewed humanitarian workers, including humanitarian health staff working on non-communicable disease (NCD) care in Syria [ 50 ] and those involved in the cross-border humanitarian response from Turkey [ 78 , 81 ].…”

Early marriage and displacement�a conversation: how Syrian daughters, mothers and mothers-in-law in Jordan understand marital decision-making

“…At least among the specific demographic of our study sample, young Syrian women dream of being able to afford dedicating the next years of their lives to starting a family and caring for their children and spouses. By contrast, finding employment might not be one of their short-term goals; this chimes with the results of a cash assistance programme for internally displaced women in Raqqa who used the money not to start small businesses, but to stop working under exploitative conditions (Blackwell et al 2019). Older women are often in charge of household economies and the upbringing of their grandchildren-this makes them important mediators.…”

‘In Exile, the Woman Became Everything’

“…Inside Syria, cash assistance allowed internally displaced women in Raqqa to pay their debts and become less reliant on their relatives in the short-term, but financial decision-making power often remained in the hands of husbands and mothers-in-law. Monetary support also allowed women to stop working outside the house, in line with conservative gender norms inside their community (Blackwell et al, 2019). In northern Lebanon, female refugees came to think of NGO-led vocational trainings as leisurely fun, not as a route to employment, when limiting Syrian women's opportunities for employment through ill-targeted, short-term humanitarian courses became necessary for preserving the fragile peace between locals and refugees (Carpi, 2019).…”