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Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study

Cash assistance has rapidly expanded in the Syrian refugee response in Jordan and global humanitarian programming, yet little is known about the effect of multipurpose cash transfers (MPC) on health in humanitarian contexts. A prospective cohort study was conducted from May 2018 through July 2019 to...

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Autores principales: Lyles, Emily, Chua, Stephen, Barham, Yasmeen, Jardenah, Dina, Trujillo, Antonio, Spiegel, Paul, Burton, Ann, Doocy, Shannon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021566/
https://www.ncbi.nlm.nih.gov/pubmed/36962676
http://dx.doi.org/10.1371/journal.pgph.0001227
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author Lyles, Emily
Chua, Stephen
Barham, Yasmeen
Jardenah, Dina
Trujillo, Antonio
Spiegel, Paul
Burton, Ann
Doocy, Shannon
author_facet Lyles, Emily
Chua, Stephen
Barham, Yasmeen
Jardenah, Dina
Trujillo, Antonio
Spiegel, Paul
Burton, Ann
Doocy, Shannon
author_sort Lyles, Emily
collection PubMed
description Cash assistance has rapidly expanded in the Syrian refugee response in Jordan and global humanitarian programming, yet little is known about the effect of multipurpose cash transfers (MPC) on health in humanitarian contexts. A prospective cohort study was conducted from May 2018 through July 2019 to evaluate the effectiveness of MPC in improving access to healthcare and health expenditures by Syrian refugees in Jordan. Households receiving MPCs (US$113–219 monthly) were compared to control households not receiving MPCs using difference-in-difference analyses. Overall health care-seeking was consistently high (>85%). Care-seeking for child illness improved among MPCs but declined among controls with a significant adjusted difference in change of 11.1% (P<0.05). In both groups, child outpatient visits significantly increased while emergency room visits decreased. Changes in care-seeking and medication access for adult acute illness were similar between groups; however, hospital admissions decreased among MPCs, yet increased among controls (-8.3% significant difference in change; P<0.05). There were no significant differences in change in chronic illness care utilization. Health expenditures were higher among MPCs at baseline and endline; the only significant difference in health expenditure measures’ changes between groups was in borrowing money to pay for health costs, which decreased among MPCs and increased among controls with an adjusted difference in change of -10.3% (P<0.05). The impacts of MPC on health were varied and significant differences were observed for few outcomes. MPC significantly improved care-seeking for child illness, reduced hospitalizations for adult acute illness, and lowered rates of borrowing to pay for health expenditures. No significant improvements in chronic health condition indicators or shifts in sector of care-seeking were associated with MPC. While MPC should not be considered as a stand-alone health intervention, findings may be positive for humanitarian response financing given the potential for investment in MPC to translate to health sector response savings.
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spelling pubmed-100215662023-03-17 Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study Lyles, Emily Chua, Stephen Barham, Yasmeen Jardenah, Dina Trujillo, Antonio Spiegel, Paul Burton, Ann Doocy, Shannon PLOS Glob Public Health Research Article Cash assistance has rapidly expanded in the Syrian refugee response in Jordan and global humanitarian programming, yet little is known about the effect of multipurpose cash transfers (MPC) on health in humanitarian contexts. A prospective cohort study was conducted from May 2018 through July 2019 to evaluate the effectiveness of MPC in improving access to healthcare and health expenditures by Syrian refugees in Jordan. Households receiving MPCs (US$113–219 monthly) were compared to control households not receiving MPCs using difference-in-difference analyses. Overall health care-seeking was consistently high (>85%). Care-seeking for child illness improved among MPCs but declined among controls with a significant adjusted difference in change of 11.1% (P<0.05). In both groups, child outpatient visits significantly increased while emergency room visits decreased. Changes in care-seeking and medication access for adult acute illness were similar between groups; however, hospital admissions decreased among MPCs, yet increased among controls (-8.3% significant difference in change; P<0.05). There were no significant differences in change in chronic illness care utilization. Health expenditures were higher among MPCs at baseline and endline; the only significant difference in health expenditure measures’ changes between groups was in borrowing money to pay for health costs, which decreased among MPCs and increased among controls with an adjusted difference in change of -10.3% (P<0.05). The impacts of MPC on health were varied and significant differences were observed for few outcomes. MPC significantly improved care-seeking for child illness, reduced hospitalizations for adult acute illness, and lowered rates of borrowing to pay for health expenditures. No significant improvements in chronic health condition indicators or shifts in sector of care-seeking were associated with MPC. While MPC should not be considered as a stand-alone health intervention, findings may be positive for humanitarian response financing given the potential for investment in MPC to translate to health sector response savings. Public Library of Science 2022-11-02 /pmc/articles/PMC10021566/ /pubmed/36962676 http://dx.doi.org/10.1371/journal.pgph.0001227 Text en © 2022 Lyles et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lyles, Emily
Chua, Stephen
Barham, Yasmeen
Jardenah, Dina
Trujillo, Antonio
Spiegel, Paul
Burton, Ann
Doocy, Shannon
Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title_full Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title_fullStr Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title_full_unstemmed Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title_short Multi-purpose cash transfers and health among vulnerable Syrian refugees in Jordan: A prospective cohort study
title_sort multi-purpose cash transfers and health among vulnerable syrian refugees in jordan: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021566/
https://www.ncbi.nlm.nih.gov/pubmed/36962676
http://dx.doi.org/10.1371/journal.pgph.0001227
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