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Title The Effects of Non-Food Item Vouchers in a Humanitarian Context The Case of the Rapid Response to Movements of Population Program in Congo
Post date 09/19/2017
C1 Background and Explanation of Rationale

In 2015, across the globe, an estimated 65 million people were forcibly displaced, and a total of $28 billion was spent on international humanitarian assistance (GHA, 2016). Despite the vast sum of money spent each year, little evidence exists on the effectiveness of emergency aid. Research on humanitarian assistance is challenging as it must overcome security concerns, logistical hurdles, a relative paucity of high quality monitoring data, and the urgency of humanitarian action. At the same time, there is an increasing demand from donors, policy-makers and implementing agencies to know what works and why, as this is directly linked to the efficient use of limited resources to achieve development outcomes.
In the Democratic Republic of Congo (DRC), humanitarian actors have been present for over 20 years in response to on-going armed conflict and low state capacity in the mountainous east of the country. Acute crises such as population displacement and natural disasters exacerbate a situation of chronic vulnerability, especially among the rural population. As of May 2017, the IDMC estimated that ongoing conflicts in North and South Kivu and an increase in inter-communal clashes in southern and central regions such as Tanganyika, the Kasais, Ituri and Uele, had caused 922,000 people to be displaced from their homes, with an additional 130,000 displaced due to natural disasters over the course of 2016 alone. The UN Office for the Coordination of Humanitarian Affairs (OCHA) estimates there are some 3.8 million Internally Displaced Persons (IDPs) in DRC as of May 2017, the highest number in Africa. Most of these IDPs lack sufficient access to food, clean water, and sanitation facilities, and threats to security are pervasive. Similar conditions hold even for most non-displaced rural populations in the east.

In May 2014, the International Initiative for Impact Evaluation (3ie), in partnership with the DRC Humanitarian Pooled Fund (HPF), requested qualifications from research teams interested in studying the effectiveness of humanitarian assistance in eastern Congo. HPF and 3ie matched qualified research teams with humanitarian organizations that had previously expressed interest in the methods promoted by 3ie. Our research team was matched with the Rapid Response to Movements of Population (RRMP) program, jointly managed by the United Nations Children’s Fund (UNICEF) and OCHA. The program that evolved into RRMP began in 2004. Currently, RRMP8 (May 2017 – April 2018) provides humanitarian assistance to groups of 500 or more households in North Kivu, South Kivu, Ituri, ex-Katanga and Tanganyika who have fled from armed conflict or natural disasters, or have recently returned to their home communities after such displacement. The program also responds to epidemics such as cholera. The RRMP8 budget is approximately 21 million USD.
RRMP is a complex program that provides assistance with non-food items, health, water, sanitation, and hygiene (WASH), and education. To reach a consensus on a feasible and relevant study design, representatives from HPF, UNICEF, OCHA, the NGOs that implement RRMP, and the research team met a number of times over three years. The final design focuses on the largest component of RRMP: vouchers for non-food items. Thus, this study aims to generate high quality evidence to answer the following research question:

What is the effect of humanitarian assistance (specifically the provision of vouchers for non-food items (NFI)) provided to recently displaced or returned persons, and vulnerable host families, on health and well-being?

C2 What are the hypotheses to be tested?

We focus on four families of primary outcomes: 1) physical health, 2) mental health, 3) social cohesion, and 4) resilience. For each family, we construct a summary index. We also test for spillovers and heterogeneous effects along several dimensions (details below).
H1: NFI vouchers have a positive effect on physical health of children
Measures [All the following concern children under 5 years old only]:
-Mothers’ reports of diarrhea, cough, and fever among children in the last two weeks
-Anthropometry: (height, weight, and MUAC)
-Hemoglobin (anemia indicator)
-Malaria rapid diagnostic test (RDT)
H2: NFI vouchers have positive effects on mental health of adults
-Selections from the Hopkins Symptom Checklist (HSC-25)
-World Health Organization Well-being Index (WHO-5)
H3: NFI vouchers have a positive or negative effect on social cohesion of adults
-Group membership
-Contributions to the village
-Contributions to other households in dwelling
-Problems with other households in dwelling
-Incidences of theft
H4: NFI vouchers have positive effect on resilience
-Self-reported and enumerator observations of number of assets owned
-Responses to standard food security questions
-Proportion of children aged 5-18 in school per household
-Unhealthy behaviors (alcohol , cigarettes, etc.)
We test for within-dwelling spillover effects on the same four families of outcomes, using a more limited set of indicators. (A dwelling is a structure containing one or more households)

We test for heterogeneous effects along the following dimensions (two-sided tests):
Baseline poverty/vulnerability
Migrant/host status
Ethnic majority/minority status (relative to village)
Discordant or concordant ethnicities within the dwelling
Assigned voucher amount per capita
Occupation of recipient
Education of recipient
Distance to market

C3 How will these hypotheses be tested? *

We randomly assign households to receive a voucher for non-food items or control. We interview households 1-4 days before a fair where they can use their vouchers. We interview the same households again six weeks after the fair. If a household is living in a multi-household dwelling, we also randomly select an additional household in the dwelling to interview at both points in time.
We estimate treatment effects using ANCOVA models.

C4 Country The Democratic Republic of Congo
C5 Scale (# of Units) 1400
C6 Was a power analysis conducted prior to data collection? Yes
C7 Has this research received Insitutional Review Board (IRB) or ethics committee approval? Yes
C8 IRB Number Catholic University of Bukavu (UCB/CIE/NC/006/2017); New York University – Abu Dhabi (#064-2017)
C9 Date of IRB Approval 26 July 2017 (CUB); 23 August 2017 (NYUAD)
C10 Will the intervention be implemented by the researcher or a third party? Unicef via implementing NGOs: MercyCorps, Danish Refugee Council, Norwegian Refugee Council, Solidarites
C11 Did any of the research team receive remuneration from the implementing agency for taking part in this research? No
C12 If relevant, is there an advance agreement with the implementation group that all results can be published? Yes
C13 JEL Classification(s) I15, I38, D74, H84