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Policy paper

Multi-purpose cash assistance and health: Evaluating the effect of the Emergency Social Safety Net (ESSN) programme on access to health care for refugees in Turkey

18 December 2019

This policy brief provides a summarizations of a 2019 analysis of data collected by WFP between 2017 and 2019 on refugees in Turkey including the Comprehensive Vulnerability Monitoring Exercise (CVME) in addition to longitudinal data from Emergency Social Safety Net (ESSN) programme applicant households collected during the Pre-Assistance Baseline and six subsequent rounds of Post-Distribution Monitoring.

Key Messages:
– Multipurpose cash transfers play a vital role in helping vulnerable (mainly Syrian) refugees to meet their basic needs in Turkey. However, they do not appear to significantly affect access to, or expenditures associated with, health service utilization.
– Care-seeking rates for both adult and child illness are high and around half of refugee households in Turkey report that they had no recent health expenditures. This finding is not unexpected since refugees1 in Turkey have good access to health services largely thanks to the Government of Turkey’s establishment of a social system that allows all refugees to benefit from free health services in public hospitals throughout the country.
– Health expenditures among refugees are very low relative to those reported in the two other major refugee- hosting countries in the region – Jordan and Lebanon. In Turkey average monthly household spending on health among refugee households is approximately 40-80 Lira (US$7-15) by comparison with an average of US$ 138 in Jordan and US$ 157 in Lebanon.