Health and Cash and Voucher Assistance

Introduction to health in the humanitarian sector

Humanitarian crisis have a profound impact on the health and well-being of affected populations.  The direct consequences of these crisis can lead to severe injuries and even death. Indirect consequences, resulting from poor living conditions, destruction of sources of livelihoods and health systems put these populations at risk of developing diseases. In light of these conditions, access to timely and appropriate care is crucial, particularly in the initial phase of crisis. The aim of health interventions within the humanitarian sector is “to reduce avoidable mortality, morbidity and disability, and restore the delivery of, and equitable access to, preventive and curative health care as quickly as possible and in as sustainable a manner as possible”. External support to mitigate the effects of a humanitarian crisis should as much as possible use and reinforce existing systems unless these systems are highly inefficient, become abused for political reasons or are unable to react to the excess health needs.

In the context of emergencies or crisis, health care systems should be supported and resorted. Many countries affected by humanitarian crises however have poorly developed health systems, which are then exacerbated by the crisis, with poor quality of care, interrupted supply lines and weak accessibility.

How is CVA used in the Health Sector?

Cash and voucher assistance (CVA) had been used to improve access and utilization of health services in humanitarian settings by reducing financial barriers to access to health services, as well as reducing direct and indirect financial barriers. When health services are available with adequate capacity and quality but user fees are applied, the preferred response option is through provider payment mechanisms, with CVA to be considered complementary to such supply side health financing strategies, and not aim to replace these.

In March 2018, the Global Health Cluster published a working paper for considering cash transfers for health in humanitarian settings. The paper discusses the potential added value and limitations of CVA to achieve health outcomes. It discusses the different types of cash transfer modalities complementary to health financing options, and alongside other response interventions to support access to quality services.

Possible interventions could include vouchers for reimbursement of costs of consultations, diagnostic tests and/or medicines, value voucher or cash for specific health services, drugs or associated indirect costs, or unconditional/unrestricted cash to compensate for funds lost on health care costs.