Background The conflict in Syria is the largest driver of displacement worldwide with 4.1 million Syrian refugees, more than 6.5 million internally displaced people (IDPs), and 13.5 million people in need (PiN) of protection and humanitarian assistance inside Syria. Over the past decade, cash-based interventions (CBIs), including both conditional and unconditional cash transfers and voucher programs, have become increasingly common. While the cash-based response within Syria to date has been small compared to in-kind assistance, there is widespread interest in expanding the use of CBIs. This study explores the feasibility of cash-based modalities with the aim of informing future humanitarian assistance delivery strategies in northern Syria. Methods The feasibility of CBIs is examined in terms of acceptability, infrastructure, humanitarian agency implementation capacity, value for money, risks, and responsiveness to changes in beneficiary needs. A mixed methods approach was used consisting of a literature review in addition to a household survey and key informant interviews (KIIs) conducted in early 2016 in four governorates of Syria (Aleppo, Hama, Idlib, and Al-Hasakeh). Results Overall, 64.5% of surveyed households received assistance during the 4-month period from October 2015 through January 2016. In-kind assistance was most common, with 59.2% of households receiving in-kind food aid. More than half of households received only one or two distributions of assistance in any form. Unmet needs were ubiquitous, and food was the priority in 74.1% of households. Despite relatively limited coverage of cash and voucher assistance programs to date, stakeholders voiced a widespread preference for cash transfers as did household survey participants. When analyzed by sector, cash assistance was preferred by survey respondents for all sectors except WASH. The most significant challenge in implementing CBIs in Syria is the lack of a regulated cash transfer system for movement of funds into the country. The bulk of humanitarian money is currently transferred through informal value transfer networks (hawala), which appears to have the capacity to handle larger-scale cash transfer programming. Technical guidance and standardized procedures are needed to ensure due diligence is conducted to mitigate fiduciary risks and ensure accountability to both beneficiaries, donors, and other stakeholders. Conclusions The possibility of more sustained, continuous assistance provided through cash transfer or voucher mechanisms negates many of the barriers faced in providing in-kind assistance. Consideration of the feasibility of cash as an alternative modality relies on local-level assessment of capacity, resources, political environment, beneficiary needs and preferences, and lessons learned from previous programs in those areas.
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