This report reviews the use and effectiveness of community-based social protection (CBSP) mechanisms, and examines how they are integrated into formal social protection schemes and what impact this might have. It begins with a loose definition of the terms used, followed by a section on the evidence on how effective CBSP appears to be. The following section presents the main observations about CBSP features which appear to generalisable across different contexts, and any evidence on how these interact with formal social protection.
The key findings of this report include:
- Effectiveness of CBSP: Effectiveness is hard to present, as informal mechanisms are often unevaluated, and/or do not have clearly measureable results and outcomes. The strongest evidence on effectiveness is in the health insurance literature.
- Integration: The literature agrees that formal and informal social protection have many complementarities and could work together to form a holistic social protection system. However, there are few examples of this in operation.
- Networks: CBSP relies on social networks. This can be effective at the small-scale, but is inequitable and unreliable. The literature is unclear whether formal social protection erodes or supports traditional networks of reciprocal exchange.
- Inequality: CBSP can be quite unequal in access and coverage. Formal social protection has a role to play in making CBSP more equitable.
- Dealing with risk: CBSP is vulnerable to covariate risk and more effective for idiosyncratic risk.
- Political impacts: There is some evidence that women’s organising can help strengthen CBSP and that community groups can develop a strong voice which may contribute to political institutions.
- Community-based health insurance (CBHI): This area has the strongest evidence base. CBHI has positive effects on reducing out-of-pocket spending for members, and somewhat weaker evidence that it improves standards of care.
- Targeting: Community participation helps social protection to be better targeted.