With unprecedented numbers of displaced persons around the world, the humanitarian system is facing huge financial pressures. The international community provides support (about US$22
billion in 2015) mainly through humanitarian programs, but the World Bank describes the current model as critically flawed (WBG 2017, p. 12) because forcibly displaced persons have to be
sustained by the international community at a high cost in large part because they are prevented from working and integrating into host communities. To overcome this, the World Bank
recommends that development actors should help work toward solutions that can be more cost-effective and sustainable (WBG, 2017).
The existing literature makes a strong case for the integration of displaced persons into host community services and labour markets, making displacement a development issue as well as a
humanitarian issue (WBG, 2017; UNCHR, 2018). There is evidence that joint humanitarian and development programmes can improve displaced persons and host communities’ access to
services and livelihoods (Centre on International Cooperation, 2015); such joint responses have proven effective in a range of contexts, including Lebanon, Colombia, Eastern Sudan, Sudan,
Jordan and China (ibid.). There is also an understanding that policies that encourage the inclusion of displaced persons in the formal economy are likely to yield benefits in the form of
increased productivity and improved fiscal revenue (ibid.).
At the same time, the picture of case-specific and empirical evidence and evaluation in the integration sphere is ‘generally bleak’ (Migration Policy Institute Europe, 2018, p. 8). There is
very little high-quality evaluation to indicate which types of interventions work best, ‘very few evaluations are robust enough to prove that any differences in integration outcomes were caused
by the intervention’ (pp. 1, 7) and in particular cost-efficiency analyses are largely absent. Still, the evidence that is available generally points towards moving away from international
humanitarian aid and care and maintenance responses towards a more holistic response that foster integration and build resilience.
The reviewed literature acknowledges that integration puts a strain on local communities, as many encounter problems meeting the demand for services that comes with the increase in population. Affordable housing, education, and availability of income-generating opportunities can be considered the primary drivers of tension (ORSAM, 2015; REACH, 2014). Consequently, it is
agreed that for integration programmes to be effective and foster social cohesion, they must also benefit host communities. Most of the world’s displaced persons are hosted in low- and middle-income countries, so hosts and displaced persons share vulnerabilities and their economic and social well-being is intertwined (ODI, 2015). This is particularly relevant to cities as many of those displaced to urban areas ‘live alongside other urban poor in slums/informal settlements where resources and services are already overstretched, social relations fragile and communal solidarity lacking’ (Cities Alliance, 2011). A good example of a response that benefits both the host community and the displaced population is the Itang integrated water infrastructure system in the Gambella region in Ethiopia (UNCHR, 2017), or the Eastleigh Community Wellness Centre (ECWC) in Kenya with a monthly attendance of close to 2500 patients, half of whom are migrants
(WHO African Region, 2018).
The literature reviewed further demonstrates that integrating support for refugees into mainstream government service provision, where it exists, can be more cost-effective and sustainable than setting up large-scale camps and setting up parallel humanitarian service delivery channels (WBG, 2015). An example of successful integration of displaced persons into existing services where the local services were in place was a case of child protection services in Tanzania, where in response to the influx of refugees from Burundi in 2015-2017 the Department of Social Welfare deployed 100 Social Welfare Officers to provide case management services to refugee children in need of individualized child protection services. This was possible because Tanzania, unlike other countries in the region, had a cadre of trained social welfare officers to draw on (UNHCR & UNICEF, 2018).
Integration of displaced persons into host community services is seen as a more sustainable and cost-efficient approach than camps (UNHCR, 2014). For the forcibly displaced in camps,
services provided by agencies may be better to what is available locally and moving to country systems may result in a nett loss of welfare (WBG, 2017). However, the overwhelming majority of
refugees and IDPs do not have access to such services and their welfare depends on the strengthening of host community systems. Therefore, in the medium term, scaling up such systems and including forcibly displaced persons into them is viewed as the most cost-effective and equitable option; the transition needs to be managed carefully, in particular in those poor and remote regions where local systems are weak (ibid.).
Systemic obstacles exist whereby weak incentives for governments and communities to integrate displaced people into the economy and services, combined with weak incentives for development and humanitarian actors to join up their efforts, results in inadequate, costly and unsustainable programs (Centre on International Cooperation, 2015). The political context needs to be given consideration alongside funding and local cooperation, as at times even successful responses that benefit both host and displaced communities can be resisted if the political will to integrate displaced persons is not there. This was the case for the Sudan UNDP/UNHCR Transitional Solutions Initiative (TSI) Joint Programme in 2012-2014, for example, which suffered from difficult cooperation with line ministries about service delivery and was temporarily suspended by the government over concerns about integration, illustrating the importance of a political process addressing all actors’ incentives and concerns (Centre on International Cooperation, 2015, p. 22).
Access to formal employment opportunities has been seen as particularly crucial for improving outcomes for displaced persons, as an opportunity to be employed, including self-employed and
possibly even creating livelihoods for others, is a sign of economic integration (Mixed Migration Centre, 2017). Recently Turkey and Jordan have tried to increase the number of Syrian refugees engaged in regular employment by simplifying the processes through which refugees can seek formal employment. However, permits tie an employee to one employer for a year (except in the agricultural sector) and most refugees are still only able to access informal work, which usually offers and most of the time informality of work offers limited opportunities for integration (ibid.). Positive responses that have proven cost-effective have been found in Georgia, where the provision of agricultural machinery and training to mixed IDP and non-IDP groups enabled them to increase their incomes and number of hectares farmed; the programme also fostered social cohesion (CARE, 2012). A key element in improving the impact of skills training initiatives is to link them to pathways to employment such as career guidance, job referrals, on-the-job training and internship schemes (UNHCR, 2018).
Finally, the literature reviewed presents a good range of examples of effective integration of displaced persons into education and health systems (UNCHR, 2017; Centre on International
Cooperation, 2015; UNICEF, 2018; UNCHR, 2018). With respect to cost efficiency, the case of Lebanon stands out as it has been noted that the integration of refugee health care within the
national health system was an important factor for the resilience of the system. It reduced administrative and set up costs and shifted the burden to several geographic areas in Lebanon
and to several different players in the Lebanese health system (Journal of Global Health, 2016).