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Our Best Shot: Frontline Health Workers and COVID-19 Vaccines

Fully realizing the social and economic benefits of halting COVID-19 requires investing in a fast and fair global rollout of COVID-19 vaccines. CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5.00 in delivering the vaccine.

Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.

Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.

Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.

As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
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A Qualitative study comparing the effects and outcomes of HIV-related interventions for Nepalese migrants – at source, transit and destination

The qualitative study, commissioned by Care Nepal, sought to explore the effects and outcomes of the EMPHASIS project, launched four years ago to reduce HIV and AIDS vulnerability among cross border migrants; and to influence national and regional policies relating to safe mobility through evidence generated regionally. The project, working along a continuum of source, transit, and destination areas, provides HIV prevention and treatment services to migrants and their families. Additionally, the project partners with local stakeholders to ensure safe passage of migrants on transit besides providing other support services. The study was, thus, designed to assess the influence of the project in addressing HIV vulnerabilities, and at the same to enquire into whether inter-country passage has been made safer for migrants. The study aimed to answer the following research questions: a) How has the EMPHASIS intervention impacted HIV vulnerabilities among Nepali migrants, b) What are the qualitative differences between HIV related attitudes and behaviors between migrants reached at destination and their spouses reached at source and those not reached either at source or destination, c) What are the qualitative differences between HIV
related attitudes and behaviors between spouses who have been reached by the project and those who have not been reached by the project, d)) What are the benefits and barriers of support services provided to migrants for safe mobility and empowerment. The study was conducted among 60 migrants and family members, and 5 key informants in four locations- two at the destination site of Delhi and two at the source site of Nepal. In depth interviews by trained researchers were conducted with the help of semi structured interview guides. [39 Pages] Read More...

Women’s involvement in coffee agroforestry value- chains Financial training, village savings and loans associations, and decision power in Northwest Vietnam

Colleagues in Vietnam and at CCAFS and the World Agroforestry Centre (ICRAF) carried out some research on our work in the coffee value chain (TEAL).

This study assessed VSLA impacts and related training on gender equality and women’s access to coffee markets in an ongoing coffee- project in northwest Vietnam.

Applying the Women’s Empowerment in Agriculture Index (WEAI), women rated perceptions of their decision-making over a range of 18 tasks related to household and agricultural responsibilities and use of income and social activities (over 18 months). There were improvements in decision-making power in categories with previously low participation and increased sharing of domestic responsibilities (biggest gains were decision-making over large purchases and use of income). Also found that husbands to women in the study embraced more equal sharing of responsibility and decision-making with their wives.
This report is 40 pages long. Read More...

The crisis we can still avert

By September of 2022, the global food crisis had gotten so extreme that 205.1 million people urgently need humanitarian food assistance just to survive. Tragically, if we do nothing, the crisis could grow by another 620.9 million people in the next 6 months. That is the crisis we can still avert. Investing in food production, increasing resilience, and functioning markets can stave off this crisis if we act fast.

A recent report from Gro Intelligence and CRU Group estimates that the impacts from the Ukraine crisis on nitrogen fertilizer availability in the global agriculture system will lead to a total loss of 72 trillion calories of food produced in 2022 alone. That loss would cause 620.9 million MORE people who are already struggling to meet their basic food needs to lose at least one more meal a day for the next 6 months. This is the crisis that is coming—growing the current crisis by more than three times higher the 205.1 million people already experiencing food crisis.

Gender inequality will play a significant role in this crisis. Based on current trends in gender equality and food security, 332.8 million of these people will be women. That means 44.7 million more women than men could miss one meal a day for the next 6 months. Women could miss 8.5 billion more meals than men.

This is not a foregone conclusion. We can still act to prevent the worst of the crisis. The number of calories lost is only part of the story. Food insecurity is as much as story of inequality as it is of food production. Read More...

EVALUATION OF LIFESAVING SHELTER, PROTECTION AND HEALTH SUPPORT FOR SOUTH SUDANESE REFUGEES IN UGANDA Rhino extension – Omugo, Arua District

CARE international in Uganda has been implementing a project on “Lifesaving Shelter, Protection and Health Support for South Sudanese Refugees in Uganda” between July 2017 and March 2018. The grant was awarded by the department of Foreign Affairs, Trade and Development (DFATD), International Humanitarian Assistance Division, through Global Affairs Canada (GAC). The GAC project was implemented in Rhino camp extension, Omugo, with a total project cost of 750,000 Canadian Dollars. The ultimate aim of the intervention was to save lives, reduce suffering, and maintain human dignity of refugees and the host communities in the Rhino settlement expansion site, with focus on the three thematic areas;
1) Increased access to appropriate, safe and dignified emergency temporary shelters for South Sudanese refugees, especially women, children and persons with special needs (PSNs) in Rhino Settlement Expansion Site;
2) Increased protection from GBV and sexual exploitation and abuse for refugees & host communities, particularly women and girls in Rhino Settlement Expansion Site; and
3) Increased access to critical SRMCH services for newly arrived refugee Pregnant and Lactating Women (PLW) to Rhino Settlement Expansion Site.
The project was designed to reach a total of 26,400 beneficiaries, 15,840 (60%) of whom are women and girls. Persons with Special Needs (PSNs) were a core target under this intervention, as well as women and girls, including Pregnant and Lactating Women (PLW). The majority of direct beneficiaries were South Sudanese refugees, with activities such as training and awareness raising also benefiting members of the host population. Read More...

At the last mile: Lessons from Vaccine Distributions in DR Congo

The Democratic Republic of the Congo (DRC) has one of the lowest COVID-19 vaccination rates in the world, with just 0.87% of people in DRC having received even one dose. While the country has received 8.2 million doses of COVID-19 vaccine, it has managed to administer 528,000 of them—just under 11% of vaccines available. In April of 2021, DRC became one of the first countries to return 1.3 million COVID-19 doses to COVAX because they could not deliver them to people before the vaccines expired.

The challenges that risked more than a million doses expiring are still in play for most of the country. In both January and February 2022, 114,705 vaccines expired in country because there was not enough investment in systems and health workers to deliver vaccines. To reach 70% of the population—62.7 million people—DRC will need to drastically scale up and accelerate COVID-19 vaccination.

CARE is working with 4 vaccination sites—2 in Butembo and 2 in Goma—to support with community mobilization in partnership with local leaders, health center operations, and training. With joint action and communication plans developed with chiefs, religious leaders, and local authorities, and additional equipment to protect health workers, those sites had vaccinated 1,132 people. In those 4 sites, we have also conducted several rounds of research and problem-solving using community dialogues between health workers and clients using the Community Scorecard, as well as the Social Analysis and Action tools, which provides the insights for this case study. The team has also supported local vaccination teams with IT infrastructure, personnel costs, and creating locally adapted COVID-19 communications plans.

Version Francaise
La République démocratique du Congo (RDC) possède un des taux de vaccination les plus bas dans le monde avec la lutte contre COVID-19. Seulement 0,87% des personnes en RDC ont reçu même une seule dose du vaccin. Alors que le pays a reçu 8,2 millions de doses de vaccin contre la COVID-19, il n’a réussi qu’à en administrer 881,204, soit un peu moins de 11% des vaccins disponibles administrés. En avril 2021, la RDC est devenue l’un des premiers pays à restituer 1,3 million de doses de COVID-19 à COVAX parce qu’elle ne pouvait pas les administrer aux personnes avant l’expiration des vaccins.

Les défis qui risquaient d’expirer plus d’un million de doses sont toujours en jeu pour la majeure partie du pays. En janvier et février, 114,705 doses ont expiré dans le pays parce qu’il n’y avait pas assez d’investissements dans les systèmes et les agents de santé pour livrer des vaccins. Pour atteindre 70 % de la population, soit 62,7 millions de personnes, la RDC devra considérablement intensifier et accélérer la vaccination contre la COVID-19.

CARE travaille avec 4 sites de vaccination – 2 à Butembo et 2 à Goma – pour soutenir la mobilisation communautaire en partenariat avec les leaders et structures locaux, les opérations des centres de santé et la formation. Ces sites avaient vacciné 1 132 personnes. Dans ces 4 sites, nous avons également mené plusieurs séries de recherches et de résolution de problèmes à travers des dialogues communautaires entre les prestataires des services et les clients avec la Carte Communautaire et l’analyse et l’action sociale, à l’aide de la carte de pointage communautaire, qui fournit les informations nécessaires à cette étude de cas. On a aussi appuyé les missions de supervisions avec l’infrastructure pour la connexion internet, la motivation des prestataires, et l’élaboration des plans de communication adaptes aux contextes.
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Evaluation of Zambia’s First 1,000 Days Nutrition Programme

National Food and Nutrition Council (NFNC) and several donors—including the United Kingdom’s Department for International Development (DFID), Irish Aid, and the Swedish International Development Cooperation Agency (SIDA) —designed a bundled, multisector programme called the First 1,000 Most Critical Days Programme (MCDP). The MCDP will run for three years (from late 2014 through 2016) in 14 districts across Zambia, and it includes targeted interventions such as micronutrient supplementation; promotion of best practices in breastfeeding and complementary feeding; promotion of diverse diets for pregnant and lactating women; zinc treatment for diarrhoea; promotion of safe water, hygiene, and sanitation; growth monitoring; deworming; and management of acute malnutrition. The impact evaluation of the MCDP consists of four components, the first of which is the rapid qualitative assessment (RQA). The RQA is intended to facilitate formative research and is designed to provide tailored, programme-relevant information to MCDP implementers in order to guide refinements to the programme. It was developed around one central research question: “What is the nature and experience of poverty and undernutrition, including access to food, dietary and feeding practices, and behaviour for households with young children in rural Zambia?” To answer this question, the RQA employed three primary methods of data collection: focused ethnographic studies (FESs); focus group discussions (FGDs); and social mapping (SM). (84 pages) Read More...

An Operational Learning Brief on Integrating Cash Assistance into Gender-Based Violence Programming in Ocaña, Colombia

With the deterioration of the economic and political situation in Venezuela, a humanitarian crisis has spilled into 16 countries across Latin America and the Caribbean, including Colombia. Colombia hosts 2.4 million Venezuelans as at
2021. Internal displacement and confinement escalated in 2019, due to a variety of armed non-state actors competing for income from narcotrafficking, human trafficking, and illegal mining.2 Despite being increasingly overshadowed by the Venezuelan migration crisis, the preexisting internal conflict in Colombia has ensured that the country has the second-largest number of internally displaced persons in the world (after Afghanistan), with an estimated 9.2 million people experiencing protracted displacement. Read More...

Haiti COVID-19 Rapid Gender Analysis

Suite à la propagation de la pandémie de la COVID-19 en Haïti qui a fait, jusqu’au 11 juillet 2020, 6727 cas de contamination et 139 morts, la population haïtienne, comme cela se passe au niveau mondial, est en train de subir les diverses conséquences de cette crise.
Certainement, celles-ci ne sont pas les mêmes partout dans le monde.
Elles changent avec la réalité socioéconomique des pays. Les retombées de cette crise sont de nature sanitaire, économique, psychologique et sociale. Cependant, les hommes et les femmes et les différentes catégories sociales ne sont pas affectés au même degré, selon leur niveau de vie, leur habilité (physique et mentale), leur orientation sexuelle et probablement d’autres facteurs qui ne sont pas pris en compte dans le cadre de l’enquête. L’Analyse Rapide Genre (ARG) vise à fournir des données et preuves sur les besoins
différenciés des femmes et des hommes par rapport à l'impact de la COVID-19 sur la vie des deux sexes en Haïti, en particulier les femmes qui représentent un groupe vulnérable et font face à de multiples discriminations. Cette démarche permettra de développer advantage des efforts sensibles au genre visant la prévention de la propagation de la COVID-19 par toutes les parties prenantes au niveau national, régional et local. En ce sens, l’ARG prend fondamentalement en compte les inégalités entre les sexes, les inégalités socioéconomiques, et tout ce qui peut engendrer des différences dans la manière dont les groupes sociaux sont affectés par la crise de la COVID-19. L’enquête qui conduit à cette analyse a été réalisée sur les dix départements géographiques du pays. Read More...

Best Approaches from the Disaster READY Project Phase II to be Replicated at Scale by Government and/or Other Partners

This report analyzes best practices in Disaster Risk Management (DRM) derived from the second phase of the Disaster READY Project (DRP II), implemented by five agencies under the Australian Humanitarian Partnership (AHP). It identifies approaches that can be effectively scaled by the government and other partners in Timor-Leste, focusing on the inclusion of vulnerable populations. The evaluation investigates the effectiveness, inclusiveness, and localization of various project implementation strategies. Among the highlighted activities, Community Action Planning (CAP), Small Scale Disaster Mitigation Activities (SSDRMA), and Participatory Community Risk Assessment (PCRA) emerge as the most successful, showcasing a significant impact on community resilience and disaster preparedness while emphasizing the importance of local engagement and support for vulnerable groups.

Donor: Department of Foreign Affairs and Trade (DFAT), Australian Government
Total Page Count: 39

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