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The Nawiri Project: Stories and Best Practices

The Siaya Maternal and Child Nutrition Nawiri Project is a 36-month intervention on maternal and child nutrition. The project targets to reach 94,435 children under 5 years; 127,065 women of reproductive age; 42,000 adolescent girls and 20,000 men in the Siaya County. The project is executed in partnership among three consortium members; CARE (the coordinator), Family Health Options Kenya (FHOK) and the Kisumu Medical and Education Trust (KMET) in Siaya County with funding support from the European Union, the Austrian Development Cooperation (ADC) and CARE.
The overall objective of the project is to contribute to improving maternal, infant and young child nutrition (MIYCN), including nutrition of women of reproductive age in Siaya County. In order to increase the nutritional status of children under the age of five and of women of reproductive age, the project aims to alleviate the most severe obstacles of poor MIYCN in Siaya County. Read More...

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 Study Report on the Link Between Land Use Planning and Rural Economic Growth through Mobile Applications in the Sagcot Area: A Case Study of Iringa Rural and Kilolo Districts

his study investigated ways in which mobile applications can best be used to link village land use planning and village economic growth so that CARE and its partners will more effectively engage key stakeholders in supporting smallholder farmers to find better ways of using their land to improve their economic wellbeing. This is because, after more than a decade of advocating for the land rights of smallholder farmers, CARE Tanzania is currently looking at how best village land use planning can, in addition to demarcation of village land and issuance of certificates of customary rights of occupancy (CCROs), help to transform the lives of those depending on land as a means of livelihood or identity.

More specifically, this study (a) assessed the extent to which village land use planning in Tanzania improves rural economy in general and the economic wellbeing of smallholder farmers in Tanzania; (b) identified and analyzed the best ways in which mobile applications can be used to link land use planning with rural economy and economic wellbeing of smallholder farmers; and (c) identified and analyzed economic, social, environmental and political factors which help or hinder smallholder farmers with formalized land rights, from improving their economic wellbeing. Read More...

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...

Impact Evaluation of Climate Change Adaptation for Resilient Small Scale Tea Production Project

The objective of the proposed study is to assess the impact of the climate change adaptation for resilient small scale tea production project with respect to set indicators for improved tea production and make recommendations.

The study had covered 30 percent of the impact population covered under the project for data collection. 150 tribal tea farming households out of 500 tea farmers and 33 hamlets out of 76 hamlets were covered. The desk review of project reports, documents, IEC materials and in depth interview with project staff involved in project development and implementation, physical verification of farms for adoption of best practices using a check list and taking photographs, in-Depth interview with key stakeholders like UPASI, Tea board members and other government line departments involved in the project, structured Interview with the tribal farmer, household members who are members of VLG, received trainings, participated in the programs like demonstration plots, adopted best practices, focused group discussion with VLG male and female members separately to identify challenges faced in adopting the best practices were done as part of the study. [49 pages]
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Rafah Governorate: Deception, Destruction & Death in the “Safe” Zone Rapid Gender Analysis

The ongoing crisis in the Gaza Strip has been described as a “human rights crisis, a human-made humanitarian disaster”1 and a “war on woman.”2 Since October 7th there has been mass scale forced displacement of over a million Palestinians from Northern Gaza to Southern Governorates. The subsequent impacts of this, compounded with pre-existing gender inequalities and multidimensional vulnerabilities, have disproportionately impacted women and girls, as well as other vulnerable groups such as persons with disabilities, children, pregnant and lactating women, elderly populations, those living with chronic and mental health conditions.
Aim and methodology: The aim of this RGA was to hear from women and men currently in Rafah, with a focus on those providing essential services to communities and Internally Displaced People (IDPs) in the Governorate. The aim was to better understand the experiences of women, men, girls and boys at this moment, and to identify how CARE and the local and international humanitarian community, including U.N. Agencies, can best respond - understanding the formidable challenges and barriers to do so.
This RGA was conducted at a time where the population of Rafah were subject to continued and threatened bombardment from land, air and sea. As such it was intentionally designed to be light and small scale in terms of primary data collection; which took place between 7th April to 17th April 2024, and is complemented by secondary data review and analysis.
This RGA is being published in the days surrounding further escalation of violence in Rafah. The Gaza side of the Rafah border crossing with Egypt is blocked 6 and an evacuation order has been issued in the Eastern parts of Rafah; the designated “safe zone” in the Gaza strip. This reinforces the voices of the men and women who told us, with no uncertainty, that nowhere in Gaza is safe.
Key findings related to each area of inquiry and recommendations are summarised below, with more details to be found in the main report.
Key findings:
1. Shifting Gender Roles: Continuous displacement has led to some traditional gender roles adapting and expanding, as well as others being reinforced. Increased and unrealistic pressure has been placed on women to meet the needs and demands of dependents in a highly stressful environment, which has led to an increase in verbal and physical violence against women.
2. Coping Mechanisms: On the verge of starvation, nearly the entire population in Rafah has reported extreme and harmful coping strategies including but not limited to bartering with other essential items, begging, gathering wild foods, scavenging under rubble or in trash or seeking food outside their shelter.8 Reports indicate some women are fasting for several days in a row,9 and boys and girls are forced to work on the street selling or begging. Female heads of household, older women and women with disabilities face security and protection obstacles seeking access to food distributions.10
3. Sustaining through Community Networks of Solidarity: Community solidarity has emerged as a lifeline for survival, such as women supporting children’s education and men distributing food parcels or organising activities for children. Religion and prayer have played a key role in the coping strategies of men, women and children. For youth, social media (when accessible) played a role to maintain connections, articulate fears and share experiences with others. For children, where possible, play and educational outlets within shelters provide a brief respite from the reality of airstrikes.
4. Maternal & Reproductive Health: With an overwhelmed and overstretched health system, people with disabilities, chronic conditions and trauma are left without the most basic care. With estimates of 155,000 women in Gaza pregnant or lactating, and 5,500 expected to deliver in the next month,11 the lack of adequate maternal, sexual and reproductive health services leave mothers, newborns and their children exposed to severe and life-threatening health risks. If women survive pregnancy and childbirth, postpartum recovery, including ability to breastfeed, also present severe challenges.12
5. Mental Health and Psychosocial Support Services (MHPSS): Of extreme concern is the severe emotional, physical and psychological distress among the displaced population, especially among children and youth. As caregivers do their best to survive and manage their own mental health, the impact on children and youth is extensive and holds intergenerational impacts.
6. Education: With formal education effectively stopped since October 7th, children have lost out on a whole academic year of education. While there were reports of some initiatives such as ‘informal learning circles’ and remote learning, these are not easily accessible. Parents, caregivers and children are focused on daily survival; there is the increasing need for adolescents and young girls to support with chores or be confined to their tents due to safety issues; and, particularly for boys, the need to help earn money or seek supplies for the family. Read More...

7th Pacific Regional Conference on Disability

Video with interviews with some of the forum's participants.
https://drive.google.com/file/d/1ravvpwL8Woubq6ARNSJYuCKV1_96s8oD/view
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A decade of results in Social Transformation for Pastoralist Women and Girls

CARE Ethiopia has spent the last 25 years working to better understand the lives of pastoralist communities in Ethiopia and how best to work alongside them for sustainable development. In the past decade alone, CARE Ethiopia has undertaken several analyses - studies, evaluations and assessments - that have provided valuable insight into how best to support pastoralists (women, men, girls and boys) to build a sustained quality of life. Pastoralists in Ethiopia are found in seven regions including Afar, Somali, SNNP, Oromia, Diredawa, Benshangul Gumuz and Gambella Regional States.

CARE has been at the forefront of encouraging a change in thinking in Ethiopia acknowledging that pastoralism should be regarded as a viable and economically effective livestock production system, and increasing awareness that widespread policies and practices are needed to reverse historical marginalization and address the now disproportionate levels of poverty and vulnerability faced by many pastoralist communities. Read More...

Addressing Root Causes Project in South Sudan

The Addressing Root Causes (ARC) project that started in September 2016, aims at tackling the root causes of armed conflict, instability and irregular migration in South Sudan by increasing community resilience to conflict-related and economically-induced shocks in 19 payams in Jonglei state in the counties of Pibor, Twic East, Duk and Bor. The project has distinguished three outcomes areas: Economic Resilience, Peaceful Conflict Resolution and Social Cohesion which are expected to be mutually reinforcing and when all are combined and stregthened together, the beneficial effects will contribute to more resilience and a culture of peace.
This mid-term review was conducted to assess the progress of project implementation since September 2016, and document best practices and lessons learned to inform key stakeholders on future activity design, programming, and implementation. Primary data was collected using household survey, key Informant Interviews and Focus Group Discussions with the targeted communities. Combined with the FGD, a Social Norm Analysis Plot (SNAP) framework was applied as it was considered best suited to measure changes in social (gender) norms.
Key findings from review indicate access to loans and training of VSLA groups is empowering women and youth in the targeted communities to engage in IGAs and micro-enterprises, thereby broadening their livelihood and resilience options and creating market linkages with traders across different ethnic communities. Further, more women and youth reported being confident to participate in economic opportunities and possess relevant tools and skills; and the role of women and youth is being appreciated in contributing to meeting household needs, thereby reflecting the conflict and gender transformation in the targeted communities. It should however be noted that more VSLAs have been formed and are engaged in IGAs and micro-enterprises in Duk and Twic East compared to Bor and Pibor.
Also, peace committees are appreciated and recognized by the targeted communities for facilitating and using peaceful mechanisms to mitigate and resolve intra and – inter community conflict and reconcile past grievances. Most project beneficiaries also reported increased collaboration with each other, and feel have more positive relationships and trust within and beyond their community. Read More...

Building sustainable and scalable peer-based programming: promising approaches from TESFA in Ethiopia

This research was written by Pari Chowdhary, Feven Tassaw Mekuria, Dagmawit Tewahido, Hanna Gulema, Ryan Derni, and Jefrey Edmeades.

In Ethiopia's Amara region, girls encounter child marriage at a high rate. They are also less able to negotiate sex or use family planning. With the purpose of improving their lives, CARE's TESFA program delivered reproductive health and financial savings curriculum to married girls through peer-based solidarity groups to 5,000 adolescent girls. This was divided into 3 interventions: sexual and reproductive health, economic empowerment, and a combination of both. Participants reported improvement in both areas. Four years after TESFA, 88% of groups communicated meeting without continued CARE's assistance, and some of the girl participants created new groups following the TESFA model. Also, some girls that did not participate in TESFA, replicated the model to create their own groups. Despite this, there is still in question who contributed to this sustainment and scale-up of groups.

Original article: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-021-01304-7
Originally published by Biomedcentral and is republished under the creative commons 4.0 license (https://creativecommons.org/licenses/by/4.0/ - https://creativecommons.org/publicdomain/zero/1.0/). Read More...

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