End of Project evaluation

(Epidemic Control and Reinforcement of Health Services (ECRHS) Phase 1 Programme in Sierra Leone)

This report presents findings from the end phase evaluation of the Epidemic Control and Reinforcement of Health Services (ECRHS) Phase 1 Programme in Sierra Leone, which was implemented from November 2015 to December 2018. The aim of the Programme is to ‘Improve the health status of the population of Sierra Leone’. The Programme was originally designed to provide response to the Ebola outbreak in Sierra Leone, but also considered a longer-term view and worked towards putting in place preparations putting in place preparations for the transition of an extended health system strengthening (HSS) effort.

The overall purpose of the evaluation was ‘to assess result and impact of the above-mentioned Epidemic Control and Reinforcement of Health Services Programme against the Programme goal and outcomes in targeted northern region of Sierra Leone. The evaluation was specifically commissioned to; 1) Assess the Programme result areas in relation to effectiveness, relevance and efficiency of the Programme, 2) assess changes made in general conditions and perspectives, 3) assess need for additional (Programme-) support in future, 4) assess sustainability of achieved results with respective to the DHMTs and Community-based Surveillance (CBS) system, 5) identify the Programme’s key challenges during implementation, and lessons learnt/best practices, and 6)generate concrete recommendations for decision making process regarding health and SRH Programming in the future.

The Evaluation integrated both quantitative and qualitative research methods. 1,608 respondents were randomly selected from across 80 communities for households/individual interviews. This sample included 1,196 female and 412 male respondents. Focus Group Discussions (FGDs) were held with community members in 60 communities and 30 key informant interviews (KIIs) were done with CARE, implementing partners, state actors and chiefdom authorities. Twenty-seven (27) Community Health Workers (CHWs) and 5 Water Management Committee members were also interviewed. Also, facility assessment was conducted for -77 PHUs using the Ministry of Health and Sanitation standard tool and case studies/insight stories were further documented from the field interviews.
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Emergency Water, Sanitation, Hygiene and Nutrition for Crisis Affected Communities in East Darfur and South Darfur, Sudan, 2017-2019

The project under evaluation was a two-year project implemented in one locality in South Darfur and three localities in East Darfur during the years 2017 and 2019. The Project was implemented by CIS in partnership with two local organizations and in cooperation with the State institutions.

The intervention activities are tailored to address urgent lifesaving needs of the vulnerable communities through improving communities’ access to WASH facilities and nutrition services. Where, the two components are expected to complement each other and the resultant outcomes are expected to reflect on the improvement of maternal and child health in particular.

The ccomparison of the actual implementation with the planned showed that the types of the activities implemented conform to the planned and that planned outputs are almost completed in accordance with the plan in quantitative and qualitative terms. while the number of beneficiaries reached exceeded the target by about 30%.
As immediate outcomes, IDPs and refugees’ camps expressed improvement in their access to safe drinking water, where 98.6% indicated obtaining water from protected sources. They also revealed satisfaction with availability of water by 65% of the HHs and the water distance has been cut to about 320 m in SD and to 106 m in ED, with an average water distance of 213 meter.

Evident progress has been made along communities’ access to and use of latrines, including women, where, 89.3% and 86.1% of target community members indicated their access to and regular use of latrines. The created hygiene awareness has induced the required positive changes in hygiene and sanitation attitude and practices among communities.

In overall, the treatment of malnutrition reached 80% of the cases and for both girls and boys the cure rate is 75% also for both sexes and the Number of MAM cases treated ranges between 10 to 15 daily, while number of PLW treated ranged between 4 to 7 women daily.

Ultimately, The WASH and nutrition interventions the project delivered so far have addressed emergency humanitarian needs of the IDPs and host communities, without which their lives would have been at great risk. The inadequate unsafe water sources are now more accessible, clean and healthy. The personal hygiene and environment has much improved due to increased awareness and positive change in attitude and practices. VSLAs have added a new livelihood means for women and their families by starting to save and becoming economically active and contributing to households’ budget.
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The Gendered Dimension of Multi-Purpose Cash Supporting Disaster Resilience (Arabic)

In 2017, in response to the mounting humanitarian crisis in Yemen, CARE Yemen and Action Contra la Faim (ACF) implemented a cash transfer program and community asset rehabilitation and skill building programing in the governorates of Abyan and Amran. This European Union (EU)-funded program integrated these interventions to enhance resilience building at household and community levels.
The overall objective of this study is to assess the impact of the Multi-Purpose Cash (MPC) on the resilience of households targeted by the program, with a focus on the experiences of female-headed households, their challenges with increasing their resilience, and barriers that male-headed households do not face. Read More...

Indashyikirwa programme to reduce intimate partner violence in Rwanda: Report of findings from a cluster randomized control trial

Intimate partner violence (IPV), which includes physical and sexual violence, economic abuse and emotional aggression within intimate relationships, is the most common form of violence against women globally. IPV can lead to a wide range of negative health consequences including depression, anxiety, suicidal ideation, post-traumatic stress disorder, drug and alcohol abuse, serious injuries, and death. The Indashyikirwa programme in Rwanda sought to reduce experience of IPV among women and perpetration of IPV among men, and also to shift beliefs and social norms that sustain IPV in communities and couples. The programme also strove to support equitable, non-violent relationships, and ensure more supportive and empowering responses to survivors of IPV seeking assistance. The impact evaluation of Indashyikirwa assessed whether and how the programme met these objectives and sought to inform the global best practices in IPV prevention by generating evidence through a rigorous community randomized controlled trial (cRCT).

The quantitative impact evaluation of Indashykirwa took the form of a cRCT with randomization at sector level and two separate evaluation components: (1) a cohort of control and intervention couples interviewed at baseline, 12 months, and 24 months, and (2) a pair of cross-sectional community surveys with control and intervention communities implemented at the beginning of the programme and 24 months later. This quantitative impact evaluation was accompanied by in-depth process evaluation and qualitative research with beneficiaries and programme staff. Read More...

Endline evaluation of WASH project in West Mosul, Iraq

This is an endline evaluation for the "Improving Sanitation, Hygiene, Renovation of Sewage Systems" project, funded by the Ministry of Foreign Affairs of the Czech Republic.
This project addressed critical needs for sanitation services in West Mosul, as a direct contribution to enable the affected populations to return home. The project aimed to repair two vital sanitation resources/infrastructure in West Mosul and to support the municipal authorities to build their capacity to eventually recover their costs, once the situation allows. Finally, the project intended to mobilize local communities towards greater ownership for their local environment, to avoid the recurrence of such sanitation risks and maintain a cleaner, more habitable environment. In addition to mitigate a number of health risks related to poor sanitation in urban areas, CARE’s engagement aimed to promote social cohesion and community participation among vulnerable populations affected by the conflict.
The End-line project Evaluation is intended to assess the relevance, performance, management arrangements and success of the project. It looks at signs of potential impact of project activities on men,
women, girls and boys identified as vulnerable and the sustainability of results, including the contribution to capacity development. The Evaluation also identifies, and documents lessons learnt and makes recommendations that project staff and the stakeholders might use to improve the design and implementation of other related projects and programs. Read More...

Are there gendered impacts to multi-purpose cash transfers intended to build resilience?

STARTING IN 2017 CARE YEMEN, in partnership with Action Contre la Faim (ACF), implemented a European Union (EU) consortium-funded resilience program in Abyan and Amran governorates. The project used a “Cash Plus” approach, combining ten monthly multi-purpose cash (MPC) transfers with the rehabilitation of vital community assets and livelihoods skills support. The program focused on previously underserved areas to enhance food and nutrition security, promote livelihood recovery and resilience of vulnerable
households, and stimulate local markets. Both interventions were deliberately integrated to enhance resilience building at the household and community levels.
See full evaluation here: http://careevaluations.org/evaluation/the-gendered-dimension-of-multi-purpose-cash-supporting-disaster-resilience/ Read More...

The Gendered Dimension of Multi-Purpose Cash Supporting Disaster Resilience

In 2017, in response to the mounting humanitarian crisis in Yemen, CARE Yemen and Action Contra la Faim (ACF) implemented
a cash transfer program and community asset rehabilitation and skill building programing in the governorates of Abyan
and Amran. This European Union (EU)-funded program integrated these interventions to enhance resilience building at
household and community levels.
The overall objective of this study is to assess the impact of the Multi-Purpose Cash (MPC) on the resilience of households
targeted by the program, with a focus on the experiences of female-headed households, their challenges with increasing
their resilience, and barriers that male-headed households do not face. Read More...

Better Environment for Education Project Endline

Throughout the past two decades, Rwanda has made significant efforts to improve the coverage of education to ensure that all Rwandans have access to quality education through the completion of secondary school. Despite policies to increase access to basic education and increase enrolment rates, dropout remains a key issue, especially in secondary school where female students tend to have lower completion rates than male students.
To promote better educational, social, and economic outcomes for students, CARE Rwanda established the Better Environment for Education (BEE) Project. Operating in the Western Province of Rwanda, the BEE Project provided holistic support--including academic resources, financial literacy training, and sexual and reproductive health education, and leadership training--to students to address obstacles to secondary education. As the BEE project neared its conclusion in 2019, CARE Rwanda commissioned this endline evaluation to assess trends and changes over time in students’ knowledge, attitudes, and practices related to the intervention’s aims. Read More...

Siaya Maternal and Child Nutrition Nawiri Project

The Siaya Maternal and Child Nutrition Nawiri Project was a 36-months intervention on maternal and child nutrition. The project was executed in partnership with 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 Commission (EC), the Austrian Development Agency (ADA) and CARE. The overall objective of the project was to contribute to improving maternal, infant and young child nutrition (MIYCN), including nutrition of women of reproductive age, in Siaya County.

The specific objectives of the end-term evaluation of the Nawiri Project were to: (1) assess against the project goal, objectives and expected results based on the indicators of the project log-frame; (2) assess the project objectives and proposed outcomes by measuring performance against each indicator under each result area and analyze key determinants that were positively or negatively critical for obtaining these results; (3) assess the efficiency of the process of achieving results. Under this objective, the evaluation would determine the contribution of the adopted gender equality Social Analysis and Action (SAA) Model and rights based approach project, community score card strategy for social accountability, advocacy strategies for political commitment, role of mother to mother support groups, male champion curriculum and training, role of MIYCN Trainer of Trainers (ToTs), impact of community outreaches, food demonstration sessions, public participation by CHVs during budget development process towards achieved results; (4) evaluate the efficiency of the organizational set‐up for the project (partnership arrangement) and systems used in the delivery of the project and to what extent these contributed to or inhibited the delivery of the project outcomes; (5) assess how gender aspects have been considered and included in the implementation (with specific focus on gender mainstreaming, setting of gender equality goals), inter alia, how women had participated or were represented meaningfully in decision-making and feedback; (6) assess the level of sustainability (financial, institutional and social) of the individual project components, and identify critical areas that may affect sustainability; and (7) provide recommendations on future project design including how to ensure effectiveness of log frames. Read More...

PROFIT Financial Graduation

The PROFIT Financial Graduation Sub-Component, funded by the International Fund for Agricultural Development (IFAD) and the Government of Kenya (GOK), aimed to enable vulnerable women and youth to build sustainable livelihoods and reduce risk aversion on supply and demand sides of financial sustainability through a sequenced set of interventions, including an asset transfer, technical and life skills training, mentorship, consumption and savings support. The program targeted 1,000 women and youth in Kitui and 1,600 women in Samburu. Ultimately, the goal of the program is to place vulnerable households on an upward trajectory out of ultra-poverty.
Since January 2017, with technical assistance from BRAC USA, the PROFIT Financial Graduation program was implemented by The BOMA Project and CARE International Kenya in Samburu and Kitui, respectively. Expanding Opportunities conducted a quasi-experimental impact evaluation of the PROFIT Financial Graduation pilots by assessing changes in income, savings, food security, health, and confidence that can be reliably attributed to program activities. This report comprises the results of the endline impact evaluation. Read More...

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