Special Evaluation/Report
Recipe for Response: What We Know About the Next Global Food Crisis, and How to Fight it
The genesis of the present hunger crisis goes back farther than February 2022 and is due to a combination of global and localized factors. Globally, climate change has compromised agricultural livelihoods and led to displacement, especially in regions like the Horn of Africa and Central America’s Dry Corridor, where famers struggle to produce yields that meet the needs of local markets. The global economic fallouts associated with COVID-19, and inadequate social safety nets, have led to record unemployment and growing poverty—especially for women and women-led households (UN Women 2021)—so that even where food is available, high prices put basic items out of reach for many. Armed conflict is also driving food insecurity, for example by making it difficult for farmers to cultivate their lands, or damaging or disrupting vital agricultural infrastructure—such as transportation, storage and distribution sites—and reducing access to markets and assistance.
Women and girls are disproportionately impacted by food insecurity and related shocks. Gender norms and roles mean that women are often responsible for their households’ food security, including shopping for and preparing food, yet they might also be the ones to eat “last and least” in their household. Women are also more likely to be excluded from decision-making when it comes
to addressing hunger in their communities (CARE 2020). These types of gendered imbalances hurt entire communities: in a 2021 assessment in Sudan, CARE found that 82% of people living in female-headed households reported recently skipping a meal, compared with 56% of people living in male-headed households. Read More...
Women and girls are disproportionately impacted by food insecurity and related shocks. Gender norms and roles mean that women are often responsible for their households’ food security, including shopping for and preparing food, yet they might also be the ones to eat “last and least” in their household. Women are also more likely to be excluded from decision-making when it comes
to addressing hunger in their communities (CARE 2020). These types of gendered imbalances hurt entire communities: in a 2021 assessment in Sudan, CARE found that 82% of people living in female-headed households reported recently skipping a meal, compared with 56% of people living in male-headed households. Read More...
How Bangladesh Is Getting COVID-19 Vaccines to the Last Mile
Bangladesh has been one of the fastest countries receiving COVAX support to scale up vaccines, delivering more than 221 million vaccines by March 14, 2022. 54% of Bangladesh’s population is fully vaccinated, and another 22% have received at least one dose. Bangladesh is on track to meet its goal of 70% of the population fully vaccinated by September 2022.
Close coordination across multiple actors—from the Government of Bangladesh to INGOs like CARE to local health entrepreneurs—have been one of the keys to success. Working closely with the government-led National Vaccination and Deployment Plan and innovating when there have been gaps and challenges have helped achieve this success. These strategies continue to make sure that vaccines reach the people who need them most.
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Close coordination across multiple actors—from the Government of Bangladesh to INGOs like CARE to local health entrepreneurs—have been one of the keys to success. Working closely with the government-led National Vaccination and Deployment Plan and innovating when there have been gaps and challenges have helped achieve this success. These strategies continue to make sure that vaccines reach the people who need them most.
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Advancing gender equality in coral reef social-ecological systems
Gender equity is considered to be a foundation for the resilience and wellbeing of people dependent on coral reef social-ecological systems. Nonetheless, gender inequality persists, and many interventions are still struggling to meet in practice the commitments they make on paper. Gender transformative approaches (GTAs) are considered the frontier of gender research and development because they challenge and shift the invisible social constructs that underpin and perpetuate inequities. A collaboration between the ARC Centre of Excellence for Coral Reef Studies at James Cook University, WorldFish, and CARE International sought to determine the extent to which GTAs have been applied alongside or within the management and conservation of coral reefs. The intent of our work is to increase awareness of and knowledge about GTAs among funders, researchers, development agencies, and fisheries and conservation stakeholders who seek to advance gender equality in coral reef-social ecological systems. Read More...
She Told Us So (Again)
COVID-19’s impacts around the world are worse than they were in September 2020. Far from a return to “normal,” women and girls CARE works with around the world are saying that their situation continues to get worse as COVID-19 drags on amid other crises. Fati Musa in Nigeria says, “Women have suffered a lot during the pandemic, and we are not yet recovering from this hardship.” 55% of women were reporting gaps in their livelihoods as a priority in 2020. Now that number is 71%. For food insecurity, the number has jumped from 41% to 66%.
Since March of 2020, CARE—and more importantly, the women CARE works with—have been warning that COVID-19 would create special challenges for women and girls, above and beyond what men and boys would face. Tragically, these women were exactly right. What they predicted even before the WHO declared a pandemic has come true. In September 2020, CARE published She Told Us So, which showed women's and men's experiences in the pandemic so far. In March 2022, updated data shows that the cost of ignoring women continues to grow. For more than 22,000 people CARE has spoken to, COVID-19 is far from over. In fact, the COVID-19 situation has gotten worse, not just for women, but for men, too.
Ignoring the voices of women, girls, and other historically marginalized groups has worsened the situation for everyone—not just for women. Men are more than twice as likely to report challenges around livelihoods, food insecurity, and access to health care as they were in 2020, and are three times more likely to report mental health challenges—although they are still only two-thirds as likely as women to report mental health as a priority. As women burn through their coping strategies and reserves, men are also facing bigger impacts over time.
Women have stepped up to the challenge—especially when they get support from each other and opportunities to lead. They are sharing information, preventing COVID-19, and using their resources to support other members of their communities. 89% of women in savings groups in Yemen are putting some of their savings to help others. Women are stepping into leadership roles, "We are women leaders in emergency . . . we have the capacity to say: I have a voice and a vote, I am not going to stay stagnant . . . (participant, Colombia). In Niger, women are saying, “Now we women are not afraid to defend ourselves when a decision does not suit us. We will say it out loud because our rights are known and we know the ways and means to claim our rights.”
Those accomplishments are impressive, but they come at a cost. The constant struggle for their rights, and for even the most basic necessities, is taking its toll. Women are almost twice as likely to report mental health challenges as they were in 2020. As one woman in Iraq describes, “If any opportunity appeared, the man would be the favorite . . . This psychologically affected many women, as they turned to household work which included preparing food and cleaning only.”
To understand these challenges and create more equitable solutions, CARE invests in listening to women, men, and people from marginalized groups to understand the challenges they face, what they need, and the ways in which they lead through crisis. This report represents the voices of more than 22,000 people in 23 countries since September of 2020.
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Since March of 2020, CARE—and more importantly, the women CARE works with—have been warning that COVID-19 would create special challenges for women and girls, above and beyond what men and boys would face. Tragically, these women were exactly right. What they predicted even before the WHO declared a pandemic has come true. In September 2020, CARE published She Told Us So, which showed women's and men's experiences in the pandemic so far. In March 2022, updated data shows that the cost of ignoring women continues to grow. For more than 22,000 people CARE has spoken to, COVID-19 is far from over. In fact, the COVID-19 situation has gotten worse, not just for women, but for men, too.
Ignoring the voices of women, girls, and other historically marginalized groups has worsened the situation for everyone—not just for women. Men are more than twice as likely to report challenges around livelihoods, food insecurity, and access to health care as they were in 2020, and are three times more likely to report mental health challenges—although they are still only two-thirds as likely as women to report mental health as a priority. As women burn through their coping strategies and reserves, men are also facing bigger impacts over time.
Women have stepped up to the challenge—especially when they get support from each other and opportunities to lead. They are sharing information, preventing COVID-19, and using their resources to support other members of their communities. 89% of women in savings groups in Yemen are putting some of their savings to help others. Women are stepping into leadership roles, "We are women leaders in emergency . . . we have the capacity to say: I have a voice and a vote, I am not going to stay stagnant . . . (participant, Colombia). In Niger, women are saying, “Now we women are not afraid to defend ourselves when a decision does not suit us. We will say it out loud because our rights are known and we know the ways and means to claim our rights.”
Those accomplishments are impressive, but they come at a cost. The constant struggle for their rights, and for even the most basic necessities, is taking its toll. Women are almost twice as likely to report mental health challenges as they were in 2020. As one woman in Iraq describes, “If any opportunity appeared, the man would be the favorite . . . This psychologically affected many women, as they turned to household work which included preparing food and cleaning only.”
To understand these challenges and create more equitable solutions, CARE invests in listening to women, men, and people from marginalized groups to understand the challenges they face, what they need, and the ways in which they lead through crisis. This report represents the voices of more than 22,000 people in 23 countries since September of 2020.
Read More...
The Cost of Delivering COVID-19 Vaccines in Zambia
While Zambia aims to deliver COVID-19 vaccines to 70% of its people by June 30, 2022, the road to getting there is uncertain. The Zambian Ministry of Health reports that, as of February 21, 2022, 21.6% of people were fully
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...
POST PROJECT SUSTAINABILITY (PPS) STUDY FOR VISTAR-II PROJECT
CARE Nepal and Handicap International implemented a community-based disaster risk reduction project called VISTAR-II in Kailali, Dadeldhura, Kanchanpur, and Dang districts under the DIPECHO-VIIII cycle. This project was for a period of 22 months from March 1, 2015, to December 31, 2016. The project aimed to strengthen the resilience of communities and institutions to natural disasters through building leadership and management capacities from the community level to the national level. After five years of the VISTAR-II intervention, a Post Project Sustainability Study was carried out in two randomly selected intervention districts, namely Kailali and Kanchanpur. out of the four districts. Read More...
CARE Malawi COVID Vaccine Delivery Situation January 2022
“The vaccines are here but support for delivery is most needed, especially at the last mile.” – District Health Management Team member, Ntcheu
As of January 10, 2022, Malawi had delivered 1.84 million doses of vaccine out of the 3.12 million doses it has received so far.1 Many doses in country have rapidly approaching expiration dates, and if they do not get to people fast, they risk expiring on the shelves. To make sure the 1.26 million doses left go to the people who need them most, we must invest more in communication, engagement, and delivery. The $37M granted by the World Bank over the past year is sufficient for covering only 8% of Malawi’s total population. What is more, as the highly contagious Omicron variant spreads worldwide, it is even more critical that more people are vaccinated now. We cannot assume that the Government of Malawi and its current health system can do it alone.
The government and other health actors in Malawi are working tirelessly to vaccinate people, while facing multiple health crises. The health system is building on a base of committed (if overstretched) health workers, an openness to community feedback, and a long expertise of delivering The government is coordinating closely with many actors to reduce gender gaps, get vaccines to the last mile, and keep existing health services open. Nonetheless, the Ministry of Health is under-resourced, and operating in a global system where the vaccine supply that arrives may be close to expiring. For example, doses of the Astra-Zeneca vaccine had to be destroyed in the spring, after arriving in Malawi with only two and a half weeks left before their expiration date.
More investment is needed. To take just one example, the national government has been able to provide one van per district to support mobile vaccination sites, to get vaccines to the last mile. Mobile vaccinations are the most effective way to serve people who live far away from health centers and do not have access to easy forms of transportation. That means that in Ntcheu, one van is expected to serve a target population of 214,929 people living over 3,424 square kilometers. One van cannot serve those people fast enough to make sure vaccines get where they need to in time, especially when an inconsistent and unpredictable vaccine supply could have doses expiring at any time. Read More...
As of January 10, 2022, Malawi had delivered 1.84 million doses of vaccine out of the 3.12 million doses it has received so far.1 Many doses in country have rapidly approaching expiration dates, and if they do not get to people fast, they risk expiring on the shelves. To make sure the 1.26 million doses left go to the people who need them most, we must invest more in communication, engagement, and delivery. The $37M granted by the World Bank over the past year is sufficient for covering only 8% of Malawi’s total population. What is more, as the highly contagious Omicron variant spreads worldwide, it is even more critical that more people are vaccinated now. We cannot assume that the Government of Malawi and its current health system can do it alone.
The government and other health actors in Malawi are working tirelessly to vaccinate people, while facing multiple health crises. The health system is building on a base of committed (if overstretched) health workers, an openness to community feedback, and a long expertise of delivering The government is coordinating closely with many actors to reduce gender gaps, get vaccines to the last mile, and keep existing health services open. Nonetheless, the Ministry of Health is under-resourced, and operating in a global system where the vaccine supply that arrives may be close to expiring. For example, doses of the Astra-Zeneca vaccine had to be destroyed in the spring, after arriving in Malawi with only two and a half weeks left before their expiration date.
More investment is needed. To take just one example, the national government has been able to provide one van per district to support mobile vaccination sites, to get vaccines to the last mile. Mobile vaccinations are the most effective way to serve people who live far away from health centers and do not have access to easy forms of transportation. That means that in Ntcheu, one van is expected to serve a target population of 214,929 people living over 3,424 square kilometers. One van cannot serve those people fast enough to make sure vaccines get where they need to in time, especially when an inconsistent and unpredictable vaccine supply could have doses expiring at any time. Read More...
Dignified and Violence-Free World of Work: A Study on Women Working in Informal Sectors in Nepal
A significant percentage (66.5%)1 of women in Nepal work in informal sectors and are vulnerable to all forms of violence and exploitation. The violence experienced by women in informal sectors ranges from physical, sexual, and verbal harassment to labor and economic exploitation by employers, co-workers and family members. Existing legal provisions such as Sexual Harassment (Elimination) at Workplace Act, 2015 do not have specific provisions for informal sectors whereas other mechanisms to address violence against women, in general, remain ineffective in implementation. In addition, socio-cultural norms and structures limit women’s access to justice-seeking mechanisms. Despite pervasive instances of violence and harassment experienced by women in informal sectors, there is a dearth of comprehensive documentation and evidence building on this issue. In this light, the paper examines the existing status, nature and experiences of violence faced by women working in diverse areas of the informal economy. It also critically analyses key gaps in existing legal provisions/policies and barriers to implementation from the perspective of informal sector workers.
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
Nepal COVID-19 Vaccine Costing Study
By December 6, 2021, 19.2 million doses of COVID-19 vaccines have been administered in Nepal, enough for 36% of the population to have gotten at least one dose of vaccine. After a rough road with unpredictable vaccine supply, the government has been able to procure several million vaccine doses. Now delivery at the last mile is the biggest hurdle they face. Nepal’s Minister of Health says, “We are not going have shortages of vaccines anymore, but our main concern and focus now is on getting these vaccines to all corners of the country, including the remote mountain areas.”
Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
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Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
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Don’t Leave Them Behind: Global Food Policies Continue to Fail Women (December 2021)
811 million people in the world are going hungry, half a million of whom are on the brink of starvation. Clearly, current approaches are simply not enough to meet the scale of the crisis we are facing. If we continue to do what we have always done, we will continue to see the same problem: people going to bed hungry. We must find better solutions to prevent and end hunger—especially if we are going to meet the Sustainable Development Goal of Zero Hunger by 2030.
One of the first things we can do is consider who is going hungry. Using the term “people” hides part of the problem: gender inequality. Globally, women are 10% more likely to go hungry than men, and that gap is growing. In Somalia, for example, men are eating smaller meals; women are skipping meals altogether. We see this inequality play out at the international level, too—global solutions consistently ignore women, their rights, and the critical role women play in food systems.
Of 84 global policies and plans designed to address hunger released between September 2020 and December 2021, only 4% refer to women as leaders who should be part of the solution or provide funding to support them. 39% overlook women entirely. This is unacceptable. Ending hunger will take everyone’s talents, opinions, and work. It requires promoting equality, respecting rights, and truly listening to the people who are on the frontlines of the problem. Local food producers and leaders—especially women—must be a core part of the solution.
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One of the first things we can do is consider who is going hungry. Using the term “people” hides part of the problem: gender inequality. Globally, women are 10% more likely to go hungry than men, and that gap is growing. In Somalia, for example, men are eating smaller meals; women are skipping meals altogether. We see this inequality play out at the international level, too—global solutions consistently ignore women, their rights, and the critical role women play in food systems.
Of 84 global policies and plans designed to address hunger released between September 2020 and December 2021, only 4% refer to women as leaders who should be part of the solution or provide funding to support them. 39% overlook women entirely. This is unacceptable. Ending hunger will take everyone’s talents, opinions, and work. It requires promoting equality, respecting rights, and truly listening to the people who are on the frontlines of the problem. Local food producers and leaders—especially women—must be a core part of the solution.
Read More...