South Sudan: The True Cost of COVID-19 Vaccines

By July 18, South Sudan was able to administer the nearly all of the 60,000 doses of COVID-19 vaccine they had in stock through a series of smart investments in delivery, training, and social mobilization coordinated with several different partners. As new doses are projected to arrive in country in August, South Sudan continues to reinforce gaps in the health systems to make COVID-19 vaccinations possible without disrupting existing health services.

CARE’s estimated delivery costs from “tarmac to arm”1 for vaccines in these areas are $9.97 per dose of vaccine administered, or $22.22 per person fully vaccinated.

This is six times more expensive than current global estimate for delivery costs. For some actors providing vaccinations in South Sudan, the cost has been as high as $20 per dose administered when they include all costs. That’s because the health system in South Sudan is fragile, and it was already struggling to deliver even routine services. South Sudan is one of many health systems around the world that will need additional personnel, resources, and infrastructure to effectively deliver COVID-19 vaccines to at-risk populations, especially in hard-to-reach areas. The exact cost will continue to evolve as new vaccines arrive in country and the country vaccinates new groups of people. Read More...

GENDER AND COVID-19 VACCINES Listening to women-focused organizations in Asia and the Pacific

More than a year into the coronavirus pandemic, COVID-19 vaccines are being distributed across at least 176 countries, with over 1.7 billion doses administered worldwide. Combating the pandemic requires equitable distribution of safe and effective vaccines, however, women and girls are impacted by gaps both in the supply side and the demand side that hamper equitable distribution of the vaccine. Evidence reveals that 75 per cent of all vaccines have gone to just 10 countries, and only 0.3 per cent of doses have been administered in low-income countries. Very few of COVID-19 vaccines are going to those most vulnerable. The vaccine rollout in Asia and the Pacific has been relatively slow and staggered amid secondary waves of the virus. India, despite being the largest vaccine developer, has only vaccinated 3 per cent of the population and continues to battle a variant outbreak that, at its peak, was responsible for more than half of the world’s daily COVID-19 cases and set a record-breaking pace of about 400,000 cases per day.5However, the small Pacific nation of Nauru, reported a world record administering the first dose to 7,392 people, 108 per cent of the adult population within four weeks. Bhutan also set an example by vaccinating 93 per cent of its eligible population in less than two weeks. That success could be at risk, given the situation in India and the suspended export of vaccines. Read More...

Nepal Second Phase COVID-19 RGA

Nepal is currently undergoing the devastating effects of the second wave of COVID-19 pandemic. With the unprecedented surge in COVID-19 infections, the government of Nepal imposed prohibitory orders since April 29 in Kathmandu valley. Similarly, District Administration Offices (DAOs) in 75 out of 77 districts in the country have enforced prohibitory orders to break the chain of COVID-19 spread.1 As the country is reeling under the weight of increasing infections and death rates with fragile health infrastructure, there has been less attention to and evidence on gender and socio-economic impacts of the crisis on the most vulnerable and marginalized populations.
Global evidence from the previous year suggests that the pandemic led to disruption of social, political and economic systems and deepening of pre-existing gender and social inequalities. UN study 2020 highlights that the distribution of effect of any disaster or emergency correlates with the access to resources, capabilities, and opportunities which systematically make certain groups more vulnerable to the impact of emergencies, in particular women and girls.2 Women and girls in Nepal are particularly vulnerable to the immediate and long-term health and socio-economic impacts of the pandemic because of the pervasive inequalities in gender norms and structures.
The RGA conducted by CARE Nepal in partnership with Ministry of Women, Children and Senior Citizens (MoWCSC), UNWOMEN and Save the Children Women 2020 had shown that women’s unpaid care work and unequal division of labor were exacerbated because of closure of schools, public spaces, and care services. In addition, men’s loss of jobs and income and use of savings on gambling and alcohol had led to increased household conflict and women’s vulnerability to domestic violence. The study also revealed that 83 per cent of respondents lost their jobs; the hardest hit among them being women working as daily wage workers. The pandemic had also aggravated intimate partners and gender based violence for women and girls especially from marginalized groups such as Dalits, gender and sexual minorities (LGBTIQ++), women with disabilities, and adolescent girls. Read More...

Community Scorecard in Emergencies Learning Brief

To be effective and equitable towards global populations, humanitarian organizations must adhere to the core standards and principles on quality humanitarian response. Since the inception of ideas on the centrality of local participation in aid in the early 2000s and the more recent evolution of that concept into accountability towards affected populations, the humanitarian community has sought to turn this doctrine into reality.
Accountability in humanitarian response requires that organizations carry out their efforts in an ethically and legally responsible manner that is inclusive of the communities they are seeking to serve. Of UNICEF’s nine Core Humanitarian Standards (depicted here to the right), three specifically refer to mechanisms of accountability towards affected peoples: response is based on communication, participation and feedback; complaints are welcome and addressed; actors continuously learn and improve. In practice this could include centralizing the voices of affected peoples by engaging communities in needs and performance assessments and decision-making. Achieving this is often hindered by the constraints inherent to conflict settings such as lack of localization of assistance, communication between actors, and exploration of needs.
CARE’s Community Score Card
Seeking to actualize these principles of community participation and accountability into our programming, CARE developed the Community Score Card as part of a project aimed at developing innovative and sustainable models to improve health services. Working in crisis settings requires an understanding of the lived experiences of people, the power dynamics, and micro-politics that inform humanitarian response approaches. It also requires bridging the gap between civil society organizations, local and national governments, international non-governmental organizations, and impacted communities. Social accountability approaches do this by connecting citizens with those responsible for providing services. The Community Score Card (CSC) is a participatory social accountability mechanism for assessment, planning, monitoring and evaluation of services. Designed for ease of use and adaptation into any sector with a service delivery scenario, the CSC brings together users and providers of a particular service or program to jointly identify service utilization and provision challenges, mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement. The CSC has five phases: (I) planning and preparation; (II) conducting the scorecard with the community; (III) conducting the scorecard with service providers; (IV) interface meeting where the all parties present their findings in the presence of duty-bearers and then jointly develop action plans; and (V) monitoring of the action plans and evaluation of overall process. Read More...

Rapid Assessment on COVID-19 Vaccine Uptake by Urban Marginalised Population in Bangladesh

As of 31 March 2021, there have been 127,877,462 confirmed cases of COVID-19 worldwide, including 2,796,561 deaths in 223 countries as reported by WHO. Bangladesh had 6,11,295 confirmed cases of COVID-19 and 9,406 confirmed deaths till the end of March 2021. In response to this situation, the administration of the first dose of the COVID-19 vaccine officially started on 7 February 2021 in the national hospitals and health complexes all over Bangladesh. Despite acute demand for the vaccine, a great deal of misinformation and misconception is also apparent among general people. With the ongoing vaccine administration, it is very important to understand community acceptance of COVID-19 vaccinations.
People’s knowledge, attitudes and perceptions towards COVID-19 are of utmost importance for Government and policymakers to address all barriers to vaccine uptake and ensuring that everyone has access to vaccine. With these contexts, this survey aims to identify the overall COVID-19 vaccination perceptions among the urban marginalized population in Bangladesh based on three main objectives:
 Understanding the knowledge and practice related to COVID-19 prevention
 Assessing the knowledge and perspective regarding COVID-19 vaccination
program
 To know the status of vaccine uptake among marginalized population
The urban marginalized population were purposively selected, as they are more likely to be unaccounted for or have the least access to the COVID-19 vaccine administration process. In this survey, researchers captured only the population that are direct service recipient of the Urban Health Programme (garment workers and people who inject drug) and other groups who are available around the catchment areas of the service centres of the facilities. Read More...

Promoting Economic Resilience of Syrian Women (PERSEVERE) Annual Project Results Report (April 2020 – March 2021)

“Promoting Economic Resilience of Syrian Women” (PERSEVERE, CAD$8,497,675) is undertaken with the financial support from the Government of Canada, provided through Global Affairs Canada. It aims to enhance the resilience of displaced and conflict-affected Syrian women, including women with disabilities. Led by CARE Canada and implemented by the Syria Resilience Consortium (SRC), CARE, and Humanity & Inclusion (HI), PERSEVERE is designed to contribute to this goal through the following Intermediate Outcomes:
1) Women, including young and older women as well as women with disabilities, participate more actively in community economic governance; and
2) Community members, institutions, and response actors actively support the inclusion of Gender, Age and Disability (GAD) consideration in economic governance. Initial project learning and methods are meant to be shared across the whole of Syria and other SRC members and introduced to wider response actors contributing to resilience.
This year, the program has been continuing to support inclusion of women and persons with disabilities in livelihood activities. More women have been provided with in-depth training to support other women to expand and grow their businesses. Read More...

Evidence Review of Women’s Groups and COVID-19: Impacts, Challenges, and Policy Implications for Savings Groups in Africa

It has been more than a year since COVID-19 lockdowns began, and economic recovery is a top priority for governments, donors, and international financial institutions (IFIs) worldwide, including in sub-Saharan Africa. Targeted investments that increase community resilience and spur economic growth will mitigate some of the negative economic consequences of this crisis. Investment in women’s economic resilience and social support is para- mount, considering that the crisis may reverse recent progress in gender equality. Around the world, women’s groups, such as self- help groups, savings groups, and health groups, play an important role in communities; evidence shows promise in their role in promoting women’s empowerment and economic outcomes. They encompass many models, but all bring women together around a shared purpose, such as financial inclusion, livelihoods, health, and women’s rights.
This brief focuses on one specific type of women’s group in sub-Saharan Africa: savings groups. Savings groups are a common form of women’s group and serve as a reliable mechanism for people in sub-Saharan Africa to save money. Members of savings groups pool small weekly savings into a common fund, which members can then borrow against, creating opportunities for investments and women’s empowerment. Savings groups show mixed, but promising, results in improving economic and social outcomes. This brief, written by a consortium of researchers and practitioners, presents emerging evidence from studies in diverse African contexts— with a deep dive into Nigeria and Uganda—on how COVID-19 has affected savings groups and how these groups have helped mitigate the pandemic’s negative consequences in sub-Saharan Africa.
This report is 23 pages long. 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.
Read More...

Gender, Disability and Inclusion Analysis for COVID-19 and Tropical Cyclone Harold

When Tropical Cyclone Harold hit on the 2nd April, the Solomon Islands was among the first countries forced to grapple with the complex intersection of COVID-19 and disaster. While the country has managed to contain the spread of COVID-19 and prevent community transmission to date, the pandemic is still having a major impact on everyday life for men, women, boys and girls. Lock-down measures, the abrupt cessation of tourism, severe disruptions to international trade and other flow-on effects of the global pandemic (combined with the effects of TC Harold and pre-existing vulnerabilities) are resulting in widespread income and job losses, heightened stress and tension, increased family violence, displacement, and disrupted access to education, health, and water and sanitation.
If community transmission of COVID-19 occurs, there will be a public health crisis with complex contextual challenges. These include a population dispersed across isolated islands and limited resources, including limited access to quality health services.
The current COVID-19 impacts are disproportionately affecting women, girls and people with disabilities in the Solomon Islands, and this will be exacerbated in the case of a wider COVID-19 outbreak. All humanitarian programming must consider gender roles and responsibilities and the existing patterns of community participation and leadership, in order to ‘do no harm’ and help facilitate a gender and disability inclusive approach to COVID-19 prevention and recovery.

This gender, disability and inclusion analysis has the following objectives:
* To analyse and understand the different impacts that COVID-19 and TC Harold is having on women, men, girls, boys, people living with disabilities and other vulnerable groups in the Solomon Islands;
* To inform humanitarian programming in the Solomon Islands based on the different needs of women, men, boys, girls and people living with disabilities with a particular focus on gender-based violence (GBV) and livelihoods. Read More...

Multiagency and Multisectoral Rapid Need Assessment in Raya Kobo, Raya Alamata, Raya Azebo, Chercher, Wajirat and Ofla Woredas of North Wollo and South Tigray Zones

2020 was ascribed as a record year of disasters by the local communities in the locations covered by this assessment; Raya Kobo, Raya Alamata, Raya Azebo, Raya Chercher, Wajirat and Ofla woredas in North Wollo and South Tigray. The multiple, complex and frequent hazards have proved relentless; COVID 19, Desert Locusts and conflict have exhausted the coping capacity and challenged the resilience of the local communities.
The Tigray conflict erupted at the backdrop of the devastating impact of COVID- 19 and locust infestation crisis. To make the matter worse, the conflict erupted in the middle of the harvest season, effectively halting attempts to gather the remains of already depleted crops. The longer- term effects of, which will impact communities for years to come.
Since there was already an influx of IDPs from the 2017 ethnic conflicts around the country, the region experienced in hosting IDP, but on this occasion, the numbers of incoming families have doubled and, in some cases, trebled, according to reports from the local Woreda authorities responsible for registering such movement. Thus, these two zones are under protracted and complex crisis that have rocked the livelihood base of the communities and put their lives into a very precarious situation.

Objectives of the Assessment
a) Assessing the current humanitarian situation and identify response requirements and preferences1 for IDPs as well as host community members with humanitarian support needs
b) Understand the response capacity and preparedness of partners operating in Amhara and Tigray and to act in a complementary manner to rescue the lives and livelihoods of the
communities and IDPs,
c) To be ready for humanitarian support in line with humanitarian principles and NGOs code of conduct, and
d) Understand current humanitarian concerns of the targeted areas in both regional states
(Amhara and Tigray) and act to raise these concerns with potential benevolent donors within the country and overseas, to generate funds

This report is 43 pages long. Read More...

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