COVID 19

COVID-19 Vaccination Uptake: A study of Knowledge, Attitudes and Practices of Marginalized Communities in Iraq

CARE Iraq conducted a study to better understand community acceptance of COVID-19 vaccination and existing barriers to vaccine uptake. The objectives of the study were to create an understanding of people’s knowledge, attitudes and perceptions about COVID-19 and the vaccines, establish what reasons undermine the COVID-19 vaccination campaign and inform about the status of vaccine uptake among marginalized communities. The results of the study can inform policy makers and health actors to design awareness campaigns and address barriers to vaccine uptake to increase the vaccination rate.

CARE found that:
• Vaccine hesitancy is high.
• Women have less access to, knowledge of, and willingness to accept the COVID-19 vaccine then men.
• Barriers to access are still high, and higher for women than for men.
• Fear of side effects is the biggest obstacle.
• There is little trust in the vaccination process.
• Many people do not believe vaccines are important.
• People are not confident they have enough accurate information.

Key recommendations
• Social media can be a primary channel for vaccine messaging.
• It’s critical to counteract misinformation.
• Multiple sources of information are critical.
• Focus messaging for women and religious leaders.
• Develop different messages in different areas.
• Build on people’s willingness to be convinced with good information. Read More...

Community Scorecard for COVID-19 Vaccines in Malawi

The significant amount of misinformation surrounding COVID-19 has deteriorated trust in governments and health systems, leading the World Health Organization to claim it as an “infodemic.” As the massive vaccine roll-out efforts launch, systematic trust-building and social accountability approaches are vital to ensure that civil society can hold governments accountable for equitable and people-centered vaccine roll-out that reaches the last mile. CARE knows that epidemics, like COVID-19 and Ebola, start and end with communities, which is why we are working to build meaningful citizen engagement into national vaccine roll-out frameworks to increase trust, accountability, and information dissemination.
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...

COVID-19 Response in Tabora Tanzania (Bloomberg)

CARE Tanzania builds on its successful partnership with the Government of Tanzania’s Regional Health Management Team (RHMT) in Tabora Region. Leveraging funding from the Government of Canada as part of the Tabora
Maternal Newborn Health Initiative (TAMANI), CARE’s Bloomberg-funded COVID-19 activities builds on efforts to improve access of and quality of health services across health facilities and communities to challenge harmful gender norms.
In partnership with the Government of Tanzania, activities cover all 8 districts in Tabora Region. CARE provides technical support and training to Community Health Workers, who are supported by the government in their duties.With the onset of COVID-19, CARE Tanzania quickly implemented a digital survey to understand the impacts of COVID-19. The majority of female respondents reported increases in gender-based violence and harassment, with COVID-19 restricting women’s access to resources and decision-making. Read More...

Estudio de Base del Proyecto “MUJERES RESILIENTES: NUEVAS OPORTUNIDADES PARA SU REACTIVACIÓN ECONÓMICA E INCLUSIÓN FINANCIERA EN RESPUESTA AL IMPACTO DE LA CRISIS DEL COVID-19”

El presente estudio de base es elaborado con el objetivo de medir la situación inicial PROYECTO “MUJERES RESILIENTES: NUEVAS OPORTUNIDADES PARA SU REACTIVACIÓN ECONÓMICA E INCLUSIÓN FINANCIERA EN RESPUESTA AL IMPACTO DE LA CRISIS DEL COVID-19”, el cual viene siendo ejecutado por CARE Perú. Para el desarrollo del estudio se implementó una metodología predominantemente cuantitativa que emplea principalmente fuente y técnica de recojo de información de naturaleza cuantitativa. El ámbito geográfico del estudio de base comprende las zonas donde actualmente interviene el proyecto, las cuales involucra 38 distritos en los departamentos de Arequipa, La Libertad y Lima. Las principales variables analizadas se corresponden con el contexto local distrital en el que opera el proyecto, con características básicas del público objetivo (características personales de las beneficiarias, de sus hogares, acceso a servicios y afectación por el COVID-19), los cambios esperados por el proyecto como estrategia de intervención (capacidades técnicas, estrategias de mercado, servicios financieros) y la transversalización de género. Estas variables se analizaron en la población objetivo del proyecto. Los informantes que proporcionaron la información requerida para el estudio fueron principalmente las mujeres emprendedoras inscritas en el Proyecto. En este grupo de informantes se aplicaron 302 encuestas a mujeres emprendedoras y se complementó con siete entrevistas a funcionarios públicos de Municipios y Programas Públicos. Para el recojo de información, se diseñó un total de 3 formatos de recojo de información primaria, los cuales fueron aplicados durante los meses de mayo y junio del 2021, con algunas limitaciones propias de una aplicación por teléfono (llamadas no contestadas, servicios suspendidos, números equivocados) y otras referentes a la disponibilidad del informante (rechazo directo, falta de tiempo). [90 Pages]
Read More...

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...

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