Emergency|Humanitarian Aid

(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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Women’s economic empowerment in emergency contexts: Niger case study

While discussion of the ‘Humanitarian, Development and Peace Nexus’ continues within the sector, there remains debate as to whether women’s economic empowerment is a luxury, or even feasible in humanitarian contexts where the priority is to keep people alive. Increasingly, however, humanitarians are seeing interventions aimed at women’s economic empowerment in emergency contexts as a key tool to increase protection and support people in crises to live in dignity. CARE set out to analyse whether financial inclusion strategies like community-led savings groups may in fact represent a way to not only respond to crises, but also to build resilience against them, even in highly fluid contexts.

In June 2018, CARE teams conducted fieldwork in two areas where it is implementing ongoing humanitarian interventions. CARE organised focus groups and interviews with communities and individuals in Diffa and Konni where it has delivered humanitarian assistance. The interventions combined blanket cash distributions, and the establishment of savings and credit groups which also provided women with life skills and business training to set up small businesses.

Within a crisis setting, combining a savings group structure including income generation support with humanitarian assistance such as food and non-food items (NFIs) helped women not only to meet basic needs in a more sustainable way, but also improved their independent access to and control over money.

During emergencies, providing women with humanitarian cash to cover basic needs allowed women in savings groups to continue saving and to invest in income generating activities (IGA), rather than using up capital on food.

If crises continue to hit, the positive impact of savings groups set up in emergencies can become strained. In this case, further cash interventions can preserve small businesses.

Membership of savings groups and receipt of IGAs and life skills training increased women’s income and confidence. Membership of a savings group provides psychosocial benefits to women who are suffering anxiety, depression or trauma by providing a social network that meets and talks regularly. Read More...

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...

Baseline Survey Report for a WASH project in West Mosul

This is a baseline survey report for the "Improving Sanitation, Hygiene, Renovation of Sewage System" project, funded by the Ministry of Foreign Affairs of the Czech Republic.
There are two priority issues to be addressed by this project: a) significant health risks posed by accumulation of solid waste in key arteries of West Mosul (Cree stream), precluding the effective flow of gray water towards the river as well as damaged pipes which serve to remove black water from residential areas (Al-Thawra neighborhood), and b) limited civic engagement and ownership of residential environment, resulting in poor communal hygiene practices and a high burden on local authorities, which are operating under severely reduced capacity to address needs.
A base-line survey was conducted to identify the current water, hygiene and sanitation conditions in the neighborhood, beneficiaries’ specific needs (disaggregated by men, women, boys and girls) and overall awareness towards water, hygiene and sanitation measures. In order to measure the impact of this projects base line data will be evaluated against end line data collected after project closure. Read More...

WASH Support to IDPs & host communities in Duhlok and Ninawa, Iraq (2017-2019)

CARE’s GAC funded WASH project started in January 2017 providing critical water, sanitation and hygiene (WASH) services to improve overall WASH services for women, men, boys and girls and reduce tensions between the host community and IDPs in the areas of 4 IDP camps (Mamrashan, Essyan, Sheikhan, and Chamishko), and host community collectives (Ardawan, Ba’adre, Kalakchi, Mahate and Ayas) of Duhok Governorate. The project also had an emergency response component in November 2017 in three neighbourhoods of West Mosul (Al-Mansour, Al-Jawsaq and Wadi Al-Hajar). The project is implemented through two local partners Harikar and REACH. Working through partners is a key modality of CARE’s country strategy to strengthen the capacity of local NGOs. This approach has had a significant impact in achieving the GAC aim of supporting vulnerable and conflict-affected people living in the Kurdistan Region of Iraq. The ongoing WASH intervention aims to provide 55,572 (27,318 women & 28,434 men)2 IDPs and members of host communities with access to water supply, safe sanitary facilities and increased awareness on safe hygiene practices in a dignified, gender-sensitive and culturally appropriate manner.
The midterm project evaluation aims to assess the relevance, performance, and progress on targets within 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 for CARE Iraq and project partners to improve the implementation of the final year of the GAC project as well and strengthen the design of future related projects. 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...

Strengthening WASH basic infrastructure, resilience and livelihoods in return areas in Ninawa, Iraq

This baseline report was prepared as part of the multi-sectoral project in Sinjar and Telafar districts, Ninawa governorate. The project is funded by the German Federal Ministry of Economic Cooperation and Development, BMZ. CARE International in Iraq, in partnership with two local NGOs, namely Harikar and HOPE are planning to implement the project in two districts in Ninawa governorate, Telafar and Sinjar. It is intended to implement activities in three geographic locations within the two selected districts, Telafar city and Zummar town in Telafar district and Sinjar area in Sinjar district. Zummar’s population is about 118,000 individuals (19,000 families). Approx. 80% (around 15,000 families) of the population have now returned to Zummar. Telafar’s population is about 200,000 individuals (40,000 families). Around 25% of the total displaced population has returned according to local Telafar authorities. Sinjar city hosts a population of about 24,000 individuals (4,000 families) .
Field work was conducted in early January 2019. The aim of the multi-sectorial baseline assessment was to collect information on the current situation in the areas of Water Supply, Hygiene and Sanitation Practices, House, Land and Property (HLP), Livelihood and Governance in the target areas.
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LIVELIHOOD RAPID MARKET ASSESSMENT REPORT Ninawa Governorate

Gender-balanced implementation structures (including vetting committees comprised of local leaders, community representatives and local partner institutions) will be established and they will determine the criterion for identification of vulnerable vocational trainees. CARE will advertise the program in strategic locations, inviting beneficiaries to apply. Vocational training beneficiaries (including those carrying out agricultural production) will be identified through inclusive processes that rank applicants according to a vulnerability criterion. Selected beneficiaries are then provided vocational training, start-up kits and apprenticeships, based on the conducted market assessment.
Supporting micro-business enterprises: Applicants for business trainings will be shortlisted and identified by committees made up of community leaders/local partners, in a similar process to the selection of vocational trainees. Training materials will be developed and finalized. Beneficiaries will be trained in running a small business and gender and gender-based-violence awareness. Trainees that successfully complete the program will be supported in designing and applying for microbusiness pre-financing, which a gender inclusive committee will award to awardees.
Providing cash for work (CFW) on public works projects: CFW projects will be conducted over three-month periods, engaging 300 workers in each of the two project sites of Rabia and Zummar. The CFW projects will be described to and prioritized with relevant stakeholders there, which include local community leaders, community and religious leaders and lowest government administrative structures involved in selecting CFW public works projects and understand community needs.
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