Laos

The First 1000 Days, Phase III in Sekong and Phongsaly Provinces

The First 1000 Days Project Phase III focuses on improving maternal and child mortality, improving health outcomes for women, adolescents, and children in the first 1,000 days of the life of children in Sekong and Phongsaly Provinces as well as to support poor and vulnerable households in remote, rural areas to facilitate access to and improve the quality of nutrition-related health services for mothers and children and improve food and nutrition security for community members. The project also integrates adolescent sexual reproductive health, women’s economic empowerment, responses to gender based violence, and stakeholder engagement in health.
This report examines the health, nutrition, and economic empowerment of women, adolescents, and children in Phongsaly and Sekong provinces of Laos. The baseline assessment aimed to understand the current situation and identify areas where interventions could have the greatest impact. Data was collected through a combination of surveys, focus group discussions, key informant interview with key stakeholders and interviews with mother of CU5, adolescent (age 15-19), men, healthcare providers, and community leaders.
The results showed that despite high antenatal care (ANC) utilization rates in both Phongsaly and Sekong, there remains room for improvement in overall healthcare delivery, particularly around childbirth. Home births remain common, highlighting the need for increased access to skilled birth attendants at health facilities and mobile outreach services. Sekong lags behind Phongsaly in skilled birth attendance rates.
Another area requiring attention is postnatal care. While attendance is satisfactory, there's potential to improve these services. Additionally, a concerning practice of some women lying over fire after childbirth needs to be addressed due to potential health risks.
Regarding family planning, awareness and usage vary significantly between the two provinces, with Phongsaly showing higher rates. Sekong especially needs increased access to family planning services, while both provinces could benefit from addressing confidentiality concerns surrounding these services, particularly in Phongsaly.
Food and nutrition security presents a significant challenge, as nutrition indicators showed poor nutritional status of children. Stunting rates among children under five are high, particularly in Sekong. Both provinces struggle with low dietary diversity, lacking adequate consumption of fruits, vegetables, legumes, and animal source proteins. While breastfeeding practices show positive trends in early initiation and colostrum feeding, there remains poor long-term rates of exclusive breastfeed. Sekong has lower rates of early initiation and exclusive breastfeeding duration compared to Phongsaly, and even in Phongsaly, many mothers wean before the recommended 6 months. Read More...

Australian NGO Cooperation Program (ANCP) Meta-Review of Evaluations

This report presents the findings of a review of the evaluations of seven programs funded by DFAT through the ANCP and implemented by CARE (Australia and respective country partners).
The purpose is to identify and summarise lessons learned, areas for development and examples of good practice that will inform CARE Australia’s implementation of its new theory of change. The review is intended for both internal and external audiences, including DFAT. Read More...

EMPOWERED WOMEN FOR AN EQUITABLE COFFEE VALUE CHAIN

The Empowered Women for an Equitable Coffee Value Chain (EW-EVC) project, funded through the Australian NGO Cooperation Program (ANCP) was implemented in Sekong Province from July 2017-June 2022, with a goal of “Reduced poverty and improved access to food for remote ethnic communities through women’s economic empowerment”. This project aligns perfectly with the CARE Laos priority of supporting women and girls through economic empowerment. Read More...

Enhancing adaptive capacity of women and ethnic smallholder farmers through improved agro-climate information in Mai and Samphanh district, Phongsaly Province, Laos

The Agro-Climate Information for the Adoption of Resilient Farming Practices by Women and Ethnic Minority Farmers (ACIS2) is implemented by CARE International in Lao PDR. The project financed by the Ministry of the Environment, Climate and Sustainable Development (MECDD) in Luxembourg, is designed to support poor and vulnerable households in remote, rural areas and to enable women and ethnic minority farmers in Mai and Samphanh districts (Phongsaly province) to better anticipate risks and opportunities related to climate variability thus improving their response through participatory and equitable agro-climatic planning. The project’s aim is to contribute to SDG 13 by increasing climate resilience of women and ethnic minority farmers in northern Laos.
The purpose of the evaluation was to determine the project’s success in implementing activities and in attaining the project’s goals and expected results. The ACIS2 has implemented a wide variety of activities to increase the resilience of ethnic communities to climate change and climate variability. The project has been successful in achieving its objectives and expected results. Project provide the weather forecast and agriculture advisory and support for cardamom production, intercropping galangal, pineapple, fruit trees, bee keeping, vegetable gardening, improved rice production and support to women’s savings and loans groups which has resulted in reducing the impact of climatic hazards and improving farmers’ incomes.
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Impact, Influence, and Innovation: Reflecting on 10 Years of the CARE-GSK Frontline Health Worker Initiative

In recognition of their critical role in health linkages and systems strengthening, CARE and GSK established a decade long strategic investment in frontline health workers (FHW) and community health workers (CHW) in 2011 called the Frontline Health Worker Initiative. Following 10 years of partnership and programming, this report explores the resulting impacts, influence, and innovation. It synthesizes reach and impact data from 13 programmes across the 9 countries included in the Frontline Health Worker Initiative between 2011 and 2021. The countries included in this initiative are Afghanistan, Bangladesh, Cambodia, Cameroon, Chad, Laos, Myanmar, Nepal, and Togo.
The data presented here is specific to the communities in which CARE delivered sexual and reproductive health, maternal and child health, nutrition, and sanitation programming with GSK’s support. The analysis is designed to identify the changes in overall health outcomes that occurred at a population level. While these findings do not necessarily imply causation, CARE’s efforts have likely reasonably contributed towards these changes within the specific communities.
The Frontline Health Worker initiative has achieved these results across multiple development and humanitarian contexts – including slow-onset and sudden shocks, conflict, and most recently the COVID-19 pandemic. Many of these results were only made possible through the long-term investment from GSK and scalable actions that were implemented across all nine countries. Critically, the Frontline Health Worker Initiative established platforms, networks and health service capacity-building that served as a catalyst for CARE to pivot towards the response to the COVID-19 pandemic quickly in the communities where these projects exist.
Learnings from this programme will serve to strengthen CARE’s private sector partnership models for future programmes to build resilience and achieve health impact in communities. Read More...

Climate Learning and Advocacy for Resilience (CLAR) Programme

Climate Learning and Advocacy for Resilience (CLAR) was a CARE Denmark global programme that during the years 2018-2021 provided technical support to CARE country programmes. The overall objective of CLAR was “Adaptive capacity and resilience of vulnerable communities to climate change impacts, risks and uncertainties has increased.” The programme had three interrelated specific objectives, focusing on (1) demonstrating good practice, innovation and impact in climate resilience, and generating new evidence and learning, (2) improving capacity and influence among CSOs and networks on global and national policies, plans and projects on climate change adaptation and finance, and (3) strengthening of climate knowledge brokering for multi-stakeholder, cross-discipline and South-South learning and coordination.
The intention with CLAR was to link practical approaches and outcomes in climate change adaptation work with influencing policy and planning processes, in particular national adaptation plans (NAPs) and finance. CLAR was to add value to CARE country programmes through the provision of technical support for integration of climate change adaptation implementation as well as cross-country learning and knowledge sharing. CLAR targeted both local, national, and global policy spaces to promote pro-poor, equitable and effective adaptation policies, and mechanisms. Through the Southern Voices on Adaptation (SVA) advocacy community of practice, CLAR supported the sharing of experiences and best practices in different contexts on how to influence adaptation policies and adaptation finance. 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...

Improving Sexual and Reproductive Health through Reducing Early Marriage in Remote Ethnic Communities in Sekong Province, Lao PDR

Lao PDR has the highest rates of early marriage in the region, even though the law sets the age of marriage at 18. Young brides are more vulnerable to sexual abuse from their partners and to unintended pregnancy. Lao PDR has the highest adolescent pregnancy rate in the region due to early marriage, limited knowledge of sexual & reproductive health, and limited access to appropriate services. The overall goal of the project is improved sexual reproductive and maternal health (SRMH) in remote ethnic communities in Sekong Province. The action contributes to reduced child marriage, as well as providing SRMH knowledge and developing youth friendly health infrastructure. The action engages the whole community to reflect on harmful traditions and their negative impact on the development of girls, and to create an enabling environment for girls. CARE also provides organizational and technical capacity development to local governments and partners to enable them to deliver key messages on the link between child marriage and pregnancy risk to the targeted ethnic minorities.
This report is 17 pages long. Read More...

A Social Impact Analysis of CARE’s ‘Enhancing Women’s Voice to STOP Sexual Harassment ’ Project

The Enhancing Women’s Voice to Stop Sexual Harassment project (STOP), an initiative of CARE Australia, has been working since 2017 to prevent and address the under-reported problem of sexual harassment in mainland Southeast Asia’s garment sector. At the time of writing, STOP is the only initiative that addresses this issue on a multi-country scale within the sub-region. Operating across a pool of garment factories in four Mekong countries—Cambodia, Lao PDR, Myanmar and Vietnam—STOP aims to enhance women’s voice and economic rights at both the national and factory levels. Based on a socio-ecological model of violence prevention, CARE Country Offices (COs) are working with participating factories to create workplaces where female workers feel safe and experience less SH through the implementation of standardised SH reporting mechanisms and rigorous training programs. Supported by CARE Regional staff, each CARE CO engages with relevant country, regional and international stakeholders to strengthen the national regulatory environment to promote laws, policies and mechanisms to address SH in the workplace.

In 2018, CARE Australia commissioned a consortium of researchers from UNSW Sydney and UNSW Canberra to undertake an independent evaluation the STOP project and provide a separate Social Impact Assessment (SIA) focused on Cambodia STOP as the particular case study. The SIA is intended to complement the findings of the Final Evaluation (FE) of the STOP, as implemented in the other three project sites. The SIA and the Final Evaluation should be read as two parts of a single whole. The UNSW team drew upon a range of evaluative sources including factory surveys, focus group discussions and key informant interviews with factory workers, middle management and government officials. A conceptual framework is also advanced in order to better capture the nuances of social impact and gender transformation, and to provide a rigorous basis on which to evaluate STOP’s development and implementation in Cambodia. [94 pages]. Read More...

Regional Mekong Rapid Gender Analysis COVID-19

COVID-19 has created unprecedented health, economic, and social impacts all over the world. As of 31 August 2020, there have been 25,405,845 confirmed cases globally, and a total of 849,389 deaths. In the Mekong region, there have been 5,612 cases, with 274 in Cambodia, 22 in Lao PDR, 882 in Myanmar, 3,390 in Thailand and 1,044 in Viet Nam. In addition to health effects and deaths caused by the virus, the economic and social impacts of COVID-19 and prevention measures taken by governments are far reaching and long-lasting, especially in the context of climate change and natural disasters in the region.
For the Mekong region, COVID-19 presents special challenges for high-risk populations, including the many migrant workers, garment industry workers, indigenous and ethnic minorities, refugees, internally displaced peoples, migrants, urban slum-dwellers, and people working in the informal sector, such as female sex workers. As with all crises, women and children are disproportionately affected. COVID-19 exacerbates the challenges at-risk populations face and makes it even harder for women to access the support services they need in times of crisis.

This brief summarises the Mekong RGA, written by Athena Nguyen, Jordan Hoffmann, Laura Baines, Ratha Ra, Rebecca Elias, and Christina Haneef in September 2020. This Rapid Gender Analysis draws from 301 interviews (including 126 women), secondary data sources, and CARE’s research to understand women’s specific challenges in the Mekong region during the pandemic. Read More...

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