Malawi
Variations in Village Savings and Loan Association (VSLA) Practices: An Assessment of Dynamics and Impacts in Zomba and Mangochi Districts – Titukulane Project
This assessment investigates variations in the practices of Village Savings and Loan Associations (VSLAs) in Zomba and Mangochi districts. While the VSLA model has been transformative in promoting financial inclusion and community empowerment in rural areas, there have been noticeable deviations from the CARE VSL methodology, commonly referred to as the standard methodology. With Titukulane's support for these VSLAs, it becomes imperative to comprehend the reasons and implications behind these changes.
The rapid assessment was instrumental in understanding the VSLA practices across selected districts. Qualitative data on the VSLA methodology variations were randomly drawn from 8 out of the 19 Traditional Authorities (TAs) where Titukulane is implementing interventions. Within this sample, the assessment encompassed diverse voices from VSLA members, Community Development Agents, Village Agents, and Titukulane staff. The research utilized a rapid assessment approach to gain a comprehensive overview of the VSLA practices in Zomba and Mangochi in a time-efficient manner. This methodology was chosen for its ability to capture immediate, relevant insights without necessitating the extended time frame typical of more intensive research methods. The rapid assessment prioritized direct interactions with participants, ensuring their experiences and perspectives were central to the data collected. This direct engagement proved invaluable, especially when exploring sensitive topics related to financial practices and internal group dynamics. Through this approach, the assessment aimed to offer a nuanced understanding of current VSLA practices and the motivations underpinning their variations. In the context of this study, variations refer to the distinct differences in approaches, outcomes, or practices observed among the groups, while deviations denote departures from the expected or standard methods prescribed by Titukulane, potentially indicating unique adaptations or challenges faced by certain groups.
Key Findings: VSLAs in both districts have adopted varied practices. Some VSLAs, for example, emphasize equal shares for every member, while others note disparities in contributions. Lending strategies, such as offering loans to non-members, also emerged, aiming to bolster financial inclusivity. However, such innovative strategies sometimes come with their own set of challenges, like difficulties in accurate record-keeping or financial strains from settling older debts using newer contributions. External influences, cultural beliefs, and regional dynamics also play key roles in these variations. Below is a complete list of the variations and deviations noted in the two districts:
• Shares and Savings: While some VSLAs continue to advocate for standardized shares per member to ensure equality, others experience disparities due to inconsistent contributions. For instance, in some groups members are allowed to purchase more than 5 shares at a time, with some purchasing up to 100 shares.
• Loan Practices: Innovative loan practices, including lending to non-members, aim to enhance financial inclusivity.
• Documentation and Record-Keeping: Challenges in maintaining accurate records are pervasive, with different approaches to record-keeping observed.
• Emergence of Digital Financing Platforms replacing cashboxes: In younger VSLA demographics, there's a rising adoption of digital financing platforms, such as Airtel Money and TNM Mpamba. However, this shift poses challenges for older members, who are less familiar with digital technologies.
• Religious and Cultural Adjustments: Deep-seated religious beliefs influence some VSLAs to refrain from charging interest.
• Influence of External Entities: VSLAs display adaptability and responsiveness to external influences, including NGOs and community initiatives.
• Group Dynamics: Many VSLAs have larger membership counts than recommended, possibly reflecting community resource pooling. Read More...
The rapid assessment was instrumental in understanding the VSLA practices across selected districts. Qualitative data on the VSLA methodology variations were randomly drawn from 8 out of the 19 Traditional Authorities (TAs) where Titukulane is implementing interventions. Within this sample, the assessment encompassed diverse voices from VSLA members, Community Development Agents, Village Agents, and Titukulane staff. The research utilized a rapid assessment approach to gain a comprehensive overview of the VSLA practices in Zomba and Mangochi in a time-efficient manner. This methodology was chosen for its ability to capture immediate, relevant insights without necessitating the extended time frame typical of more intensive research methods. The rapid assessment prioritized direct interactions with participants, ensuring their experiences and perspectives were central to the data collected. This direct engagement proved invaluable, especially when exploring sensitive topics related to financial practices and internal group dynamics. Through this approach, the assessment aimed to offer a nuanced understanding of current VSLA practices and the motivations underpinning their variations. In the context of this study, variations refer to the distinct differences in approaches, outcomes, or practices observed among the groups, while deviations denote departures from the expected or standard methods prescribed by Titukulane, potentially indicating unique adaptations or challenges faced by certain groups.
Key Findings: VSLAs in both districts have adopted varied practices. Some VSLAs, for example, emphasize equal shares for every member, while others note disparities in contributions. Lending strategies, such as offering loans to non-members, also emerged, aiming to bolster financial inclusivity. However, such innovative strategies sometimes come with their own set of challenges, like difficulties in accurate record-keeping or financial strains from settling older debts using newer contributions. External influences, cultural beliefs, and regional dynamics also play key roles in these variations. Below is a complete list of the variations and deviations noted in the two districts:
• Shares and Savings: While some VSLAs continue to advocate for standardized shares per member to ensure equality, others experience disparities due to inconsistent contributions. For instance, in some groups members are allowed to purchase more than 5 shares at a time, with some purchasing up to 100 shares.
• Loan Practices: Innovative loan practices, including lending to non-members, aim to enhance financial inclusivity.
• Documentation and Record-Keeping: Challenges in maintaining accurate records are pervasive, with different approaches to record-keeping observed.
• Emergence of Digital Financing Platforms replacing cashboxes: In younger VSLA demographics, there's a rising adoption of digital financing platforms, such as Airtel Money and TNM Mpamba. However, this shift poses challenges for older members, who are less familiar with digital technologies.
• Religious and Cultural Adjustments: Deep-seated religious beliefs influence some VSLAs to refrain from charging interest.
• Influence of External Entities: VSLAs display adaptability and responsiveness to external influences, including NGOs and community initiatives.
• Group Dynamics: Many VSLAs have larger membership counts than recommended, possibly reflecting community resource pooling. Read More...
Community-led Resource Mobilization & Early Warning Systems Process Assessment: Titukulane Project
This report examines the motivation and willingness of Village Civil Protection Committees (VCPCs) and communities to mobilize resources at community level for Disaster Risk Management (DRM). To do this, a participatory action research (PAR) approach was utilized, facilitated by SWOT analyses, in combination with focus group discussions (FGDs) and key informant interviews (KIIs). The findings revealed that communities had prepositioned resources to prepare for disaster response as part of risk reduction. Participants identified their ability to mobilize themselves as a community; to mobilize funds and food; well trained and knowledgeable structures, good agricultural practices, and good governance as major strengths. Opportunities for resource mobilization included enterprise, piece work (ganyu), irrigation farming, access to safety net programs, and youth participation. Weaknesses included the disorganization of some community structures, lack of support or political will from community leaders and the government, lack of accountability from VCPC members, and reluctance to adopt improved agricultural practices. Community-based early warning systems, although available, are insufficient to provide effective risk reduction for natural disasters. There is a lack of documentation concerning indigenous early warning systems, which impedes the development of effective and contextual strategies for risk reduction. The recommendations include increasing awareness among traditional leaders, defining resource mobilization structures, documenting guidelines and transactions for transparency, investing in early warning infrastructure and capacity building, documenting indigenous early warning signs, and intensifying watershed restoration and conservation to increase disaster preparedness. Read More...
Titukulane Gender Progress Marker Monitoring Report
Titukulane is a five-year, US $75 million Resilience Food Security Activity funded by the Bureau for Humanitarian Assistance. The project is led by the Cooperative for Assistance and Relief Everywhere (CARE) in partnership with Emmanuel International (EI), the International Food Policy Research Institute (IFPRI), the National Smallholders Farmers’ Association of Malawi (NASFAM), Save the Children (SC), and WaterAid. Implemented in 19 Traditional Authorities (T/As) of two southern districts of Malawi (Zomba and Mangochi), Titukulane directly impacts 510,910 individuals – including adolescent girls and boys aged 10 to 19, and young women and men aged 20 to 29 – who face an uncertain future as farming becomes less viable. Titukulane offers an integrated and gender-responsive package of interventions across the following program elements: maternal and child health; nutrition and water, sanitation, and hygiene, (WASH); agriculture sector capacity; microenterprise productivity; civic participation; and capacity building, preparedness, and planning. The program works across three purpose areas:
Purpose 1: Increased, diversified, sustainable incomes for ultra-poor, chronically vulnerable households (HHs), women and youth.
Purpose 2: Nutritional status among children < 5, adolescent girls, and women of reproductive age improved; and
Purpose 3: Increased institutional and local capacities to reduce risk and increase resilience among very poor and chronically vulnerable households in alignment with the National Resilience Strategy.
Gender integration is a crosscutting component among all activities and project emphasizes the critical importance and benefits of increased voice, participation and leadership of women and youths, including young women. A Gender Analysis was initially conducted for Titukulane in 2020 to identify context specific gender barriers, inequalities, and potential risks that could negatively affect the achievement of the project’s expected outcomes, as well as to assess how these constraints could be addressed in Zomba and Mangochi. Read More...
Purpose 1: Increased, diversified, sustainable incomes for ultra-poor, chronically vulnerable households (HHs), women and youth.
Purpose 2: Nutritional status among children < 5, adolescent girls, and women of reproductive age improved; and
Purpose 3: Increased institutional and local capacities to reduce risk and increase resilience among very poor and chronically vulnerable households in alignment with the National Resilience Strategy.
Gender integration is a crosscutting component among all activities and project emphasizes the critical importance and benefits of increased voice, participation and leadership of women and youths, including young women. A Gender Analysis was initially conducted for Titukulane in 2020 to identify context specific gender barriers, inequalities, and potential risks that could negatively affect the achievement of the project’s expected outcomes, as well as to assess how these constraints could be addressed in Zomba and Mangochi. Read More...
2023 Participant Based Survey: Titukulane Project – PaBS Outcome Report
Despite decades of robust government and donor investments in livelihoods, food security, nutrition, and resilience, over 50% of the population lives below the poverty line. Previous activities have not sufficiently reduced the number of chronically food and nutrition insecure households nor effectively enhanced the capacity of local and government structures to implement resilience focused policies and actions. To address these issues, the Government of Malawi developed a National Resilience Strategy 2018-2030 (NRS) to guide investments in agriculture, reduce impacts and improve recovery from shocks, promote household resilience, strengthen the management of Malawi’s natural resources, and facilitate effective coordination between government institutions, civil society organizations and development partners. CARE and consortium partners designed the Titukulane Resilience Food Security Activity (RFSA) which means “let us work together for development” in the local Chichewa language—to support pilot implementation of NRS in Zomba and mangochi districts. The Titukulane RFSA, implemented by CARE International in Malawi (CIM), aims to achieve sustainable, equitable, and resilient food and nutrition security for ultra-poor and chronically vulnerable households. Specifically, Titukulane is designed to increase households’ abilities to deal with shocks without experiencing food insecurity following a three-purpose approach:
1. Increased diversified, sustainable, and equitable incomes for ultra-poor, chronically vulnerable households, women, and youth.
2. Improved nutritional status among children under 5 years of age, adolescent girls, and women of reproductive age.
3. Increased institutional and local capacities to reduce risk and increase resilience among poor and very poor households in alignment with the Malawi NRS.
To meet these three purposes, the Titukulane RFSA provides households with a package of interventions, including: Care Groups with Nutritional Cash Transfers (NCT), Farmer Field Business Schools and crop marketing support, Village Savings and Loan Associations, Adolescent nutrition, Irrigation farming, Youth vocational training including start-up capital and Gender dialogues. Read More...
1. Increased diversified, sustainable, and equitable incomes for ultra-poor, chronically vulnerable households, women, and youth.
2. Improved nutritional status among children under 5 years of age, adolescent girls, and women of reproductive age.
3. Increased institutional and local capacities to reduce risk and increase resilience among poor and very poor households in alignment with the Malawi NRS.
To meet these three purposes, the Titukulane RFSA provides households with a package of interventions, including: Care Groups with Nutritional Cash Transfers (NCT), Farmer Field Business Schools and crop marketing support, Village Savings and Loan Associations, Adolescent nutrition, Irrigation farming, Youth vocational training including start-up capital and Gender dialogues. Read More...
Baseline Report of the Titukulane Resilience Food Security Activity in Malawi
While Malawi is moving up on the Human Development Index, in 2017 it is still classified as a low human development country (171 of 189). Despite decades of robust government and donor investments in livelihoods, food security, nutrition, and resilience, over 50% of the population lives below the poverty line. Previous activities have not sufficiently reduced the number of chronically food and nutrition-insecure households nor effectively enhanced the capacity of local and government structures to implement resilience focused policies and actions. To address these issues, the Government of Malawi has developed a National Resilience Strategy (NRS) to guide investments in agriculture, reduce impacts and improve recovery from shocks, promote household resilience, strengthen the management of Malawi’s natural resources, and facilitate effective coordination between government institutions, civil society organizations and development partners. CARE and consortium partners have designed the Titukulane Resilience Food Security Activity (RFSA) which means “let us work together for development” in the local Chichewa language—to support implementation and ensure the effectiveness of the NRS. The Titukulane RFSA, implemented by CARE International in Malawi (CIM), aims to achieve sustainable, equitable, and resilient food and nutrition security for ultra-poor and chronically vulnerable households. Titukulane is implemented in Zomba and Mangochi districts of Malawi’s Southern Region. Read More...
PENNIES TO POWER FINAL REPORT
Globally, women have access to 10% of the available credit, 7% of the training on productive activities and are 40% less likely to have access to agricultural inputs than men. Women also have limited technological inputs and market access, and only 4.3% of women have access to agricultural extension services. Although women provide about 50% of the agricultural workforce, they still lack equal access to productive resources.
Due to looming threats including climate change, an estimated 20% increase in hunger is predicted by 2050. The COVID-19 pandemic and its economic aftermath likely will push 426 million more people into poverty in the next three to five years. Responding to these challenges requires creative solutions that prioritize the most vulnerable, including women and young people. To this end, CARE implemented the Pennies to Power program with generous support from the Arthur M. Blank Family Foundation. This final report describes the program’s accomplishments over the full implementation period (June 1, 2019 to June 1, 2022).
Pennies to Power played a critical role in building resilience and increasing the capacity of people to cope with crises. Moreover, it helped create thriving and sustainable communities, where farmers prosper, people are empowered, and the planet is healthier. CARE implemented the program in Malawi, Nigeria and Tanzania to build resilience, unlock market access for women and youth, and ensure they are economically and socially empowered through savings groups known as village savings and loan associations (VSLAs). Moreover, the program contributed to the achievement of the following U.N. Sustainable Development Goals (SDGs): No Poverty (SDG 1), Zero Hunger (SDG 2), Gender Equality (SDG 5), and Climate Action (SDG 13).
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Due to looming threats including climate change, an estimated 20% increase in hunger is predicted by 2050. The COVID-19 pandemic and its economic aftermath likely will push 426 million more people into poverty in the next three to five years. Responding to these challenges requires creative solutions that prioritize the most vulnerable, including women and young people. To this end, CARE implemented the Pennies to Power program with generous support from the Arthur M. Blank Family Foundation. This final report describes the program’s accomplishments over the full implementation period (June 1, 2019 to June 1, 2022).
Pennies to Power played a critical role in building resilience and increasing the capacity of people to cope with crises. Moreover, it helped create thriving and sustainable communities, where farmers prosper, people are empowered, and the planet is healthier. CARE implemented the program in Malawi, Nigeria and Tanzania to build resilience, unlock market access for women and youth, and ensure they are economically and socially empowered through savings groups known as village savings and loan associations (VSLAs). Moreover, the program contributed to the achievement of the following U.N. Sustainable Development Goals (SDGs): No Poverty (SDG 1), Zero Hunger (SDG 2), Gender Equality (SDG 5), and Climate Action (SDG 13).
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VSLA By the Numbers: A Comprehensive Analysis of the Impact and ROI of VSLAs
Village Savings and Loans Associations (VSLAs) have been a foundational programmatic approach at CARE since 1991. Since then, CARE has helped over 13.7 million people join savings groups. The savings group model has been adopted and adapted by a variety of organizations globally. Through this report, we will examine the social and financial effects and returns of savings groups as well as how groups affected members’ resilience to COVID-19. The results gave an overview of the financial return on investment (ROI), group economic outcomes, savings groups costs, and individual and household effects for savings groups both inside and outside of CARE.
In order to calculate a return on investment, the financial benefit for a typical participant over three years was considered as well as the financial benefits for a replicated VSLA for two years related to the cost that the donor/implementer spends to set up and oversee the VSLA for its first cycle. Using internal CARE data such as budgets, evaluation, and impact reports, the average ROI of costs to establish a saving group was between 7:1 and 20:1. For every $1 invested by CARE, there is evidence for the savings of a typical VSLA participant to increase between $7 and $20. For the average VSLA participant, median income increased by $9.35 (+/- $0.55 USD) within the first year of joining the group for each $1 USD invested. Additionally, average income increased by $18.85 (+/-$1.15 USD) within five years of each $1 USD invested. Using industry data and internal CARE data, this analysis showed that for every $250 USD invested three net new children attended school.
The financial effect of a VSLA appears to outlast the formal lifecycle of the group. Evaluation of VSLAs as they phased out found that the return on savings (ROS) was 50% (+/-10%) during the supported formal lifecycle of the group and decreased to around 35% (+/-19%) after the VSLA is phased out. However, the positive outcomes and impact of participating in VSLAs continue even after project phase out. Members continue saving and getting benefits. Share value even increase for 57% (+/-13%) of groups in the available data.
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In order to calculate a return on investment, the financial benefit for a typical participant over three years was considered as well as the financial benefits for a replicated VSLA for two years related to the cost that the donor/implementer spends to set up and oversee the VSLA for its first cycle. Using internal CARE data such as budgets, evaluation, and impact reports, the average ROI of costs to establish a saving group was between 7:1 and 20:1. For every $1 invested by CARE, there is evidence for the savings of a typical VSLA participant to increase between $7 and $20. For the average VSLA participant, median income increased by $9.35 (+/- $0.55 USD) within the first year of joining the group for each $1 USD invested. Additionally, average income increased by $18.85 (+/-$1.15 USD) within five years of each $1 USD invested. Using industry data and internal CARE data, this analysis showed that for every $250 USD invested three net new children attended school.
The financial effect of a VSLA appears to outlast the formal lifecycle of the group. Evaluation of VSLAs as they phased out found that the return on savings (ROS) was 50% (+/-10%) during the supported formal lifecycle of the group and decreased to around 35% (+/-19%) after the VSLA is phased out. However, the positive outcomes and impact of participating in VSLAs continue even after project phase out. Members continue saving and getting benefits. Share value even increase for 57% (+/-13%) of groups in the available data.
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...
SANI (Southern Africa Nutrition Initiative)
The Southern Africa Nutrition Initiative (SANI) is a $29,487,135 CAD project to address undernutrition in women of reproductive age (15-49) and children under 5 years in Malawi, Mozambique and Zambia. A partnership between CARE, Cuso International, Interagency Coalition on AIDS and Development (ICAD) and McGill University and the Governments and communities of implementing countries, SANI aimed to improve the nutritional status of women of reproductive age (15-49 years) and children under-5 years old. SANI was designed to align with national health and nutrition strategic priorities of Malawi, Mozambique and Zambia, and has been implemented in close collaboration with the Ministries responsible for Health, Agriculture, and Gender in each country, as well as national and district-level nutrition coordination committees (NCC and DNCC). Between June 2016 and March 2021, SANI contributed directly to the improved health of 234,000 women, children and men directly and over 498,000 individuals indirectly.
This final report covers the implementation period of the original SANI contribution agreement and project implementation plan finalized in February 2017.
Key project achievements:
Outcome 1100 aimed to improve nutrition practices and services for women of reproductive age, boys, and girls under 5 by strengthening the delivery of community-based nutrition services at the intersection between community health and the health system. Growth Monitoring and Promotion (GMP) and Community Management of Acute Malnutrition (CMAM) programs built this link, working on the continuum of prevention of malnutrition and early detection and treatment of moderate and severe acute malnutrition. Training and support on Maternal, Infant, and Young Child Nutrition (MIYCN), CMAM, and GMP was provided to health service workers and community health workers, and Care groups were established to support families to learn about and apply gender-sensitive MIYCN practices. Interactive teaching was also done at scale through participatory education theatre and cooking demonstrations using local nutritious foods. Social Analysis and Action (SAA) dialogues encouraged families involved in the program to identify, discuss, and challenge traditional social norms and practices that affect women’s health, nutrition, and empowerment.
Endline data revealed the following increases in nutrition-specific indicators from baseline:
- All three countries had considerable increases in rates of exclusive breastfeeding of children up to 5 months, increasing by 15-percentage points in Zambia (from 70% to 85%), 25- percentage points in Malawi (from 61% to 86%) and 17-percentage points in Mozambique (from 65% to 82%)
- Minimum Acceptable Diet (MAD) for children 6 to 23 months increased by 24-percentage points for boys and girls in Malawi (from 7% to 31%) and in Zambia by 7-percentage points for boys (from 24% to 31%) and by 13-percentage points for girls (from 17% to 30%)
- Knowledge of men and women on MIYCN practices improved by 6-percentage points for men (from 79% to 85%) and 4 percentage points for women in Malawi (from 90% to 94%), by 12- percentage points among women (from 59% to 71%) in Mozambique, and by 11-percentage points for women (from 81% to 92%) and 14-percentage points for men (from 72% to 86%) in Zambia. Read More...
This final report covers the implementation period of the original SANI contribution agreement and project implementation plan finalized in February 2017.
Key project achievements:
Outcome 1100 aimed to improve nutrition practices and services for women of reproductive age, boys, and girls under 5 by strengthening the delivery of community-based nutrition services at the intersection between community health and the health system. Growth Monitoring and Promotion (GMP) and Community Management of Acute Malnutrition (CMAM) programs built this link, working on the continuum of prevention of malnutrition and early detection and treatment of moderate and severe acute malnutrition. Training and support on Maternal, Infant, and Young Child Nutrition (MIYCN), CMAM, and GMP was provided to health service workers and community health workers, and Care groups were established to support families to learn about and apply gender-sensitive MIYCN practices. Interactive teaching was also done at scale through participatory education theatre and cooking demonstrations using local nutritious foods. Social Analysis and Action (SAA) dialogues encouraged families involved in the program to identify, discuss, and challenge traditional social norms and practices that affect women’s health, nutrition, and empowerment.
Endline data revealed the following increases in nutrition-specific indicators from baseline:
- All three countries had considerable increases in rates of exclusive breastfeeding of children up to 5 months, increasing by 15-percentage points in Zambia (from 70% to 85%), 25- percentage points in Malawi (from 61% to 86%) and 17-percentage points in Mozambique (from 65% to 82%)
- Minimum Acceptable Diet (MAD) for children 6 to 23 months increased by 24-percentage points for boys and girls in Malawi (from 7% to 31%) and in Zambia by 7-percentage points for boys (from 24% to 31%) and by 13-percentage points for girls (from 17% to 30%)
- Knowledge of men and women on MIYCN practices improved by 6-percentage points for men (from 79% to 85%) and 4 percentage points for women in Malawi (from 90% to 94%), by 12- percentage points among women (from 59% to 71%) in Mozambique, and by 11-percentage points for women (from 81% to 92%) and 14-percentage points for men (from 72% to 86%) in Zambia. 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...
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...