Malawi
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...
Support for Service Delivery Integration- Services (SSDI-Services) Endline
SSDI-Services was the flagship project for USAID/Malawi’s health office. The project was implemented from November 8, 2011 to March 7, 2017 under a cooperative agreement, valued at USD 89 million. Active project implementation occurred over a 4.5-year period from April 2012 to December 2016, with the preceding and following months focused on startup and closeout activities respectively.
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
Malawi VSLA Survey for COVID-19 September 2020
CARE is working with women in savings groups to better understand their needs in COVID-19 and how they are already leading and adapting to cope with the crisis. This is the first of 3 planned rounds of data collection to better understand how women's needs are evolving during the crisis. The findings in this survey are informing CARE's programming for VSLAs in Malawi and globally. Read More...
MALAWI COVID-19 RAPID GENDER ANALYSIS
Coronavirus disease (COVID-19), an infectious disease caused by a newly discovered coronavirus has had a devastating impact globally. While WHO declared COVID-19 as a world pandemic on 30th January 2020, Malawi declared a state of disaster on 20th March 2020 and this was followed with some restrictions including closure of schools. While countries in Southern Africa have imposed lockdowns and other restrictions, as of 7th May Malawi was yet to go on lockdown, which was stopped through a court decision. Malawi is in an election period for fresh presidential elections and with the campaign period officially opened, observance of COVID-19 safety and preventive measures will be a challenge.
Global research findings have shown that COVID-19 has significant social and economic impact on people, especially those living in poverty-stricken countries. Malawi is at more risk due to other significant health challenges that would exacerbate the severity of COVID-19, such as high levels of malnutrition, malaria, anemia, HIV/AIDS, and tuberculosis.
For women and girls, the impacts can be much higher due to their social responsibilities as primary caregivers, coupled with childcare and nutrition and farm work. Further a majority of health care workers are female (especially nurses). In Malawi, the nursing profession is dominated by female nurses of which 91.5% are professional and 84.7% are associates . With the Covid 19 response, there is also an increased risk of exposure to the infection for health care workers, particularly if health care services are not provided with adequate Personal Protection Equipment (PPE).
Read More...
Global research findings have shown that COVID-19 has significant social and economic impact on people, especially those living in poverty-stricken countries. Malawi is at more risk due to other significant health challenges that would exacerbate the severity of COVID-19, such as high levels of malnutrition, malaria, anemia, HIV/AIDS, and tuberculosis.
For women and girls, the impacts can be much higher due to their social responsibilities as primary caregivers, coupled with childcare and nutrition and farm work. Further a majority of health care workers are female (especially nurses). In Malawi, the nursing profession is dominated by female nurses of which 91.5% are professional and 84.7% are associates . With the Covid 19 response, there is also an increased risk of exposure to the infection for health care workers, particularly if health care services are not provided with adequate Personal Protection Equipment (PPE).
Read More...
Gender Implications of Cash Transfers in Malawi
The government of Malawi operates a national safety net program targeting the poorest 10% of the population with unconditional cash transfers and the next poorest 15% with conditional cash transfers through a Cash for Work (CfW) program and vouchers for subsidized agricultural inputs. In 2019 the Government, with support from development partners, has started implementation of an ultra-poor graduation program in nine districts which support ultra-poor households with livelihood grants and complementary services. This safety net is designed to quickly scale to more people or to provide more money to existing participants in case of emergencies.
CARE Malawi set out to identify the gendered implications of this cash programming and how participants’ experiences of cash transfers affected gender equality. To do so, CARE used a combination of literature review and primary data collection with stakeholder consultations, key informant interviews, and focus group discussions (FGDs) at national, district, and community levels. Because of the large-scale cash response to Cyclone Idai in 2019—largely operated through international nongovernmental organizations (NGOs)—the study also compared gendered impacts of the government program and NGO humanitarian response. Read More...
CARE Malawi set out to identify the gendered implications of this cash programming and how participants’ experiences of cash transfers affected gender equality. To do so, CARE used a combination of literature review and primary data collection with stakeholder consultations, key informant interviews, and focus group discussions (FGDs) at national, district, and community levels. Because of the large-scale cash response to Cyclone Idai in 2019—largely operated through international nongovernmental organizations (NGOs)—the study also compared gendered impacts of the government program and NGO humanitarian response. Read More...
CARE Rapid Gender Analysis for COVID 19 East, Central and Southern Africa
The impacts – direct and indirect – of public health emergencies fall disproportionally on the most vulnerable and marginalized groups in society. Interconnected social, economic, and political factors pose complex challenges for the ECSA region’s ability to respond to COVID-19. The region already faces significant health challenges that would exacerbate the severity of COVID-19, such as high levels of malnutrition, malaria, anemia, HIV/AIDS, and tuberculosis. Access to healthcare in the region is the lowest in the world, thus there is limited capacity to absorb the pandemic1. Gender-based inequality is extensive in the region. Women are at a higher risk for exposure to infection due to the fact that they are often the primary caregivers in the family and constitute 70% of frontline healthcare responders.2 Most women already face limited access to sexual and reproductive health and rights (SRHR) services, and the region struggles with high levels of maternal mortality. For example, mother mortality rates recorded in South Sudan were 1150 per 100 000 live births3. COVID-19 will only increase women’s safety risks and care burdens as health services become stretched and resources shift to COVID-19 responses.
Women and girls are at increased risk of violence during the COVID-19 period. Current rates of violence against women and girls combined with the prevalence of harmful traditional practices leads to increased vulnerability. Income loss and limited mobility, compounded with existing gender role expectations, may contribute to increases in intimate partner violence and other forms of gender-based violence. Read More...
Women and girls are at increased risk of violence during the COVID-19 period. Current rates of violence against women and girls combined with the prevalence of harmful traditional practices leads to increased vulnerability. Income loss and limited mobility, compounded with existing gender role expectations, may contribute to increases in intimate partner violence and other forms of gender-based violence. Read More...
United in Building and Advancing Life Expectations Participatory Gender Analysis Final Report
United in Building and Advancing Life Expectations (UBALE), is a five-year (2015-2019) Food for Peace program funded by the United States Agency for International Development (USAID) and implemented by a consortium led by Catholic Relief Services (CRS) in partnership with the Cooperative for Assistance and Relief Everywhere (CARE), Save the Children, and the Catholic Development Commission in Malawi (CADECOM). The program aims to reduce chronic malnutrition and food insecurity and build resilience among vulnerable populations in threedistricts in Malawi, Blantyre Rural, Chikwawaand Nsanje.
The UBALE team carried out a gender analysis in August and September of 2015, with the participation of UBALE key staff from across the program. This is the final report for that gender analysis.
Read More...
The UBALE team carried out a gender analysis in August and September of 2015, with the participation of UBALE key staff from across the program. This is the final report for that gender analysis.
Read More...
UBALE: United in Building and Advancing Life Expectations – PARTICIPATORY GENDER ANALYSIS FINAL REPORT
United in Building and Advancing Life Expectations (UBALE), is a five-year (2015-2019) Food for Peace program funded by the United States Agency for International Development (USAID) and implemented by a consortium led by Catholic Relief Services (CRS) in partnership with the Cooperative for Assistance and Relief Everywhere (CARE), Save the Children, and the Catholic Development Commission in Malawi (CADECOM). The program aims to reduce chronic malnutrition and food insecurity and build resilience among vulnerable populations in three districts in Malawi, Blantyre Rural, Chikwawa and Nsanje.
This report describes the process and findings specific to the UBALE program. Read More...
This report describes the process and findings specific to the UBALE program. Read More...