Nepal

SATH (Self-Applied Technique for Quality Health Tool) Systems Level Impact Evaluation

Poor and marginalized women often encounter obstacles in accessing healthcare information and services in Nepal. In response to this equity gap, CARE Nepal introduced a social mapping tool named Self-Applied Technique for Quality Health (SATH) within Health Mothers’ Groups (HMGs) . The objective of this approach is to enhance women's access to health services and information, empowering them to take informed actions based on their learnings. Since 2008, CARE Nepal has implemented SATH in over 3,100 HMGs across 42 districts out of 77, through various projects. To assess the effectiveness of SATH, evaluation reports, case studies, relevant articles, and policy documents were reviewed and analyzed. It was found that SATH significantly contributes to strengthening the community health system by fostering women's involvement in health matters and operationalizing HMGs. Moreover, the tool aids in generating demand for, and utilization of, healthcare services by empowering women and supporting advocacy efforts.

As a result of these positive outcomes, the Government of Nepal adopted SATH as a successful approach under the Equity, Access, and Utilization Program in 2021. This initiative aims to improve access to, and utilization of, child health and nutrition services among marginalized communities, and it has since been expanded nationwide. This milestone marked a significant achievement in localizing the SATH tool within Nepal's health policy framework. CARE Nepal's rigorous policy advocacy played a pivotal role in this integration, highlighting its commitment to advancing maternal, newborn and child health initiatives. Read More...

System Level Impact Evaluation Report on Categorization-based Farmer ID (FID) System in Nepal

This report highlights CARE's transformative initiatives through the Farmer Identity (FID) Card system, which significantly benefitted landless individuals, women, persons with disabilities, Dalits, Janajatis, and other marginalized groups in Nepal. Conducted from May to June 2024, the comprehensive impact evaluation utilized a participatory approach and contribution analysis to assess the impacts of the FID system. Key findings illustrate how the FID Card system has been integrated into local and federal agriculture policies, enhancing access to services for marginalized farmers and empowering communities. The report details the significant changes in agriculture policy, improved accountability, reduced discrimination, and enhanced social norms resulting from the intervention. The evaluation also identifies challenges and sustainability factors, providing actionable recommendations for future advocacy and implementation strategies.

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How Can Approaches that Achieve Gender Equality Help Advance all the SDGs: Impact Evaluations Evidence from CARE Programs

Approaches that achieve gender equality, that move beyond the individual level to address greater interpersonal, socio-cultural, and community factors that influence gender attitudes and behaviors, have been shown by rigorous impact evaluations to be impactful in promoting gender-equitable attitudes (e.g., SASA! Program in Uganda), reducing gender-based violence (e.g., Stepping Stones and Creating Futures program in South Africa), and decreasing social acceptance of intimate partner violence (e.g., RESPECT program in Tanzania).
Key Findings Summary:
What are the Impacts of Approaches that Achieve Gender Equality?
• Empowerment of women and girls: 8 out of 8 programs have positive impacts on increasing women’s and girls’ self-efficacy, mobility, sexual and reproductive agency, egalitarian gender attitudes, and economic situations; 5 out of 8 programs have positive impacts on reducing early marriage rates and intimate partner violence (IPV), and increasing women’s intrahousehold decision-making power; 6 out of 8 programs have positive impacts on changing community traditional gender norms and increasing women’s community leadership.
• Increased impact on other SDGs, such as poverty reduction (SDG 1), food security (SDG 2), health (SDG 2), education (SDG 4), access to clean water and sanitation (SDG 6), decent work (SDG 8), and reduced inequalities (SDG 10).
How Did These Changes Happen?
• Village Savings and Loan Associations (VSLAs).
• Active engagement of men and boys, community members and leaders.
• Couples’ curriculum and gender dialogues.
• Community-level social norms intervention: Social analysis and action (SAA)
• Life skills and financial management training. Read More...

Private Sector Health Facility Assessment USAID Adolescent Reproductive Health (ARH)

USAID Adolescent Reproductive Health (ARH) is a youth co-led initiative to empower girls and boys,10-19 years old, including the most marginalized, to attain their reproductive rights. The project's primary goal is to support adolescents to reach their full potential and strengthen public systems and private entities to create an enabling environment for healthy reproductive health (RH) behaviors by ensuring the readiness of private health facilities to provide adolescent-responsive services.

OBJECTIVES
The study's main objective is to assess most private health facilities meeting USAID ARH specific criteria and identify gaps in providing high-quality services to adolescents. Read More...

USAID ADOLESCENT REPRODUCTIVE HEALTH A Baseline Study Report

USAID Adolescent Reproductive Health (ARH) is a youth coled initiative to empower girls and boys of 10-19 years,
including the most marginalized, to attain their reproductive health (RH) rights. The goal of the program is to support
Nepali adolescents to reach their full potential by choosing and practicing healthy reproductive behaviors together with the support of their community members.
The baseline study aims to assess the current situation of adolescents' sexual and reproductive health in USAID ARH
working areas (11 districts and 60 municipalities), with specific objectives:
* to identify family planning (FP) and reproductive health (RH) knowledge and practices among adolescents,
exploring mass media exposure and preference among adolescents,
* assess menstrual hygiene practices among adolescents,
* identify factors affecting the age at marriage, and
* identify gender and social norms related to adolescent
SRH issues in the community. Read More...

Understanding the Policy Environment for Scaling Farmers’ Field Business School in Nepal: A Gender Focused Context Analysis with a Focus on Local and Sectoral Governance

The objectives of the Rupantaran project are to enhance dignity and self-esteem with livelihood promotion of Farmer Field Business School (FFBS) groups especially landless, women and Dalits, and other marginalized communities. The project is transforming the knowledge and skills of Small Holder Women Farmers (SHWFs) through the ‘Krishak Pathshala’ (Farmer Field Business School) model based on the ‘Learning by Doing’ approaches at the community level, and beneficiaries are taking the project positively and participating in FFBS model in their respective community.

The study is implemented by National Farmer Group Federation (NFGF) in partnership with CARE Nepal. The primary purpose of the study is to carry out a gender-focused context analysis to understand the policy environment and governance context with a focus on the local governance and sectoral governance of associated sectors with the FFBS scale-up, specifically agriculture, food security, climate change adaptation, nutrition, and markets. The study is focused on structure, institutional and governance arrangement, and the main change actors/stakeholders to enable the promotion of the FFBS model and identify the formal and informal institutions and opportunities that support upscaling of the FFBS model. It is found through the study that the structural barriers for women and Dalits are caste, class, gender, education, land size, ownership, and the traditional patriarchal mindset. Additionally, the study area's socially harmful practices include untouchability, child marriage, Gender Based Violence (GBV), dowry systems, and domestic violence from their intimate partner. Moreover, the care economy does not recognize women’s contribution to household chores.


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Modelling Catalytic Impact at CARE

CARE has set an aspirational catalytic impact target of 200 million people. Catalytic impact is a new impact category that comes from Vision 2030’s focus on impact at scale. CARE defines catalytic impact as the “sustainable impact through the independent adoption or funding of solutions by governments, donors, the private sector, or open replication that originated with CARE and/or its partners”. CARE’s contribution to catalytic impact is indirect. That means it is the impact of our work after our direct programming efforts end or impact, as an indirect effect of our work. Read More...

CARE’s experience of Engaging Men and Boys in programming for Climate Justice: A learning review

While there is a substantive body of gender analysis documenting the gendered impacts of climate change for women and girls, understanding of the ways in which men and boys’ impact and are impacted by climate change remains limited. Environmental disasters caused by climate change also negatively affect boys and men in gendered ways that are, Executive summary in general, different from girls and women, and which can contribute to increased vulnerabilities and risks for women and girls. These differences reflect concepts of masculinity and the influence of associated social norms and processes of gender socialization on the attitudes, values and behaviours of men and boys.

Achieving progress towards Climate Justice is therefore closely and inherently linked to gender justice. Addressing the root causes of the climate emergency will require the engagement of men and boys as actors who are also vulnerable to climate change impacts as actors with agency to bring about transformative change by working alongside women activist allies.

CARE’s EMB model is based on the guiding principle that male engagement to challenge gender inequality involves working with men and boys to shift beliefs, behaviours and practices at household and community levels in support of gender equality and the empowerment of women and girls. Engagement with men and boys contributes to processes of gender transformative change by reducing barriers women and girls face to building agency, addressing inequitable power relations and ensuring that changes in power dynamics and social structures are sustained. CARE’s work with men and boys is also broadly categorised in terms of three levels of male engagement whereby men and boys are engaged as participants, supporters and allies and champions of gender equality. Read More...

Tipping Point Global Impact Evaluation Summary

This summary presents the major findings from a mixed methods impact evaluation study conducted in Bangladesh (Rangpur district) and Nepal (Rupandehi and Kapilvastu Districts) in 2021. This impact evaluation was coordinated by CARE and led by its research partners, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in Bangladesh and Emory University & Interdisciplinary Analysts (IDA) in Nepal. Read More...

Impact Evaluation Summary of Tipping Point Nepal

This brief summarizes the methods, key findings, and results and the implications of the Tipping Point impact evaluation in Kapilvastu and Rupandehi, Nepal. Read More...

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Keywords

Adolescents Agriculture AIDS Basic and Girls' Education Cash Vouchers Child Health Child Nutrition Civil Society and Governance Climate Change Conflict Mitigation COVID 19 COVID 19 RGA Disaster Risk Reduction Economic Development Education Emergency and Humanitarian Aid Entrepreneurship Environment FFBS Food Security Gender Gender Based Violence Gender Equality Health Livelihoods Maternal Migrants and Refugees Natural Resources Nexus Nutrition Resilience RGA Sexual Sexual and Reproductive Health Shelter Social Norms Usaid Vaccination Value Chain VSLA WASH Water Women's Economic Empowerment Women's Empowerment Youth