Nepal
Evaluating systems-level change and impact in CARE’s programming in Ecuador, Ethiopia, Nepal and Uganda: A global report
This report provides a detailed analysis and review of the evaluations of four CARE systems-level change projects - from Ecuador, Ethiopia, Nepal and Uganda exploring the extent to which their actions influenced systems change and led to impacts in people’s lives. It represents what is understood as the first time CARE has undertaken a deep dive evaluation into its systems-level approaches. The report begins with an overview of these projects and the Outcome Harvest evaluation methodology used across these countries to measure systems change, including the adaptations made to apply Outcome Harvesting to a systems-level project rather than standard CARE programming. Read More...
Evaluating Systems-level change and impact Findings from the evaluation of the SAMARTHYA project in Nepal
CARE’s ten-year strategy, Vision 2030, seeks to deepen the organizational focus on systems-level change and impact to support CARE’s mission to save lives, defeat poverty and achieve social justice. To support this, CARE launched a systems-level impact initiative to measure the effect of our programs that have influenced or changed systems, and the impact that this systems-change had on people’s lives. The initiative also increased capacity across the CARE confederation to design and implement high-quality systems change programs, and to strengthen the focus on systems-level change within our Country Office organizational frameworks and strategies. Four CARE Country Offices were selected to evaluate one systems-level program, and to synthesize the results and learning of this evaluation for national and global knowledge translation Read More...
Expanding Access to Education and Life Opportunities (Excel)
Expanding Access to Education and Life Opportunities (EXCEL) is an education initiative implemented in Pratappur, Sarawal and Palhinandan Rural Municipalities of Nawalparasi (west) district of Lumbini province. The project aimed to provide access to basic education for marginalized adolescent girls for better life opportunities through a year-long accelerated learning program known as “UDAAN”. Read More...
COVID-19 Vaccine Acceptance among People in Kailali, Nepal
COVID-19 has caused massive disruption and destruction worldwide, with millions of deaths since 2019. Vaccination plays a vital role in ending COVID-19. The objective of the study was to assess
the acceptance of the COVID-19 vaccine and its determinants among the general population aged 18 years and above. A total of 506 participants were interviewed in the study. A quantitative questionnaire covered socio-demographic characteristics of the respondent's knowledge related to the vaccine, misconceptions related to the vaccine, perceived reliable sources, and acceptability of the vaccine. The COVID-19 vaccine acceptance rate was 76% in the study area. The vaccine acceptance rate was slightly lower among female participants (74%) in comparison to their male counterparts (78%). The Bivariate analysis showed a significant association of acceptance of the COVID-19 vaccine with the municipality, caste/ethnicity, and family type. Similarly, in the multivariate analysis, religion, caste/ethnicity, and disability statuses were found to be significantly associated with vaccine acceptance. Concluding that the COVID-19 pandemic cannot be curbed if people do not accept the vaccine. The findings of the study showed that a considerable proportion of the respondents did not accept the vaccine due to fear of the side effects and doubt about vaccine efficacy. Therefore there is a need to increase advocacy and awareness of the COVID-19 vaccine to increase people's trust in it. Read More...
the acceptance of the COVID-19 vaccine and its determinants among the general population aged 18 years and above. A total of 506 participants were interviewed in the study. A quantitative questionnaire covered socio-demographic characteristics of the respondent's knowledge related to the vaccine, misconceptions related to the vaccine, perceived reliable sources, and acceptability of the vaccine. The COVID-19 vaccine acceptance rate was 76% in the study area. The vaccine acceptance rate was slightly lower among female participants (74%) in comparison to their male counterparts (78%). The Bivariate analysis showed a significant association of acceptance of the COVID-19 vaccine with the municipality, caste/ethnicity, and family type. Similarly, in the multivariate analysis, religion, caste/ethnicity, and disability statuses were found to be significantly associated with vaccine acceptance. Concluding that the COVID-19 pandemic cannot be curbed if people do not accept the vaccine. The findings of the study showed that a considerable proportion of the respondents did not accept the vaccine due to fear of the side effects and doubt about vaccine efficacy. Therefore there is a need to increase advocacy and awareness of the COVID-19 vaccine to increase people's trust in it. Read More...
Strengthening Approaches for Maximizing Maternal and Newborn Health (SAMMAN)
The use of the family planning method enables people to achieve their desired number of children and helps to reduce unintended and high-risk pregnancies and unsafe abortions, which contributes to saving the lives of many women. The main objective of this study is to examine the post-intervention impact on the use of family planning methods among married women of reproductive age in Nepal. Read More...
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...
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...
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...
POST PROJECT SUSTAINABILITY (PPS) STUDY FOR VISTAR-II PROJECT
CARE Nepal and Handicap International implemented a community-based disaster risk reduction project called VISTAR-II in Kailali, Dadeldhura, Kanchanpur, and Dang districts under the DIPECHO-VIIII cycle. This project was for a period of 22 months from March 1, 2015, to December 31, 2016. The project aimed to strengthen the resilience of communities and institutions to natural disasters through building leadership and management capacities from the community level to the national level. After five years of the VISTAR-II intervention, a Post Project Sustainability Study was carried out in two randomly selected intervention districts, namely Kailali and Kanchanpur. out of the four districts. Read More...
Dignified and Violence-Free World of Work: A Study on Women Working in Informal Sectors in Nepal
A significant percentage (66.5%)1 of women in Nepal work in informal sectors and are vulnerable to all forms of violence and exploitation. The violence experienced by women in informal sectors ranges from physical, sexual, and verbal harassment to labor and economic exploitation by employers, co-workers and family members. Existing legal provisions such as Sexual Harassment (Elimination) at Workplace Act, 2015 do not have specific provisions for informal sectors whereas other mechanisms to address violence against women, in general, remain ineffective in implementation. In addition, socio-cultural norms and structures limit women’s access to justice-seeking mechanisms. Despite pervasive instances of violence and harassment experienced by women in informal sectors, there is a dearth of comprehensive documentation and evidence building on this issue. In this light, the paper examines the existing status, nature and experiences of violence faced by women working in diverse areas of the informal economy. It also critically analyses key gaps in existing legal provisions/policies and barriers to implementation from the perspective of informal sector workers.
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
Nepal COVID-19 Vaccine Costing Study
By December 6, 2021, 19.2 million doses of COVID-19 vaccines have been administered in Nepal, enough for 36% of the population to have gotten at least one dose of vaccine. After a rough road with unpredictable vaccine supply, the government has been able to procure several million vaccine doses. Now delivery at the last mile is the biggest hurdle they face. Nepal’s Minister of Health says, “We are not going have shortages of vaccines anymore, but our main concern and focus now is on getting these vaccines to all corners of the country, including the remote mountain areas.”
Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
Read More...
Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
Read More...