Gender Assessment

Rapid Gender Analysis TO SUPPORT THE GOVERNMENT OF SIERRA LEONE TO STRENGTHEN ITS HEALTH SYSTEM

This Rapid Gender Analysis (RGA) report presents findings from the gender and power analysis carried out in November and December 2023 in Falaba, Kambia, Bonthe, Tonkolili, Kenema, Karene, Kailahun, and Pujehun districts of Sierra Leone. The purpose of the RGA is to understand how gender and social norms, roles, relationships, and dynamics influence health outcomes and health-seeking behavior in Sierra Leone, especially for vulnerable populations. The report will inform the development of CARE’s future health programming and proposed interventions for health funding opportunities.
The document is structured into four primary chapters – Background, Methodology, Findings: Results and Analysis, and Recommendations—each containing sub-chapters. The background section outlines the study’s purpose, objectives, and underlying rationale. The methodology section describes the research design, applied approaches, data collection methods and participant information. The study’s key findings are categorized into distinct thematic areas aligned with CARE's Good Practices Framework for Gender Analysis and includes the following Core Areas of Inquiry:
• Household decision-making, division of labor and control of productive assets
• Control over one’s body
• Access to public spaces and services
• Claiming rights and meaningful participation in public decision-making
The RGA also applies the above domains related to health outcomes, behaviors, and health-seeking behavior, including gender dynamics within the Sierra Leone health system with recognition that unequal gender dynamics gaps impact health care providers and their ability to deliver quality services. Finally, the recommendations section outlines actions or interventions CARE should consider in future programming.
Key Findings:
* Men have more influence over decisions for the household than women—including the seeking of healthcare—and women lack control over key decisions related to sex, marriage, and children, including if and when to use contraception. Women’s mobility is limited by social norms which require male permission for movement.
• Contraceptive use is low. Despite around 70% of people knowing about contraceptives and where to get them, only 50% are currently using them. Many community members believe modern forms of family planning are haram or unhealthy, with anecdotal evidence suggesting there is perception that it promotes extramarital affairs.
• Front Line Health Workers (FLHW) face major barriers to effective service delivery: almost half of FLHWs interviewed are unpaid, effectively operating as volunteers, struggle with difficult living conditions and lack of supplies, and report inequitable treatment between male and female workers.
• There is a lack of evidence-based health information for pregnant women: only 27% of pregnant women in the study reported having received any information related to sexual and reproductive health or associated risks.
• Despite generally positive health-seeking behavior, both women and men are concerned by lack of availability of medicine. Read More...

Rafah Governorate: Deception, Destruction & Death in the “Safe” Zone Rapid Gender Analysis

The ongoing crisis in the Gaza Strip has been described as a “human rights crisis, a human-made humanitarian disaster”1 and a “war on woman.”2 Since October 7th there has been mass scale forced displacement of over a million Palestinians from Northern Gaza to Southern Governorates. The subsequent impacts of this, compounded with pre-existing gender inequalities and multidimensional vulnerabilities, have disproportionately impacted women and girls, as well as other vulnerable groups such as persons with disabilities, children, pregnant and lactating women, elderly populations, those living with chronic and mental health conditions.
Aim and methodology: The aim of this RGA was to hear from women and men currently in Rafah, with a focus on those providing essential services to communities and Internally Displaced People (IDPs) in the Governorate. The aim was to better understand the experiences of women, men, girls and boys at this moment, and to identify how CARE and the local and international humanitarian community, including U.N. Agencies, can best respond - understanding the formidable challenges and barriers to do so.
This RGA was conducted at a time where the population of Rafah were subject to continued and threatened bombardment from land, air and sea. As such it was intentionally designed to be light and small scale in terms of primary data collection; which took place between 7th April to 17th April 2024, and is complemented by secondary data review and analysis.
This RGA is being published in the days surrounding further escalation of violence in Rafah. The Gaza side of the Rafah border crossing with Egypt is blocked 6 and an evacuation order has been issued in the Eastern parts of Rafah; the designated “safe zone” in the Gaza strip. This reinforces the voices of the men and women who told us, with no uncertainty, that nowhere in Gaza is safe.
Key findings related to each area of inquiry and recommendations are summarised below, with more details to be found in the main report.
Key findings:
1. Shifting Gender Roles: Continuous displacement has led to some traditional gender roles adapting and expanding, as well as others being reinforced. Increased and unrealistic pressure has been placed on women to meet the needs and demands of dependents in a highly stressful environment, which has led to an increase in verbal and physical violence against women.
2. Coping Mechanisms: On the verge of starvation, nearly the entire population in Rafah has reported extreme and harmful coping strategies including but not limited to bartering with other essential items, begging, gathering wild foods, scavenging under rubble or in trash or seeking food outside their shelter.8 Reports indicate some women are fasting for several days in a row,9 and boys and girls are forced to work on the street selling or begging. Female heads of household, older women and women with disabilities face security and protection obstacles seeking access to food distributions.10
3. Sustaining through Community Networks of Solidarity: Community solidarity has emerged as a lifeline for survival, such as women supporting children’s education and men distributing food parcels or organising activities for children. Religion and prayer have played a key role in the coping strategies of men, women and children. For youth, social media (when accessible) played a role to maintain connections, articulate fears and share experiences with others. For children, where possible, play and educational outlets within shelters provide a brief respite from the reality of airstrikes.
4. Maternal & Reproductive Health: With an overwhelmed and overstretched health system, people with disabilities, chronic conditions and trauma are left without the most basic care. With estimates of 155,000 women in Gaza pregnant or lactating, and 5,500 expected to deliver in the next month,11 the lack of adequate maternal, sexual and reproductive health services leave mothers, newborns and their children exposed to severe and life-threatening health risks. If women survive pregnancy and childbirth, postpartum recovery, including ability to breastfeed, also present severe challenges.12
5. Mental Health and Psychosocial Support Services (MHPSS): Of extreme concern is the severe emotional, physical and psychological distress among the displaced population, especially among children and youth. As caregivers do their best to survive and manage their own mental health, the impact on children and youth is extensive and holds intergenerational impacts.
6. Education: With formal education effectively stopped since October 7th, children have lost out on a whole academic year of education. While there were reports of some initiatives such as ‘informal learning circles’ and remote learning, these are not easily accessible. Parents, caregivers and children are focused on daily survival; there is the increasing need for adolescents and young girls to support with chores or be confined to their tents due to safety issues; and, particularly for boys, the need to help earn money or seek supplies for the family. Read More...

Strengthening Productive Safety Net Program (PSNP) Institutions and Resilience II (SPIR II) Gender Analysis

Ethiopia’s current estimated population is around 123 million; out of which, approximately 50% are women, and 41% are under the age of 15 (The World Bank). Despite Government's efforts to close the gender gap, women and girls still do not have the same opportunities as men and boys. For instance, in Ethiopia girls and women aged 10 and above spend about 19.3% of their time on unpaid care and domestic work in comparison to only 6.6% spent by men (UN Women). This situation limits their ability to enter and remain in the labor force, which in turn hinders economic growth and development.

World Vision (WV), CARE Ethiopia, IFPRI, and ORDA Ethiopia are jointly implementing Strengthening Productive Safety Net Program (PSNP) Institutions and Resilience II (SPIR II) – a five- year program funded by the USAID. SPIR II's goal is aligned with the Government of Ethiopia’s Productive Safety Net Program 5 (PSNP 5), that aims to address the pervasive issues of food and nutrition insecurity in Ethiopia’s Amhara, Oromia, and Tigray regions. SPIR II targets 531,788 PSNP clients in nine, eight and fours woredas in the Amhara, Oromia and Tigray, respectively.

In March 2023, SPIR II conducted a Gender Analysis (GA) to identify gender and social inequalities that could negatively affect the achievement of SPIR II project objectives and to ensure that the design and interventions to increase women’s empowerment, equity for women, men, boys and girls, and other vulnerable groups (including the elderly, PWDs1, IDPs2) do not exacerbate existing power or abusive gender relations. SPIR II was not implementing in Tigray at that time, so the results generated are from Amhara and Oromia only. Read More...

Rapid Gender Analysis on Power and Participation Shafiullah Khata, Ukhiya, Cox’s Bazar Bangladesh

The current Rohingya refugee crisis is regarded as one of the world's worst humanitarian crises of the twenty-first century. Myanmar's Rohingya Muslims are a stateless Muslim community that have faced systematic discrimination and targeted persecution in Myanmar’s Rakhine State for decades. As the Myanmar government refuses to give Rohingya any citizenship rights, the vast majority of Rohingya have no legal documentation which is effectively making them stateless and trying to escape from the military’s campaign of violence, killing, rape, arson, and other grave abuses.

Bangladesh has taken in the greatest number of refugees thus far. Since 25th August 2017 a large number of Rohingya people has fled into Bangladesh from Myanmar after facing statelessness, targeted violence and discrimination. As of February 2022, there are 923,179 people and 194,091 households in 33 camps in Kutupalong and Nayapara area of Cox’s Bazar District.

There is limited to no participation and/or influence of Rohingya women in decision making or leadership roles within the humanitarian response in Cox’s Bazar Refugee Camp. Societal and religious norms of the Rohingya are patriarchal and tend to favor men’s participation and leadership over that of women; however, there are opportunities identified to support greater participation and leadership of women in public life.
Read More...

Rapid Gender Analysis: Gender, Conflict and Internal Displacement in and from South Lebanon

The overarching objective of this Rapid Gender Analysis (RGA) is to highlight the differential impacts of the growing insecurity at Lebanon’s southern border for men, women and other vulnerable populations such as migrant domestic workers, refugees, and those with diverse sexual identities. The specific objectives are to: (1) Unpack potential shifts in attitudes, behaviours, roles and responsibilities among men and women within the household and community that may enable or prevent more equitable participation in humanitarian program planning and response, especially among internally displaced populations; (2) Identify the gender-based constraints (including gender-based violence and mobility restrictions) that hinder equitable participation or access to humanitarian services/resources/programs; (3) Understand the direct and indirect impacts of the conflict on health, livelihood, shelter, safe access to essential services and resources, including solidarity networks; (4) Generate actionable recommendations for CARE and other humanitarian stakeholders to design and implement more inclusive, equitable and targeted program interventions around key priority areas.

Key Findings
• For domestic migrant workers, refugee and IDP and those identifying as LGBTQI+ mutual aid groups and seeking local solidarity networks are essential in securing essential services, creating advocacy channels and build social safety nets.
• Women in urban regions hold more influencing power over household decisions than those in rural areas.
•Female refugees/IDPs, domestic migrant workers and LGBTQI+ individuals reported barriers to accessing sexual and reproductive health services as well as other essential health services.
•The psychological toll of the current violence is triggering overwhelming levels of stress, anxiety, and fear across the community, especially affecting children and those with memories of migration and conflict.
• Overcrowded shelters lack gender-sensitive considerations and amplify risks of GBV, particularly exploitation and harassment.
• Economic coping strategies from the long-standing economic crisis is taking a toll on livelihoods and the ability of households to save, leading women and other vulnerable groups to be exposed to disproportionate safety and protection risks. Read More...

Her Voice 2024

About this report
Increases in global conflict, the economic impact of COVID-19, market inflation, and the growing effects of climate change are compounding global crises. Those crises disproportionately affect the most vulnerable communities, especially women and girls. Addressing the unprecedented and overwhelming humanitarian crisis requires response and recovery efforts to listen to and address the needs of those affected the most, especially women and girls.

What are women telling us?
1. Crises are compounding: Women are reporting climate change, food insecurity, and conflict as the top three crises that drive impact on livelihood, food security, and safety.

2. Impact on livelihood and food security continue to be the top two reported impacts: 78% of women and 67% of men reported an impact on their livelihood. 74% of women and 72% of men reported an impact on food security. Women are more likely to eat less and sell their assets than men. Soaring food prices and inflation on essential commodities are significant factors that also affect access and availability of food.

3. Safety has overtaken mental health as one of the biggest impact areas: 47% of women and 62% of men reported an impact on their safety. In 2020 and 2021, mental health was the third prioritized impact area; in 2023, however, more women and men prioritized safety.

In the face of unimaginable and compounded crises and impacts, women still show leadership and take action to support their households and communities – 59% of women and 62% of men are trying to restore their livelihood. Women are also supporting to lead community response and are leading at the grassroots level, however, the space for their participation and leadership is shrinking.

The best way to understand what is happening to crises affected population is to listen to their voices and experiences and understand the support they need. This year, we asked women what we should recommend, and their top four asks are: livelihood recovery; addressing food insecurity; strengthening health services and addressing safety concerns.

This report represents 9,517 respondents (7,208 women) from twelve countries and provides quantitative and qualitative insights from countries that CARE conducted assessments in 2023. 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...

OUTCOME MAPPING ASSESSMENT REPORT RESILIECE IN PASTORAL AREAS (RIPA – NORTH)

Gender transformation is a major cross-cutting approach of the Mercy Corps-led RIPA-North program which aims to build resilience in the lowlands of Ethiopia. A key pillar of this approach is to address restrictive gender and social norms which limit female participation in market opportunities, exclude women from having an active voice in community institutions, and undermine nutrition improvements. The approach, led by CARE International, is a process of Social Analysis and Action (SAA) in which participants in RIPA-North community and market platforms engage in dialogue with their communities to identify and ultimately address the restrictive norms.
RIPA-North’s ‘Gender Outcome Mapping' Study, conducted in February 2023, aimed to assess how communities themselves measure theirprogress towards gender equality. The findings indicate very positive signs of progress, with almost 75% of women reporting 'high' or 'medium' levels of change for all eight main categories of gender norm that pose a challenge for women's participation and gender equity. Read More...

Rapid Gender Analysis on Power and Participation Ségou region, Mali (GENRE+II PROJECT)

This Rapid Gender Analysis on Power and Participation (RGA-P) is part of the GENRE+II project in the cercles of Bla, Ségou and Barouéli in the Ségou region of Mali. The project is funded by the Foreign and Commonwealth Office (FCDO) to build capacity for climate change adaptation, gender equality and social cohesion in the Ségou region.
This RGA-P is the first step in CARE's Women Lead in Emergencies (WLiE) model. It summarises the impact of the crisis on gender roles and relations, the capacity of women/girls to cope, participate and influence decision-making in response to the crisis, and offers ideas on how women can strengthen their own participation and leadership. The RGA-P is based on secondary and primary data collection carried out in March 2023 in eight communes in the cercles of Ségou, Bla and Barouéli in the Ségou region. Read More...

Rapid Gender Analysis Ukraine October 2023

This Rapid Gender Analysis (RGA) has been carried out to shed light on the gender dynamics, needs, experiences and challenges of women, men, adolescent girls and boys and people with diverse gender identities, from different groups and backgrounds, as they cope with the humanitarian crisis after more than one and a half years of full-scale war. The analysis explores how pre-existing and reinforced power relations affect people’s experiences of conflict, and how they cope with the ensuing humanitarian emergency. This report draws on primary data collected in four oblasts (Kharkivska, Dnipropetrovska, Odeska, and Mykolaivska), as well as secondary data from before and during the crisis. A mix of quantitative and qualitative research methods was used, including 45 key informant interviews (KIIs), 611 individual surveys, 12 focus group discussions (FGDs), 12 community mapping exercises and eight individual stories. Data was collected from a total of 735 individuals, of which 43% female adults, 28% male adults, 18% adolescent girls, and 11% adolescent boys, including 9.5% individuals living with some form of disability, and 3.9% identifying as LGBTQI+. Additionally, the role of women-led organizations and women’s rights organizations (WLOs/WROs) was highlighted, with a particular interest in understanding barriers and opportunities around leadership and participation in the humanitarian response.
The war in Ukraine is not gender neutral. Since the beginning of the full-scale invasion, women and men have been playing distinct and specific roles. As the humanitarian crisis ensues, a general trend has emerged: women are often providing alone for their families while facing loss of income, family separation, and massive disruptions in the provision of essential services; whilst many men are engaged in the more direct war efforts on the frontlines, exposing themselves to potential death, severe injuries and mental health distress. Although Ukraine has not yet adopted full
conscription, men between ages 18-60 may be called into military service unless they have legal grounds for deferment or exclusion. Many Ukrainian women have also voluntarily enrolled in the military and territorial defense forces.1 Yet, the mobilization of men is deeply rooted in beliefs around masculinity related to self-sacrifice on the battlefield and the defense of their country and family, which reinforces notions of feminine roles rooted in reproductive care. The implications of amplified and more polarized beliefs around gender roles will continue with the ongoing war and its aftermath, particularly for those who may not fit those social norms and expectations, such as people with disabilities and LGBTQI+ individuals. Read More...

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