Special Evaluation/Report

GENDER AND COVID-19 VACCINES Listening to women-focused organizations in Asia and the Pacific

More than a year into the coronavirus pandemic, COVID-19 vaccines are being distributed across at least 176 countries, with over 1.7 billion doses administered worldwide. Combating the pandemic requires equitable distribution of safe and effective vaccines, however, women and girls are impacted by gaps both in the supply side and the demand side that hamper equitable distribution of the vaccine. Evidence reveals that 75 per cent of all vaccines have gone to just 10 countries, and only 0.3 per cent of doses have been administered in low-income countries. Very few of COVID-19 vaccines are going to those most vulnerable. The vaccine rollout in Asia and the Pacific has been relatively slow and staggered amid secondary waves of the virus. India, despite being the largest vaccine developer, has only vaccinated 3 per cent of the population and continues to battle a variant outbreak that, at its peak, was responsible for more than half of the world’s daily COVID-19 cases and set a record-breaking pace of about 400,000 cases per day.5However, the small Pacific nation of Nauru, reported a world record administering the first dose to 7,392 people, 108 per cent of the adult population within four weeks. Bhutan also set an example by vaccinating 93 per cent of its eligible population in less than two weeks. That success could be at risk, given the situation in India and the suspended export of vaccines. Read More...

CROSS-BORDER MIGRATION INTO INDIA AND DEVELOPMENT – Advocacy Paper

The migration discourse has not remained confined to focusing upon the mobility of people from low income countries to high income countries. There has been growing attention to migration from higher-income countries to lower-income countries. The current literature, however, is increasingly taking note of human movements within any of the two regions – the higher income countries and the lower income countries, also described as the global north and the global south respectively. Based on the level of development of the countries of origin and destination, the United Nations has therefore identified a typology of two inter-regional and two intra-regional streams of contemporary international migration: south-north and north-south, south-south and north-north (United Nations 2013). This typology also subsumes the category of a transit country in its roles of being an origin and a destination country at the same time. [26 Pages] Read More...

Women, Migration and Development: Investing in the future

On the 17th and 18th of July 2014, the International Conference on Women, Migration and Development: Investing In The Future was convened by CARE
International and hosted at the Overseas Development Institute in London. The objectives of the conference were to: 1) highlight the challenges faced by vulnerable migrant workers, especially women, 2) advocate, based on CARE and others’ experiences, for strategies, policy and practical responses which need to be taken to protect migrant workers’ well-being, particularly with respect to safe mobility and access to healthcare, 3) recognize women migrants’ contribution as economic actors and advocate for policies and planning processes that ensure their protection, 4) advocate for recognition of the role of migration as a key development enabler in the post-2015 development agenda. CARE and ODI presented the findings from their five year EMPHASIS (Enhancing Mobile Populations’ Access to HIV and AIDS Services, Information and Support) programme in South Asia. EMPHASIS, a project which started as a HIV and health intervention, was successful in surfacing and addressing other aspects such as safety and dignity of migrants, economic empowerment, financial inclusion and safe remittances, access to education for migrants’ children, and women’s empowerment. The conference was a response to the call at the May 2014 Stockholm Global Forum for Migration and Development both for civil society/government cooperation around regional systemic approaches to migration and for urgently needed programmatic data and evidence on migration. EMPHASIS is considered among very few projects globally which comprehensively cover the migration experience from source, through transit, to destination countries. The EMPHASIS Learning Series report, which provides a comprehensive overview of
the EMPHASIS programme, was launched during the conference. [5 Pages] Read More...

A Qualitative study comparing the effects and outcomes of HIV-related interventions for Nepalese migrants – at source, transit and destination

The qualitative study, commissioned by Care Nepal, sought to explore the effects and outcomes of the EMPHASIS project, launched four years ago to reduce HIV and AIDS vulnerability among cross border migrants; and to influence national and regional policies relating to safe mobility through evidence generated regionally. The project, working along a continuum of source, transit, and destination areas, provides HIV prevention and treatment services to migrants and their families. Additionally, the project partners with local stakeholders to ensure safe passage of migrants on transit besides providing other support services. The study was, thus, designed to assess the influence of the project in addressing HIV vulnerabilities, and at the same to enquire into whether inter-country passage has been made safer for migrants. The study aimed to answer the following research questions: a) How has the EMPHASIS intervention impacted HIV vulnerabilities among Nepali migrants, b) What are the qualitative differences between HIV related attitudes and behaviors between migrants reached at destination and their spouses reached at source and those not reached either at source or destination, c) What are the qualitative differences between HIV
related attitudes and behaviors between spouses who have been reached by the project and those who have not been reached by the project, d)) What are the benefits and barriers of support services provided to migrants for safe mobility and empowerment. The study was conducted among 60 migrants and family members, and 5 key informants in four locations- two at the destination site of Delhi and two at the source site of Nepal. In depth interviews by trained researchers were conducted with the help of semi structured interview guides. [39 Pages] Read More...

Bangladeshi Sailors Vulnerability to HIV and AIDs

Enhancing Mobile Populations’ Access to HIV and AIDS Services, Information, and Support (EMPHASIS) is a 5-year initiative funded by the UK’s Big Lottery Fund. The project has been implemented by CARE in three countries,
Bangladesh, India and Nepal. This study was initiated to generate evidence around the vulnerabilities faced by migrant populations traveling to India. Both qualitative and quantitative methods were used to explore the vulnerability of sailors and a standard BCC questionnaire was used to assess knowledge around HIV and AIDS. Qualitative methods were used to compliment quantitative findings to reveal other socio-economic dynamics that can contribute HIV and AIDS related vulnerabilities. Data collection was carried out in both Bangladesh and India. Both qualitative and quantitative data collection was done in Bangladesh,. As entry into the ports in India was restricted, only qualitative methods were used there. A total of 154 were interviewed with a quantitative questionnaire and 24 sailors participated in in-depth interviews. Focus group discussions (FGD) and Key Informant Interviews were conducted with selected community members such as doctors, Noujan Srameek Union members, and vendors. [46 Pages] Read More...

Journeys: Experiences of Nepalese and Bangladeshi cross border migrants living with HIV

Enhancing Mobile Population’s Access to HIV and AIDS Information (EMPHASIS), Services and Support is a 5-year project funded by Big Lottery Fund, UK. EMPHASIS is implemented in Nepal, India and Bangladesh to address AIDS related vulnerabilities of cross border populations who are moving between Bangladesh, India and Nepal EMPHASIS is an operations research project and one of the pioneer regional projects to address HIV and AIDS vulnerability among cross border populations. The project aims to address its goals through service provision,
capacity building of relevant partners/stakeholders, and advocacy through generating evidence. As part of generating evidence, EMPHASIS developed a research study to investigate the dynamics associated with accessing services for mobile groups who are already affected by HIV and AIDS. This study examines people and questions that were not covered by the EMPHASIS baseline survey that was previously conducted.

Three separate studies were conducted in Bangladesh, Nepal and India. Bangladesh and Nepal first initiated the study aiming to understand the dynamics of HIV infection among migrant populations and also to assess barriers to accessing services at source. In India the study was initiated later, to assess the barriers to accessing services at destination. The prime objective of the study was to present these barriers to services at the regional level among the regional stakeholders. Sharing the findings at South Asian Association for Regional Cooperation (SAARC) could be an important way to initiate dialogue between the governments of Nepal and India to formalize a cross border referral system. Country specific barriers to services will be provided as evidence to inform policy at the national level. [45 Pages] Read More...

EXAMINING WOMEN AND GIRLS’ SAFE SPACES (WGSS) IN HUMANITARIAN CONTEXTS: Research Findings from Northwest Syria and South Sudan

Gender-based violence (GBV) in humanitarian contexts represents a global issue of grave concern, disproportionately affecting women and girls. In light of its detrimental impact on the health, well-being and development of survivors, the international community has placed a strong priority on combatting and responding to GBV in all its forms.
Women and Girls’ Safe Spaces (WGSS) are among the most widely implemented GBV prevention and response programming interventions globally. In spite of their popularity and potential to increase the well-being, safety, and empowerment of women and girls, there is a lack of rigorous evidence regarding the role of these spaces in the lives of participants. Building an evidence base is particularly crucial in order to understand the impact and effectiveness of WGSS as an intervention and determine ways in which existing programming can be adapted to increase overall quality.
In response to the crucial need for evidence around WGSS programming globally, CARE USA conducted a study to examine the effectiveness of WGSS in the lives of women and girls in two conflict-affected settings, Northwest Syria and South Sudan. These locations are particularly relevant for this research as the selected study sites are home to a large number of internally displaced persons (IDPs), and are settings in which women and girls face a significant risk of experiencing GBV. These contexts are also ones in which CARE has existing WGSS interventions in place. Read More...

CASH AND VOUCHER ASSISTANCE IN RESPONSE TO THE COVID-19 PANDEMIC

In April 2020, CARE received a five million dollar grant from MARS to implement a multi-country program, including Cote d’Ivoire, Ecuador, Ghana, Guatemala, Haiti, Honduras, India, Peru, Thailand, and Venezuela1, with the aim of reducing the negative impacts of COVID-19 on vulnerable populations, especially women and girls, using complementary and multimodal approaches. A key activity of this program was the provision of cash and voucher assistance (CVA) to vulnerable populations to meet their diverse basic needs. Program data indicated that CVA was implemented in Cote d’Ivoire, Ecuador, Ghana, Guatemala, Haiti, Honduras, and Thailand. Monitoring data from different countries showed that CVA was unconditional; with cash modality representing 95% of transfers. Key targets populations for CVA activities vary by country and include: vulnerable households (Cote d’Ivoire, and Haiti); migrants and refugees (Honduras, Ecuador, and Thailand); domestic workers (Guatemala and Ecuador); survivors of GBV and other forms of violence against women (Guatemala and Ecuador); and lesbian, gay, bisexual, transgender, intersex, and queer/questioning (LGBTQI+) individuals (Ecuador). Across all projects (or countries), participants reported numerous uses of CVA including purchase foods stuff, payment of health services, hygiene services, rental/housing, savings and livelihoods activities.
Given the nature and scale of this program as well as its organizational commitment to learning, CARE was keen to understand the extent to which the project supported and protected vulnerable populations against the loss or disruption of their livelihoods in a gender sensitive manner. The study seeks to provide open-source learnings for peer
companies and agencies on how CVA was utilized in this program with two major questions: (i) How gender sensitive was the process for CARE’s CVA? (ii) How gender sensitive was the intended outcome of CARE’s CVA?
This documentation report compiles lessons from across the projects implemented in the targeted countries and draws from the diversity of their experiences to provide some recommendations on more gender sensitive CVA in the future. Read More...

MAGNIFYING INEQUALITIES AND COMPOUNDING RISKS The Impact of COVID-19 on the Health and Protection of Women and Girls on the Move

More than one year into the coronavirus disease (COVID-19) pandemic—with some countries seemingly on their way out of the crisis while others enter new waves—evidence of its impact is growing. COVID-19 is increasing short-term humanitarian needs and negatively affecting longer-term outcomes for marginalized populations and people in vulnerable situations, significantly setting back hard-won development gains, magnifying inequalities, and compounding risks. Among those worst affected are the more than 80 million people worldwide—approximately half of whom are women and girls—who have been forcibly displaced by drivers such as persecution, conflict, generalized violence or human rights violations.1
The majority of forcibly displaced people live in resource-poor countries with weak public health and social protection systems, and economies that have been hard-hit by the pandemic.2 Yet, to date, there has only been limited research around the unique ways in which women and girls on the move are affected.3 This despite predictions of significant impacts on access to, and use of, basic health services—including for sexual and reproductive health (SRH)—and the overall protection environment, including increases in prevalence and risk of gender-based violence (GBV).
Placing gender at the center of its humanitarian and development responses, CARE undertook new research in Afghanistan, Ecuador, and Turkey between April and May 2021 to better understand how COVID-19 is impacting the health and protection of women and girls on the move. The three countries represent different types of forced displacement across multiple regions: internally displaced persons (IDPs) and refugee returnees in Afghanistan; more recent migrants and refugees due to the Venezuelan crisis in Ecuador; and longer-term Syrian refugees living under temporary international protection in Turkey. The primary data collected for this research included more than 1,000 surveys with women on the move and from host communities, to allow comparison; 31 focus group discussions (FGDs) with women and adolescent girls; and 45 key informant interviews (KIIs) with government actors, health and protection service providers, humanitarian organizations, and CARE staff. Read More...

Community Scorecard in Emergencies Learning Brief

To be effective and equitable towards global populations, humanitarian organizations must adhere to the core standards and principles on quality humanitarian response. Since the inception of ideas on the centrality of local participation in aid in the early 2000s and the more recent evolution of that concept into accountability towards affected populations, the humanitarian community has sought to turn this doctrine into reality.
Accountability in humanitarian response requires that organizations carry out their efforts in an ethically and legally responsible manner that is inclusive of the communities they are seeking to serve. Of UNICEF’s nine Core Humanitarian Standards (depicted here to the right), three specifically refer to mechanisms of accountability towards affected peoples: response is based on communication, participation and feedback; complaints are welcome and addressed; actors continuously learn and improve. In practice this could include centralizing the voices of affected peoples by engaging communities in needs and performance assessments and decision-making. Achieving this is often hindered by the constraints inherent to conflict settings such as lack of localization of assistance, communication between actors, and exploration of needs.
CARE’s Community Score Card
Seeking to actualize these principles of community participation and accountability into our programming, CARE developed the Community Score Card as part of a project aimed at developing innovative and sustainable models to improve health services. Working in crisis settings requires an understanding of the lived experiences of people, the power dynamics, and micro-politics that inform humanitarian response approaches. It also requires bridging the gap between civil society organizations, local and national governments, international non-governmental organizations, and impacted communities. Social accountability approaches do this by connecting citizens with those responsible for providing services. The Community Score Card (CSC) is a participatory social accountability mechanism for assessment, planning, monitoring and evaluation of services. Designed for ease of use and adaptation into any sector with a service delivery scenario, the CSC brings together users and providers of a particular service or program to jointly identify service utilization and provision challenges, mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement. The CSC has five phases: (I) planning and preparation; (II) conducting the scorecard with the community; (III) conducting the scorecard with service providers; (IV) interface meeting where the all parties present their findings in the presence of duty-bearers and then jointly develop action plans; and (V) monitoring of the action plans and evaluation of overall process. Read More...

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