Special Evaluation/Report

Gender Gaps in Vaccines November 2021

COVID-19 vaccinations are quickly becoming a story of inequality. Gender inequality is a critical part of this story. In 22 of 24 countries where CARE has data, women are less likely to be vaccinated and less likely to feel vaccines are safe.

There are massive local and global gaps in who can get vaccinated. Only 4.5% of people in low-income countries are vaccinated, and 79% of vaccinations have been in wealth countries. Tragically, wealth and geography are just two factors that skew access to vaccines. Another is gender. In many low and middle-income countries, women are less likely to get COVID-19 vaccines than men are. This compounds gender inequality women are already facing in health and decision-making Read More...

Who pays to deliver vaccines? An Analysis of World Bank Funding for COVID-19 Vaccination and Recovery

The World Bank is one key source of funding in the global push to vaccinate 70% of the world’s population against COVID-19. Many actors point to this as the funding that will cover any additional delivery needs for COVID-19 vaccines that national governments cannot meet. With $5.8 billion in funding already approved out of a $20 billion commitment, the World Bank funding is an important part of the picture, but the World Bank alone cannot cover the full gap in vaccine delivery needs.

Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.

• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.

Enquête Trimestrielle pour le Rapportage du Plan de Mesure de Performance Projets “OLAM VSLA” & “TOUTON VSLA”

Dans le cadre de cette enquête trimestrielle, la méthode d’échantillonnage utilisée est le sondage aléatoire systématique stratifié au premier degré. La taille de l'échantillon de l'enquête trimestrielle des projets OLAM VSLA et TOUTON VSLA a été calculée et s’établit à 339 membres de VSLA. [7 pages] Read More...


L’intervention du PROMEESS III est soutenue par l'analyse genre détaillée en tenant compte des spécificités des participants en termes des différents besoins, rôles, relations, risques de protection dynamiques de pouvoir entre les femmes/hommes/filles/garçons. Read More...

Learning to Listen: Regional Partnerships and Impacts

In 2017, CARE asked, “What will it take to scale our impact by 10 times more than we currently do? What about 100 times?” Part of the answer to that, with significant unrestricted investments from 2017-2020, were CARE’s Impact Growth Strategies. These aim to address the “missing middle” by supporting the skills, staff, and connections needed to bring our work together across regions and partners.
A recent review of these 4 regional platforms—Equal value, equal rights (EVER) in LAC; Women on the move (WoM) in West Africa; Her harvest, our future (HHOF) in Southern Africa; Made by Women in Asia Pacific—shows significant return on the investment. These returns merit continued investment in regional platforms that take creative approaches to partnership, local leadership, and the evolution of CARE’s operating models.
• Contributing to impact for 12 million people, with potential impact for 78 million more people impacted over the coming years.
• Paving the scaling pathways by demonstrating different models of partnership, design, evidence, impact, and fundraising. These experiences provide valuable experience and evidence of what works (and doesn’t) and how to continue our ambition of sustainable impact at scale.
• Demonstrating concrete tools and ability to center the voices of the people we serve, in new partnership models, feedback systems, power structures, and evidence. This includes crucial lessons on how to live out our strategic goal of being locally led and globally connected.
• Mobilizing resources by contributing to roughly $100 million in new restricted and flexible funding.

Cost-efficiency analysis Conditional Cash for Education and Protection

This case study summarizes an analysis conducted by CARE using the Dioptra tool to generate cost-efficiency estimates for Conditional Cash for Education and Protection in Jordan. The analysis revealed that:
● Conditional Cash for Education and Protection cost $1,474 per child on average, across nine projects within the program portfolio.
● Tweaking the transfer size and frequency can affect cost-efficiency by more than 30 percent. It can free up funds to reach at least 40 percent more children with conditional cash, or allow existing recipient households to benefit from other economic resilience interventions.
● Providing awareness sessions on the importance of education is a small cost component of conditional cash that could be cost-effective.
● Different interventions are required for different groups of children. At minimum, the children receiving conditional cash should be differentiated by age: young (6-11) and old (12-16).
● Providing conditional cash for the full school year of at least 10 months is believed to be more effective and protective for children in need.
● Despite its effectiveness, cash incentives are unlikely to be a sustainable intervention to ensure children’s school attendance. It could benefit from other supporting interventions that address social barriers preventing children from attending school.
● Based on further assessments on different approaches and best practices, the program team intends to test a gradual reduction in transfer amounts for 10 months per year over 3 years, differentiated by age group, including livelihoods support for all recipient households, and referrals to Emergency Cash Assistance for highly vulnerable households.
Cost-efficiency estimates are cited for learning purposes only, and should not be used as the sole basis for future budgeting or benchmarking. All cost-efficiency estimates include Direct Project Costs, Direct Shared Costs, and Indirect Costs. Read More...

START Fund Distributions In Pakistan

The activities of the START Fund were designed in lieu of the communities' needs identified by the existing field staff monitoring flood situation and working in Muzaffargarh. As part of the activities, medical supplies were given to target beneficiaries and hygiene promotion sessions were conducted to inform the communities of the risk and prevention measures from COVID-19, and water borne diseases
CARE International in Pakistan conducted post distribution monitoring study with 10 participants (90% female and 10% male) in UC Rang Pur of District Muzaffargarh. The study was conducted to get beneficiaries feedback. satisfaction about the distribution, familiarity with feedback & complaint response mechanism, and COVID-19 information and compliance.

Gender Gaps in COVID 19 Vaccines

COVID-19 vaccinations are quickly becoming a story of inequality. Gender inequality is a critical part of this story. In 16 countries where CARE has data, women are less likely to be vaccinated, and less likely to feel vaccines are safe.
There are massive local and global gaps in who can get vaccinated Only 1 9 of people in low income countries are vaccinated, and 79 of vaccinations have been in wealth countries Tragically, wealth and geography are just two factors that skew access to vaccines Another is gender In many low and middle income countries, women are less likely to get COVID-19 vaccines than men are This compounds gender inequality women are already facing in health and decision making Read More...

COVID-19: Impacts, Attitudes, and Safety Nets in Haiti (April 2021)

In April 2021, CARE conducted interviews with savings group members and leaders to understand their experiences of COVID-19, and how it was changing their lives. The survey included 364 women and 175 men, for a total of 539 respondents. This follows a survey done in June 2020 to understand what was happening at that time for members of savings groups. The surveys covered Artibonite and Grand Anse.

COVID-19 continues to have important impacts for women and men in savings groups. In general, men and women in these groups were reporting similar challenges across the sample. 86% of women and men are reporting impacts in their livelihoods, and 98% of people say that COVID-19 is affecting their ability to save. 64% say they can’t meet family needs and hunger has gone up. 90% of people are reporting that COVID-19 is impacting their social lives. More women than men report that Gender Based Violence has gone up. While women are more likely to have lost influence in the household than men (39% compared to 33%), men are more likely to report that they lost social status in the community (48% compared to 43%). 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...

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