Special Evaluation/Report

Provision of life-saving WASH services to the Rohingya refugee population in Ukhiya and Teknaf Upazila, Cox’s Bazar District.

Applying both quantitative and qualitative tools and approaches, the KAPB was conducted. It covers 777 respondents' households from camps 15 and 16. After quality checking, 757 household response was finalized. Among them, 242 household survey was for Camp 16. All data collection was done with mobile in KoBo. The samples were drawn stratified random sample process. First, the sample size was determined following the most common statistical formula, then stratified. The objectives
of the study are as follows: 1) To know the present situation context on WASH; 2) To identify the targeted respondent's current Knowledge, Attitude, Practice, and Behavior (KAPB). Read More...

The Impact of Integrating Cash Assistance into Gender-Based Violence Response in Northwest Syria

Traditionally, refugees and internally displaced persons (IDPs) have received aid in the form of in-kind assistance. Increasingly, however, cash and voucher assistance (CVA) is being used in humanitarian response to meet the diverse needs of those displaced by crisis and conflict. Preliminary findings by the Women’s Refugee Commission (WRC) indicate that CVA supports gender-based violence (GBV) prevention and response activities, yet humanitarian GBV programming does not comprehensively or consistently consider using CVA. This is a critical gap, as a refugee, internally displaced, and migrant women and girls face multiple risks and incidents of GBV before, during, and after crises. Read More...

Integrated Cash and Gender-Based Violence Programming for IPV Survivors in Guayaquil, Ecuador

Migrant and refugee women and girls are vulnerable to a range of risks before, during, and after humanitarian crises. Intimate partner violence (IPV), a type of gender-based violence (GBV), is among the many protection-specific risks
they face. Traditionally, refugees and internally displaced persons have received aid in the form of in-kind assistance, such as food and blankets. Increasingly, cash and voucher assistance (CVA) is being used in humanitarian response to meet the diverse needs of those displaced by crisis and conflict, enhancing recipients’ autonomy over what they use the funds for. Read More...

The Effectiveness of Cash Assistance Integrated into Gender-Based Violence Case Management for Forced Migrants, Refugees, and Host Nationals in Norte de Santander, Colombia: A Quasi-Experimental Mixed-Methods Evaluation

As a complement to core aspects of GBV case management, preliminary evidence finds that cash and voucher assistance (CVA) may strengthen survivors’ capacities to recover from GBV and enable access to services. For example, CVA can help a GBV survivor to pay the costs associated with fleeing an abusive relationship, such as temporary accommodation and transportation, and to access legal assistance. There may also be indirect pathways in which CVA could be used by survivors and individuals at risk to reduce their exposure to GBV, such as decreasing their financial dependence on abusive partners or family members and shifting power dynamics in intimate relationships. Read More...

Women’s Voice and Leadership Program Formative Evaluation

The formative evaluation of the Women’s Voice Leadership (WVL) Program covered the period from its announcement in June 2017 to March 2021. The evaluation had three objectives: to determine if and to what extent Global Affairs Canada was “fit for purpose” to support WVL as a feminist program; to determine if WVL’s design features and implementation modalities were relevant and appropriate to address the needs of women’s rights organizations (WROs), and to determine WVL’s progress toward results. Read More...

Rapid Assessment on Inclusion Environment of Persons with Disabilities in Selected Garment Factories in Cambodia

Persons with disabilities are among the most vulnerable in Cambodia and have been particularly disadvantaged by the socioeconomic impact of COVID-19 and the response to the pandemic. As part of the GIZ funded project “Strengthening the Economic Resilience of Garment Workers with disabilities during COVID19 and beyond”, implemented by CARE International in Cambodia in partnership with ADD International Cambodia, a rapid assessment was conducted from March to May 2022. The purpose of the assessment was to assess garment factories’ current practice related to Gender Equality, Disability and Social Inclusion and to identify supportive aspects as well as access and inclusion issues related to employment situation of garment factory workers with disabilities. The assessment used participatory multi-stakeholder rights-based approaches to gather qualitative information from 30 different stakeholders, including 16 garment workers with disabilities, 5 garment factory human resource managers as well as 9 representatives from government institutions, NGOs/CSOs, UN agencies and the private sector, supplemented by a literature review and dissemination workshop. Read More...

Urban Community Health Workers in Afghanistan

Building strong relationships and trust between community health workers and the communities they serve prior to public health emergencies can help ensure continuity of health seeking behaviors during times of crisis. When health services dropped during COVID-19 lockdowns, women community health workers increased services 25%.

Health-seeking significantly decreased during COVID-19 lockdown due to fear of contracting the virus, and
many of the health posts in CHWs homes were shut down at this time. In contrast, CARE-supported urban CHWs,
particularly in Kabul and Balkh, were able to continue service provision in their homes due to the strong trust
they had built with the communities they served and their recognized leadership among community members
and as part of the health system. The relationship between CHWs and local communities was complemented by
CARE’s efforts to quickly provide CHWs with personal protective equipment and build capacity on WHO
protocols for COVID-19 screening, detection, and referral of cases as well as risk communication and
community engagement. During COVID-19 lockdown, the CHWs also continued provision of SRH, GBV services,
and referrals to midwives at community-based health centers run by CARE. In addition to maintaining service
delivery, the CHWs also began offering counseling and support to local women using mobile phones. Read More...

Women at the last mile: How investments in gender equality have kept health systems running during COVID-19

Even before COVID-19, investments in health systems—and especially female health workers—were too low. In 2019 the world had a gap of 18 million health workers. Two years and fifteen million deaths later, we have at least 26 million fewer health workers than we need. , This leaves us severely underprepared for future pandemics and other major shocks to the health system, including conflict and climate change. We must invest in health systems that don’t just meet the needs of today, but that are also resilient in the face of future shocks.

Pandemic preparedness requires gender equality: equal recognition, support, and fair pay for ALL health workers. Globally, 70% of health workers are women, but half of their work is unpaid. We must do more to support these health workers. The glimmers of success in COVID-19 built on previous investments in women health workers, their skills, and equality in health systems. Pre-existing investments in equality helped systems respond to COVID-19. Increased investments will build better resilience for the crises that come next.

This report highlights case studies and lessons learned from 20 countries during COVID-19. The evidence shows that we must invest in gender equality in health systems to prepare for and respond to the next pandemic. Health worker training is not enough. Focusing only on health workers working within the formal health system is not enough. We need to work for equality.


At the last mile: Lessons from Vaccine Distributions in DR Congo

The Democratic Republic of the Congo (DRC) has one of the lowest COVID-19 vaccination rates in the world, with just 0.87% of people in DRC having received even one dose. While the country has received 8.2 million doses of COVID-19 vaccine, it has managed to administer 528,000 of them—just under 11% of vaccines available. In April of 2021, DRC became one of the first countries to return 1.3 million COVID-19 doses to COVAX because they could not deliver them to people before the vaccines expired.

The challenges that risked more than a million doses expiring are still in play for most of the country. In both January and February 2022, 114,705 vaccines expired in country because there was not enough investment in systems and health workers to deliver vaccines. To reach 70% of the population—62.7 million people—DRC will need to drastically scale up and accelerate COVID-19 vaccination.

CARE is working with 4 vaccination sites—2 in Butembo and 2 in Goma—to support with community mobilization in partnership with local leaders, health center operations, and training. With joint action and communication plans developed with chiefs, religious leaders, and local authorities, and additional equipment to protect health workers, those sites had vaccinated 1,132 people. In those 4 sites, we have also conducted several rounds of research and problem-solving using community dialogues between health workers and clients using the Community Scorecard, as well as the Social Analysis and Action tools, which provides the insights for this case study. The team has also supported local vaccination teams with IT infrastructure, personnel costs, and creating locally adapted COVID-19 communications plans.

Version Francaise
La République démocratique du Congo (RDC) possède un des taux de vaccination les plus bas dans le monde avec la lutte contre COVID-19. Seulement 0,87% des personnes en RDC ont reçu même une seule dose du vaccin. Alors que le pays a reçu 8,2 millions de doses de vaccin contre la COVID-19, il n’a réussi qu’à en administrer 881,204, soit un peu moins de 11% des vaccins disponibles administrés. En avril 2021, la RDC est devenue l’un des premiers pays à restituer 1,3 million de doses de COVID-19 à COVAX parce qu’elle ne pouvait pas les administrer aux personnes avant l’expiration des vaccins.

Les défis qui risquaient d’expirer plus d’un million de doses sont toujours en jeu pour la majeure partie du pays. En janvier et février, 114,705 doses ont expiré dans le pays parce qu’il n’y avait pas assez d’investissements dans les systèmes et les agents de santé pour livrer des vaccins. Pour atteindre 70 % de la population, soit 62,7 millions de personnes, la RDC devra considérablement intensifier et accélérer la vaccination contre la COVID-19.

CARE travaille avec 4 sites de vaccination – 2 à Butembo et 2 à Goma – pour soutenir la mobilisation communautaire en partenariat avec les leaders et structures locaux, les opérations des centres de santé et la formation. Ces sites avaient vacciné 1 132 personnes. Dans ces 4 sites, nous avons également mené plusieurs séries de recherches et de résolution de problèmes à travers des dialogues communautaires entre les prestataires des services et les clients avec la Carte Communautaire et l’analyse et l’action sociale, à l’aide de la carte de pointage communautaire, qui fournit les informations nécessaires à cette étude de cas. On a aussi appuyé les missions de supervisions avec l’infrastructure pour la connexion internet, la motivation des prestataires, et l’élaboration des plans de communication adaptes aux contextes.

Tackling Vaccine Hesistancy and Expanding Vaccine Access in Tanzania with Community Health Workers in the Lead

Since September 2021, CARE Tanzania has worked as a partner to the Government of Tanzania to improve vaccine access across the country. CARE’s logistical support has helped the government to cover large, underserved geographical areas. To increase vaccine uptake, CARE staff has also engaged local Community Health Workers (CHWs) to address vaccination misconceptions and developed improved health communication and data management tools. An initial training took place in November 2021 and trained 217 CHWs in the Tabora region. With these new resources, these health workers on the front lines have put in place two new strategies. First, COVID-19 vaccination is now integrated with other basic health services at local facilities. CARE supported COVID-19 vaccine distribution in 268 health facilities in Tabora Region. These facilities distributed 20,287 COVID vaccines in areas supported by CARE. Second, the CHWs are now conducting targeted outreach informed by local concerns to address vaccine hesitancy in women and children. Now, not only are vaccinations being provided, CHWs have confirmed that women have increased their acceptance of vaccination shots. Read More...

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