COVID 19
The True Cost of COVID-19 Vaccination Campaigns in South Sudan
By November 2023, South Sudan had received 7,076,570 doses and administered 5,101,991 doses of COVID-19 vaccine through various vaccination strategies to curb the detrimental effects of COVID-19. The country has fully vaccinated 5,033,836 individuals across 80 counties of 10 states and 3 administrative areas .
CARE got funding from the United Nations Children's Fund (UNICEF) through Crown Agents (prime recipient of UNICEF). CARE International South Sudan conducted both static and intensified National COVID-19 Vaccination Campaign (NCVC)/Integrated COVID-19 Vaccination and Preventive Therapy (ICVOPT) in 9 counties from 3 states and 2 administrative areas out of 80 counties in South Sudan. CARE implemented the NCVC in Jonglei State (Twic East, Bor South & Duk counties), Western Bahr El Ghazal State (Jur River and Wau counties), Unity State (Rubkona and Mayom counties), Greater Pibor Administrative Area (Pibor County and Boma sub-county), and Ruweng Administrative Area (Pariang county).
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CARE got funding from the United Nations Children's Fund (UNICEF) through Crown Agents (prime recipient of UNICEF). CARE International South Sudan conducted both static and intensified National COVID-19 Vaccination Campaign (NCVC)/Integrated COVID-19 Vaccination and Preventive Therapy (ICVOPT) in 9 counties from 3 states and 2 administrative areas out of 80 counties in South Sudan. CARE implemented the NCVC in Jonglei State (Twic East, Bor South & Duk counties), Western Bahr El Ghazal State (Jur River and Wau counties), Unity State (Rubkona and Mayom counties), Greater Pibor Administrative Area (Pibor County and Boma sub-county), and Ruweng Administrative Area (Pariang county).
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CARE’s Fast and Fair COVID-19 campaign: Comprehensive local-to-global impact
Report available in English, French and Spanish
In November 2020, CARE launched the Fast and Fair campaign to push for fairness and efficiency in the global COVID-19 vaccination effort. We skillfully leveraged our global reach and influence to build and maintain support for more comprehensive funding for vaccine delivery while working hand-in-hand with national and local governments in 34 countries to get the vaccines into the arms of those most in need. Our advocacy and influencing of US and global policy, along with our deep engagement in communities and years of programming investments drove systems-level change that contributed to 21.2 million people getting fully vaccinated in 29 countries. To determine the comprehensive impact of the Fast and Fair campaign, we utilized country case studies, internal program data, and an external evaluation. These sources all affirmed CARE's advocacy and influencing contributions to the global vaccination effort, resulting in millions of vaccinations at the last mile. Read More...
In November 2020, CARE launched the Fast and Fair campaign to push for fairness and efficiency in the global COVID-19 vaccination effort. We skillfully leveraged our global reach and influence to build and maintain support for more comprehensive funding for vaccine delivery while working hand-in-hand with national and local governments in 34 countries to get the vaccines into the arms of those most in need. Our advocacy and influencing of US and global policy, along with our deep engagement in communities and years of programming investments drove systems-level change that contributed to 21.2 million people getting fully vaccinated in 29 countries. To determine the comprehensive impact of the Fast and Fair campaign, we utilized country case studies, internal program data, and an external evaluation. These sources all affirmed CARE's advocacy and influencing contributions to the global vaccination effort, resulting in millions of vaccinations at the last mile. Read More...
Fast and Fair Country Case Studies: Mini Advocacy and Influencing Impact Reporting (AIIR) Tool Analysis
Fast and Fair Country Case Studies: Mini Advocacy and Influencing Impact Reporting (AIIR) Tool Analysis Read More...
Global Covid-19 Supplemental Campaign: A case study to assess the efficacy of CARE and the coalition’s advocacy strategies
Between December 2021 and late March 2022, CARE and five close allies led an ad hoc coalition advocating for US government approval of $17B in supplemental funding for global COVID-19 relief, specifically for resources to support vaccine delivery and front-line health workers. The purpose of this case study is to assess the effectiveness of the advocacy strategies employed by CARE and allies and draw out lessons to (1) inform future campaigning and (2) better integrate this type of assessment in CARE’s MEL activities. Read More...
Fighting for the Least Vaccinated
The global vaccination effort was generally considered inequitable and ineffective. Vaccination rates mostly followed an income-based pattern both in terms of onset of large-scale vaccination efforts and numbers of people vaccinated. Despite global efforts to address vaccine inequity, vaccination coverage in low-income countries has remained low, though the gap is shrinking. CARE USA, an international poverty fighting and human rights organization, began its Fast and Fair COVID vaccine initiative and advocacy campaign in late 2020 –relatively early in the pandemic period. As the campaign’s name suggests, CARE wanted to help steer the global vaccination effort down the path of fairness and efficiency. This evaluation is an assessment of whether and to what extent CARE, in collaboration with its partners, achieved its objectives Read More...
Gender and Power Analysis on CoVID-19 Health System Strengthening Project (CoHSiS)
From July 2022 to April 2025, the COVID-19, and Health System Strengthening Support Project (commonly known as CoHSiS) will be in operation. This three-year initiative, funded by the Japan Social Development Fund (JSDF) and administered by the World Bank Group, aims to empower municipalities to prepare for and respond to COVID-19 and other health emergencies. Specifically, CoHSiS’s implementation is focused on two municipalities: Covalima and Viqueque. To ensure gender equality, the project will incorporate CARE's Gender Equality and Women’s Voice Framework into all its intervention. As part of its planning process, the project aims to conduct a comprehensive gender analysis on six key areas of inquiry: (i) Sexual/gender division of labour, (ii) household decision-making, (iii) claiming rights and meaningful participation in public decision-making, (iv) access to public space and services, (v) control over productive assets, and (vi) violence and restorative justice using both primary methods which include utilising SAA methodology in focus group discussions, key interviews with key stakeholders as key informants and individual survey with the community and secondary data sources.
Key findings
Sexual/Gender Division of Labor
Timor-Leste is predominantly a patriarchal society with strong social and gender norms and gendered power imbalances that lead to gender inequality. At the household level, women and girls are overburdened with work as they perform most of the household chores and child and elder care; and spend their time on agriculture or horticulture work as well as contributing to community or cultural events. On the other hand, based on the primary data analysis, men are expected to be breadwinners for the family and women are expected to take care of the household. In cases where men have performed chores outside their prescribed roles, for example, the daily clock showed caring for babies, taking care of the children, and doing household activities like cooking and fetching water, women and the community at large have stigmatised men. When men try to take up roles that are already defined as women's roles, women and the community can even call men "gay". Additionally, women spend an average of 12 hours daily (5 am – 10 pm) on household chores while men spend an average of 9 hours daily on productive work (6 am – 10 pm) taking out resting time from both males and females. Self-confidence and belief in their own abilities are key components that aid women in negotiating for a fairer household division of labour with their partner.
Despite the existence of negotiation between partners for sharing household chores, tasks remain gendered and resistant to change. Men and boys who challenge these norms by performing household chores face backlash and stigmatization. However, there is some evidence of shifting trends, with more men participating in traditionally female chores.
Household Decision-Making
Generally, women have less decision-making power in households, with their scope often limited to daily matters like food consumption and management of finances for daily expenses. Men tend to make the more substantial decisions regarding matters like buying and selling large animals, land, and generally making agricultural choices.
The division of decision-making power varies depending on the marriage system, with some communities adhering to matrilineal traditions where women have more influence, but even in such cases, significant decisions still require consultation with males within the family.
The study highlights that attending traditional ceremonies and making decisions about children's futures, education, and financial matters can lead to conflicts if not handled jointly. While discussions with community members indicated the importance of mutual consultation in women's negotiation for decision-making, the study also found that women who make independent decisions without consulting their husbands are blamed if the outcomes are unfavourable.
Control over productive assets
In Timor-Leste, control over productive assets, including agricultural land, crops, and animals, poses a significant challenge for women. Men predominantly hold control over big productive assets, such as buffalos and horses, and are the primary decision-makers for household assets. There's a clear distinction between "big assets" and "small assets," with women primarily owning the latter, which includes items like Tais (traditional weavings) which have a lower monetary value.
However, there are signs of change, with recent developments, such as training and activities by NGOs and the government, leading to increased participation of women in decisions about household and productive assets. Joint decision-making, especially on assets with lower monetary value, is now more common. In some cases, men are giving women more autonomy over these assets.
Strategies employed by women to negotiate control over productive assets include mutual agreement, open communication, temporary changes in responsibilities, and shared responsibility.
The study also identifies differences in ownership and control of assets between patrilineal and matrilineal societies, where practices can vary significantly. For example, in patrilineal societies, the presence of a male family member often automatically bestows inheritance rights, while in matrilineal societies, women are prioritized for inheritance, particularly regarding land. However, the study notes that it is essential to consider the specific context of individual families. Read More...
Key findings
Sexual/Gender Division of Labor
Timor-Leste is predominantly a patriarchal society with strong social and gender norms and gendered power imbalances that lead to gender inequality. At the household level, women and girls are overburdened with work as they perform most of the household chores and child and elder care; and spend their time on agriculture or horticulture work as well as contributing to community or cultural events. On the other hand, based on the primary data analysis, men are expected to be breadwinners for the family and women are expected to take care of the household. In cases where men have performed chores outside their prescribed roles, for example, the daily clock showed caring for babies, taking care of the children, and doing household activities like cooking and fetching water, women and the community at large have stigmatised men. When men try to take up roles that are already defined as women's roles, women and the community can even call men "gay". Additionally, women spend an average of 12 hours daily (5 am – 10 pm) on household chores while men spend an average of 9 hours daily on productive work (6 am – 10 pm) taking out resting time from both males and females. Self-confidence and belief in their own abilities are key components that aid women in negotiating for a fairer household division of labour with their partner.
Despite the existence of negotiation between partners for sharing household chores, tasks remain gendered and resistant to change. Men and boys who challenge these norms by performing household chores face backlash and stigmatization. However, there is some evidence of shifting trends, with more men participating in traditionally female chores.
Household Decision-Making
Generally, women have less decision-making power in households, with their scope often limited to daily matters like food consumption and management of finances for daily expenses. Men tend to make the more substantial decisions regarding matters like buying and selling large animals, land, and generally making agricultural choices.
The division of decision-making power varies depending on the marriage system, with some communities adhering to matrilineal traditions where women have more influence, but even in such cases, significant decisions still require consultation with males within the family.
The study highlights that attending traditional ceremonies and making decisions about children's futures, education, and financial matters can lead to conflicts if not handled jointly. While discussions with community members indicated the importance of mutual consultation in women's negotiation for decision-making, the study also found that women who make independent decisions without consulting their husbands are blamed if the outcomes are unfavourable.
Control over productive assets
In Timor-Leste, control over productive assets, including agricultural land, crops, and animals, poses a significant challenge for women. Men predominantly hold control over big productive assets, such as buffalos and horses, and are the primary decision-makers for household assets. There's a clear distinction between "big assets" and "small assets," with women primarily owning the latter, which includes items like Tais (traditional weavings) which have a lower monetary value.
However, there are signs of change, with recent developments, such as training and activities by NGOs and the government, leading to increased participation of women in decisions about household and productive assets. Joint decision-making, especially on assets with lower monetary value, is now more common. In some cases, men are giving women more autonomy over these assets.
Strategies employed by women to negotiate control over productive assets include mutual agreement, open communication, temporary changes in responsibilities, and shared responsibility.
The study also identifies differences in ownership and control of assets between patrilineal and matrilineal societies, where practices can vary significantly. For example, in patrilineal societies, the presence of a male family member often automatically bestows inheritance rights, while in matrilineal societies, women are prioritized for inheritance, particularly regarding land. However, the study notes that it is essential to consider the specific context of individual families. Read More...
PROHORI: Combating Intimate Partner Violence in Bangladesh in the Context of COVID-19
In July 2021, CARE Bangladesh and its local partner GBK launched the Prohori project to prevent intimate partner violence (IPV) and respond to survivors of violence through safe spaces, behavior change communication and capacity building approaches that address gender norms and practices. The 12-month project was generously funded by Voices Against Violence: The Gender-Based Violence Global Initiative, a public-private partnership led by Vital Voices and funded with support from the State Department and the Avon Foundation. The project targeted female garment workers and their male partners in Gazipur District, and female agricultural workers and their male partners in Rangpur District. CARE implemented activities in four locations in Gazipur, a peri-urban industrial area in central Bangladesh, and GBK implemented activities in five locations in Rangpur in northwest Bangladesh. Prohori used a blend of community-based, participatory approaches to prevent IPV, improve IPV survivors’ linkages to post-GBV referral services, and strengthen the capacity of first responders to respond empathetically to people who disclose they have experienced GBV. The project built 9 Women and Girls’ Safe Solidarity Spaces (WSSSs, adding to the 18 that CARE had already established in Gazipur) and strengthened GBV services through capacity building and referral service coordination. Read More...
Foster good health and economic resilience (in the COVID-19 pandemic and beyond): Integrated Programme to Reduce the Medium-term effects of COVID-19 (IPIC) in Sudan
This is the final evaluation for the Kassala state-implemented "Foster Good Health and Economic Resilience (in the COVID-19 Pandemic and Beyond): Integrated Programme to Reduce the Medium-Term Effects of COVID-19 (IPIC)". The evaluation's goal is to assess the project's impact on the targeted beneficiaries and to assess the project's level of achievement, as well as to provide project stakeholders with information about the project's performance in relation to its stated objectives, from January 2020 to December 2022.
Relevance: The project was found to be relevant and responding to the real needs of the targeted communities. The selected communities are among the most vulnerable people in the state, with the majority of them living below the poverty line. According to the baseline survey conducted in October 2020, most of the targeted beneficiaries (53%) have incomes ranging from 10,000 to 20,000 SDG’s per month, which is equivalent to 22 to 44 USD.
Efficiency: The project was carried out with good and acceptable efficiency; the project completed 100% of its planned activities with a high level of participation from the targeted communities and important institutions, particularly the state ministry of health.
Effectiveness: The project was determined to be very effective and resulted in many changes among the targeted persons, as well as a substantial contraption for preventing COVID-19 and reducing its harmful influence on the targeted people, as evidenced by the fact that:
During the project's implementation period, a total of 47,268 people received COVID-19 knowledge and capacity building. This includes all people in the targeted areas, with the possibility of duplicate counting because some people received the awareness more than once. These capacity building and awareness programs were carried out through the execution of awareness campaigns, and the trained community outreached played important roles in disseminating information to their community members. The community outreached were carefully selected with gender (50% women) in mind, and they were trained and provided with the necessary COVID-19 prevention items.
The evaluation witnessed high level of impact and effectiveness in health sector, this ensured by the feedback of all consulted people by direct interviews, FGDs and KII interviews, in addition to the observation of the evaluation team. Different sorts of support offered to the three health facilities enhanced access to health care for 3015 HH (21,105 people), this representing all HH in the three villages.
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Relevance: The project was found to be relevant and responding to the real needs of the targeted communities. The selected communities are among the most vulnerable people in the state, with the majority of them living below the poverty line. According to the baseline survey conducted in October 2020, most of the targeted beneficiaries (53%) have incomes ranging from 10,000 to 20,000 SDG’s per month, which is equivalent to 22 to 44 USD.
Efficiency: The project was carried out with good and acceptable efficiency; the project completed 100% of its planned activities with a high level of participation from the targeted communities and important institutions, particularly the state ministry of health.
Effectiveness: The project was determined to be very effective and resulted in many changes among the targeted persons, as well as a substantial contraption for preventing COVID-19 and reducing its harmful influence on the targeted people, as evidenced by the fact that:
During the project's implementation period, a total of 47,268 people received COVID-19 knowledge and capacity building. This includes all people in the targeted areas, with the possibility of duplicate counting because some people received the awareness more than once. These capacity building and awareness programs were carried out through the execution of awareness campaigns, and the trained community outreached played important roles in disseminating information to their community members. The community outreached were carefully selected with gender (50% women) in mind, and they were trained and provided with the necessary COVID-19 prevention items.
The evaluation witnessed high level of impact and effectiveness in health sector, this ensured by the feedback of all consulted people by direct interviews, FGDs and KII interviews, in addition to the observation of the evaluation team. Different sorts of support offered to the three health facilities enhanced access to health care for 3015 HH (21,105 people), this representing all HH in the three villages.
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“Supporting the response to COVID-19 alongside the Community”. Fast & Fair Initiative
The “Supporting the response to COVID-19 alongside the Community” Project contributed to the government's efforts to control the pandemic. The project strengthened outbreak prevention and control measures in selected communities, targeting people in human mobility, LGBTIQ+ individuals, sex workers and indigenous people of the Awa nationality. The project was implemented in partnership with ASOCIACION RIOS (in Spanish), a local NGO with experience in community health work. This project was funded by CARE USA, as part of the Fast & Fair strategy, in response to COVID-19, which objective is to support countries so that the most vulnerable people can access the vaccine and overcome gender-based and other types of barriers that create inequalities regarding access to vaccination and health services. Read More...
Fast and Fair Support to COVID-19 Vaccine Delivery in Burundi
As response to the COVID-19 pandemic, CARE International in Burundi has implemented a COVID-19 humanitarian intervention (funded by CARE USA/ECSA’s flexible funds) that ended in June 2021. CARE Burundi focused its risk communication and community engagement intervention on the negative economic impacts of the pandemic on women’s workload and health. CARE Burundi has experimented with SMS awareness and community and youth-focused hackathons (idea challenges/solutions) as empowering and dignified mobilizations approaches, unlike traditional outreach activities (widely known as "sensitization", a rather tiring and degrading concept). Read More...