Sistematización del modelo de respuesta sanitaria desde la comunidad – FORS

CARE Perú en asociación con la compañía minera Antamina implementó el Proyecto de Fortalecimiento de la Respuesta Sanitaria Local a través de la Movilización y Reactivación Social (FORS), con el objetivo de fortalecer las capacidades de respuesta organizada de los sistemas de salud locales y las comunidades/territorios del Área de Influencia Operativa (AIO) de Antamina, frente a la emergencia de la CODIV-19, priorizando a la familia como unidad de vigilancia, información y cambio de hábitos, a través de dos componentes: 1) Movilización local de respuesta a la COVID-19 y Reactivación Social; y 2) Fortalecimiento de los Establecimientos de Salud locales para la atención de la pandemia según nivel de atención. Read More...

CAP Final Proyecto FORS

Este estudio se ha desarrollado en el marco del proyecto Proyecto Fortalecimiento de la Respuesta Sanitaria Local a través de la Movilización y Reactivación Social (FORS). El objetivo del estudio fue implementar el estudio de línea de salida (final) de los Conocimientos, Actitudes y Prácticas (CAP) de las familias del Área de Influencia Operativa de Antamina, del personal de establecimientos de salud del AIO, y valorar la contribución del proyecto FORS en el impacto de la reducción del COVID-19. 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...

COVID-19 Vaccine Acceptance among People in Kailali, Nepal

COVID-19 has caused massive disruption and destruction worldwide, with millions of deaths since 2019. Vaccination plays a vital role in ending COVID-19. The objective of the study was to assess
the acceptance of the COVID-19 vaccine and its determinants among the general population aged 18 years and above. A total of 506 participants were interviewed in the study. A quantitative questionnaire covered socio-demographic characteristics of the respondent's knowledge related to the vaccine, misconceptions related to the vaccine, perceived reliable sources, and acceptability of the vaccine. The COVID-19 vaccine acceptance rate was 76% in the study area. The vaccine acceptance rate was slightly lower among female participants (74%) in comparison to their male counterparts (78%). The Bivariate analysis showed a significant association of acceptance of the COVID-19 vaccine with the municipality, caste/ethnicity, and family type. Similarly, in the multivariate analysis, religion, caste/ethnicity, and disability statuses were found to be significantly associated with vaccine acceptance. Concluding that the COVID-19 pandemic cannot be curbed if people do not accept the vaccine. The findings of the study showed that a considerable proportion of the respondents did not accept the vaccine due to fear of the side effects and doubt about vaccine efficacy. Therefore there is a need to increase advocacy and awareness of the COVID-19 vaccine to increase people's trust in it. 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.


Impact, Influence, and Innovation: Reflecting on 10 Years of the CARE-GSK Frontline Health Worker Initiative

In recognition of their critical role in health linkages and systems strengthening, CARE and GSK established a decade long strategic investment in frontline health workers (FHW) and community health workers (CHW) in 2011 called the Frontline Health Worker Initiative. Following 10 years of partnership and programming, this report explores the resulting impacts, influence, and innovation. It synthesizes reach and impact data from 13 programmes across the 9 countries included in the Frontline Health Worker Initiative between 2011 and 2021. The countries included in this initiative are Afghanistan, Bangladesh, Cambodia, Cameroon, Chad, Laos, Myanmar, Nepal, and Togo.
The data presented here is specific to the communities in which CARE delivered sexual and reproductive health, maternal and child health, nutrition, and sanitation programming with GSK’s support. The analysis is designed to identify the changes in overall health outcomes that occurred at a population level. While these findings do not necessarily imply causation, CARE’s efforts have likely reasonably contributed towards these changes within the specific communities.
The Frontline Health Worker initiative has achieved these results across multiple development and humanitarian contexts – including slow-onset and sudden shocks, conflict, and most recently the COVID-19 pandemic. Many of these results were only made possible through the long-term investment from GSK and scalable actions that were implemented across all nine countries. Critically, the Frontline Health Worker Initiative established platforms, networks and health service capacity-building that served as a catalyst for CARE to pivot towards the response to the COVID-19 pandemic quickly in the communities where these projects exist.
Learnings from this programme will serve to strengthen CARE’s private sector partnership models for future programmes to build resilience and achieve health impact in communities. Read More...

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...

Post Distribution Monitoring/Evaluation finale du projet « COVID-19 : Prévention, protection et relèvement économique »

Les premiers cas de COVID-19 ont été enregistrés au Cameroun en début mars 2020. Au 18 avril 2020 le Cameroun est le 2e pays le plus touché en Afrique subsaharienne et le premier pays de la CEMAC avec 7860 cas confirmés au 08 juin 20201. Afin de limiter la propagation du virus COVID19, le gouvernement a mis en place des mesures de prévention strictes, dont la suspension des
vols commerciaux, la fermeture des frontières, la fermeture des écoles, la fermeture dès 18h des bars, restaurants et lieux de loisirs, l’interdiction de rassemblements de plus de 50 personnes, ou encore l’obligation du port du masque en public à partir du 13 avril 2020.
Pour apporter sa contribution à cet effort de solidarité, CARE International au Cameroun, a mis en œuvre le « Projet COVID-19 : Prévention, protection et relèvement économique » dans le District de santé de Biyem-Assi (Yaoundé) de juin à septembre 2020 en ciblant spécifiquement 150 femmes et filles IDPs et TS. Mis en œuvre en collaboration avec Horizons Femmes, ce projet a fait l’objet d’une évaluation finale interne afin de mesurer et apprécier les changements (éventuels) dus à l’intervention du projet sur les bénéficiaires par rapport à la période concernée.
En ce qui concerne la qualité de l’intervention, l’évaluation établit : (i) la pertinence du projet qui est aligné sur les besoins prioritaires des cibles, les objectifs de développement durable et les politiques nationales, y compris les stratégies de réponse face au COVID-19 ; (ii) une efficacité et une efficience satisfaisantes, les activités réalisées ayant permis d’atteindre les objectifs visés à des coûts et des délais raisonnables ; (iii) une pérennité envisagée, malgré la courte durée du projet, notamment par la continuité de certaines activités dans le cadre du projet CHAMP ; une prise en compte du genre acceptable, ce qui a permis d’adresser les besoins différenciés à chaque groupe ciblé par le projet.
Les recommandations formulées vont dans le sens de : (i) élargir l’intervention dans d’autres zones accueillant la même cible ; (ii) clarifier au lancement du projet les différents niveaux de diffusion de l’information ainsi que le type d’information à communiquer ; (iii) déployer le transfert monétaire inconditionnel dans davantage de projets du programme de redressement et relèvement post-crise ; (iv) accompagner les bénéficiaires ayant développé/redynamisé des AGR à la maturation de leurs activités ; (v) penser à une composante qui permettent aux IDPs qui le souhaitent de retourner vers leurs localités d’origine dans la mesure ou la situation sécuritaire évoluerait dans le sens de l’apaisement ; (vi) revoir la stratégie de sensibilisation sur la Hotline en insistant sur la signification du terme « Hotline » ou trouvant une appellation plus accrocheuse ; (vii) conserver la dynamique du code unique et l’implication des bénéficiaires dans les différentes étapes du projet pour une meilleure redevabilité. Read More...

STRENGTHENING WOMEN AND YOUTH AT RISK OF GENDER BASED VIOLENCE Challenges and opportunities for enhancing resilience, with a focus on urban contexts and adolescent girls

This learning brief documents challenges, capacities and opportunities of women and youth at risk of gender based violence (GBV), in particular in urban areas in Northern Uganda. It summarizes key findings from various studies of the Women and Youth Resilience Project (WAYREP), including two Rapid Gender Analyses, the baseline, knowledge model papers, and a qualitative assessment.
The learning brief informs WAYREP’s learning agenda which aims at:
 Gaining a better understanding of the livelihood and safety, security, and wellbeing challenges that marginalised and vulnerable communities face in urban poor and settlement settings with a focus on girls,
 Identifying and documenting effective and sustainable support strategies to alleviate challenges, namely poverty and gender-based violence (GBV), in the nexus, urban and COVID 19 context.
WAYREP’s overall objective is to “Strengthen the resilience of refugee and Ugandan women, girls and youth to live a life free from violence in Uganda”. WAYREP focuses on women and girls’ empowerment within the context of some of Uganda’s most pressing current challenges such as rapid urbanization, regular and high rates of displacement and migration across and within Uganda’s borders and a very young and largely unemployed population. In 2020, this fragile context was further exacerbated with the outbreak of the COVID-19 pandemic not only in terms of its health implications, but also in terms of its impact on livelihoods, safety and security. Read More...

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