Sexual and Reproductive Health

SATH (Self-Applied Technique for Quality Health Tool) Systems Level Impact Evaluation

Poor and marginalized women often encounter obstacles in accessing healthcare information and services in Nepal. In response to this equity gap, CARE Nepal introduced a social mapping tool named Self-Applied Technique for Quality Health (SATH) within Health Mothers’ Groups (HMGs) . The objective of this approach is to enhance women's access to health services and information, empowering them to take informed actions based on their learnings. Since 2008, CARE Nepal has implemented SATH in over 3,100 HMGs across 42 districts out of 77, through various projects. To assess the effectiveness of SATH, evaluation reports, case studies, relevant articles, and policy documents were reviewed and analyzed. It was found that SATH significantly contributes to strengthening the community health system by fostering women's involvement in health matters and operationalizing HMGs. Moreover, the tool aids in generating demand for, and utilization of, healthcare services by empowering women and supporting advocacy efforts.

As a result of these positive outcomes, the Government of Nepal adopted SATH as a successful approach under the Equity, Access, and Utilization Program in 2021. This initiative aims to improve access to, and utilization of, child health and nutrition services among marginalized communities, and it has since been expanded nationwide. This milestone marked a significant achievement in localizing the SATH tool within Nepal's health policy framework. CARE Nepal's rigorous policy advocacy played a pivotal role in this integration, highlighting its commitment to advancing maternal, newborn and child health initiatives. Read More...

Examining Barriers to Family Planning Information, Products, and Services Among Ukrainian Refugees and Host Communities in Poland (English)

Cash and Voucher Assistance for Family Planning in Poland Assessment Report: This report examines barriers Ukrainian refugees and Polish host communities face in accessing family planning (FP) services. Refugees struggle with financial obstacles like transportation and private healthcare costs, compounded by Poland’s restrictive sexual and reproductive health (SRH) policies. The report highlights the potential of cash and voucher assistance (CVA) to improve access to FP services, with the need for contextual adaptation to Poland’s healthcare system.

Poland SRHR Stakeholder Workshop Learning Brief (August 2024): This brief shares insights from a workshop on sexual and reproductive health rights (SRHR) for Ukrainian refugees and Polish communities. It identified financial barriers, restrictive policies, and stigma as major challenges, and explored how CVA could improve SRH access by partnering with local stakeholders and adapting to Poland's restrictive policy environment. Read More...

USAID’s Community Nutrition and Health Activity (CNHA) Report – Consultation (Meetings with Stakeholders, Households & Community People to Understand Information Sources, Media Access and Habits of CNHA Primary Target Groups to Inform CNHA SBC Strategy)

The USAID Community Nutrition and Health Activity (CNHA) is a five-year project (2023-2028) aimed at improving the nutritional status of women and children within the first 1,000 days of life in vulnerable communities across Bangladesh. Implemented in collaboration with CARE-Bangladesh and partners, the project spans 50 Upazilas in 14 districts and focuses on enhancing service delivery at the community level through health facilities and a strong Social and Behavior Change (SBC) strategy. The project aims to increase the adoption of family planning, maternal and child nutrition, and other health-related practices among its target population of 4 million direct and 10 million indirect participants. To inform its SBC strategy, CNHA conducted stakeholder consultations in February 2024, gathering data from various groups, including pregnant and lactating mothers, adolescents, and community health service providers, through individual and group consultations.

The consultations revealed key findings on the sources and trustworthiness of health-related information, with community health workers like CHCPs and FWAs emerging as the most trusted sources. Although many pregnant and lactating mothers received information on nutrition and family planning, adolescents and mothers-in-law were less informed. Common barriers to accessing accurate information included limited literacy, restricted access to health facilities due to poor transportation, and traditional beliefs that discouraged the adoption of new practices. Despite the widespread use of mobile phones, especially smartphones, media access was limited, with most women relying on family and community gatherings for information. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services. The consultations also highlighted the need for improved communication flow from health facilities to the community, particularly for nutritional information and family planning services, emphasizing the importance of targeted interventions to bridge gaps in knowledge and access within these vulnerable groups.

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Systems-Level Change in Niger: Women and Girls Are Better Off Today Than in 1991

Few development programs have a decades-long lifespan and impact. CARE’s Mata Masu Dubara model (MMD) has been rolled out since 1991, championing women's leadership and economic empowerment in Niger. Originally conceived as savings and credit groups, the model has evolved over the years to address women’s groups demands to have better access to public health services, improve nutrition, receive technical training and participate in civic and electoral processes, among others.

In 2023, CARE initiated a ground-breaking systems evaluation of MMD groups in Niger to explore the actual influence the groups have on women’s and girl’s voice, leadership, economic autonomy and climate justice, published in a May 2023 report. A complementary mixed-methods evaluation conducted from July to December 2023 explores the influence of MMD on women and girls’ maternal health, early and forced marriage, education and nutrition, in partnership with the Government of Niger.

Using CARE’s pathways of systems-level change, combined with qualitative and quantitative data, the study explored four dimensions of change for each one of the topics mentioned above: 1. Advocacy to influence policies and programs; 2. Changes in social norms; 3. Supporting social movements; 4. Strengthening systems and social responsibility. Today, CARE Niger serves 33,795 groups with 865,000 women and girl members. In Maradi, Zinder, Dosso and Tahoua 1,378 women and men answered a survey; 314 women and men participated in focus group discussions and individual interviews.

Are women and girls of Niger better off in 2023 than they were in 1991? Yes. While the review noted progress made towards more gender equity for girls’ education, access and use of sexual and reproductive health services and more attention paid to the welfare of pregnant and breastfeeding women, early and forced marriage still persists. Leveraging the power of MMD groups and other trusted community leaders (teachers, principals, MMD female leaders, religious leaders) to design interventions to curb early marriage would yield tremendous benefits. Indeed, early marriage robs girls of 9% of their future income.

Through MMD, women of Niger have found their voice, been elected to parliament in record numbers (over 30% in 2021), and participate in local decision making processes as town councilors and local representatives. Acting both at the program, local level and the national, influencing one, CARE, its partners and networks of MMD groups will continue to create a better, safer, more prosperous environment for Nigerien girls. (86 pages) Read More...

ELLA ALIMENTA AL MUNDO – PERÚ-Informe Final de Evaluación

CARE PERÚ, desde abril 2019 a diciembre 2022 implementa el proyecto “Ella Alimenta al Mundo”- EAM (SFtW - She Feeds the World - por sus siglas en inglés), programa lanzado en varios países por la Fundación PepsiCo a través de CARE USA. El propósito del proyecto ha sido reducir la desnutrición crónica y la anemia en niñas y niños menores de 5 años e incrementar los ingresos de 4,000 familias pobres que residen en 4 distritos priorizados, correspondiente a las provincias de Lima, Ica y Sullana con enfoque de género. El grupo objetivo son niñas y niños menores de 5 años y mujeres gestantes. Read More...

Intervenciones en Educación Sexual Integral (ESI) en Piura-Evaluación Final

El presente documento contiene los resultados del proyecto “Intervención en educación sexual integral (ESI) y empoderamiento de niñas y adolescentes en Piura” aplicado en Morropón, Piura. Este proyecto fue implementado fuera de la escuela en el C.P. de Yapatera, distrito de Chulucanas y dentro de la escuela en tres instituciones educativas de la zona: IIEE 14618, IIEE 14619, José Pintado Berru. El documento se
divide en cinco partes. En la primera, se presentan los objetivos del estudio y el alcance de éste. En la segunda, los pasos metodológicos necesarios para cumplir con los objetivos. En la tercera, los indicadores de propósito, resultados y productos. La cuarta sección presenta los resultados desagregados de estudiantes y docentes. La quinta parte los resultados cualitativos de docentes y facilitadores. Finalmente, la última parte contienen las conclusiones y recomendaciones de la implementación del proyecto.
El presente trabajo ha identificado mejoras en los indicadores priorizados tanto en docentes como estudiantes a nivel general. En cuanto a los indicadores de propósito, se puede decir que: i) se registraron 330 estudiantes y 15 docentes, ii) hubo un incremento del 8% de la tasa de variación del índice de igualdad de género en las estudiantes mujeres, iii) hubo un incremento global del 22% de la tasa de variación del
índice de igualdad de género en los y las docentes, iv) incremento del 10.55% en tasa de variación de niñas y adolescentes mujeres que obtienen un puntaje deseado (3 a 4 puntos) en el índice de educación sexual integral y normas sociales de género. Read More...

Intervención en educación sexual integral (ESI) y empoderamiento de niñas y adolescentes en Piura-Línea de Base

El presente documento contiene los resultados de la línea de base del proyecto “Intervención en educación sexual integral (ESI) y empoderamiento de niñas y adolescentes en Piura” aplicado en la provincia de Morropón, Piura. Este proyecto fue implementado en tres instituciones educativas de la zona: IIEE 14618, IIEE 14619, José Pintado Berrú. El documento se divide en tres partes. En la primera, se presentan los objetivos del estudio y el alcance de este. En la segunda, los pasos metodológicos necesarios para cumplir con los objetivos. En la tercera, los resultados de los indicadores de propósito, resultados y productos. Finalmente, la última parte contienen las
conclusiones y recomendaciones de la implementación del proyecto.
En cuanto a los indicadores de propósito, se puede decir que: i) se registraron 44 niñas y adolescentes embarazadas en el distrito de Chulucanas; en el C.P. Yapatera se identificaron 3 adolescentes en situación de embarazo, ii) el Índice de igualdad de género promedio ponderado general es de 2.35 (en una escala de 0 a 4), y iii) un 23.84% de las niñas y adolescentes obtuvieron un puntaje de 3 a 4 puntos (en una escala de 0 a 4) en el índice de educación sexual integral y normas sociales de género. Read More...

INFORME FINAL DE EVALUACIÓN Niñas con Oportunidades (NCO)

El presente documento contiene los resultados de la evaluación correspondiente al proyecto “Niñas con Oportunidades” (NCO) implementado por CARE. El documento se divide en cuatro partes. En la primera, se presentan los antecedentes del proyecto. En la segunda, la metodología utilizada. En la tercera, los resultados de los indicadores de propósito, resultados y productos. Finalmente, la última parte contienen las conclusiones y recomendaciones de la implementación del proyecto. Si bien se recogen todos indicadores sujetos a medición del marco lógico, especialmente los indicadores de propósito muestran los primeros avances en los cuatro meses de implementación que ha tenido el proyecto, lo que les permitirá tomar las decisiones necesarias para alcanzar el impacto al 2024.
En cuanto a los indicadores de propósito, se puede decir que: i) las mujeres han mejorado 0.04 puntos en el indicador de bienestar integral; ii) el porcentaje de mujeres embarazadas disminuyó en 0.07%, en base a la respuesta de 28 directores1, y iii) el porcentaje de adolescentes mujeres que terminan la secundaria disminuyó en 10.29%, esto podría deberse a factores contextuales que se deben evaluar. Read More...

INFORME FINAL DE LÍNEA DE BASE Niñas con Oportunidades (NCO)

El presente documento contiene los resultados de la línea de base correspondiente al proyecto “Niñas con Oportunidades” (NCO) implementado por CARE. El documento se divide en cuatro partes. En la primera, se presentan los antecedentes del proyecto. En la segunda, la metodología utilizada. En la tercera, los resultados de los indicadores de propósito, resultados y productos. Finalmente, la última parte contiene las conclusiones y recomendaciones de la implementación del proyecto.

En cuanto a los indicadores de propósito, se obtuvo que: i) las estudiantes mujeres obtuvieron 2.26 puntos en el indicador de bienestar integral ii) en base a la respuesta de 28 directores1, el porcentaje de mujeres embarazadas es 1.46%, iii) el porcentaje de adolescentes mujeres que terminan la secundaria es 65.04%, y iv) el 48.75% sí estudia en un instituto superior o universidad. Read More...

Uganda: Food insecurity a pressing concern

The Development Initiative for Northern Uganda (DINU) was a 38-month long project (January 2020 to February 2023) with an aim to improve food security, maternal and child nutrition, and household incomes for smallholder farmers in 11 districts of Uganda. The project has three major outcomes: increased production of diversified food by both men and women smallholder farmers, enhanced market accessibility for these farmers, and improved nutrition and family planning services through gender responsive community-based approaches. As a result, here was a significant 16.3% increase in adoption and production of diverse food crops and animal products, as well as 23.8% increase in the adoption of climate-smart technologies among the project participants. Read More...

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