Social Norms

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...

End-line evaluation for Building and Strengthening Healthy households’ Order (BAHO) Project

This endline evaluation assessed the performance and impact of the BAHO/Indashyikirwa project implemented by CARE International Rwanda from September 2022 to August 2024 in Gatsibo and Nyagatare districts of Rwanda. The project aimed to enhance women economic condition by reducing intimate partner violence (IPV) through interventions at household, community and village levels. Key interventions included training of couples on equitable and healthy relationships, reducing gender-based violence (GBV) and increasing women’s economic decision-making power as well as engaging Women from Village Savings and Loan Associations (VSLAs), opinion leaders and Community Activists to influence positive change in the target communities. Additionally, the project leveraged digital technology to optimize the program’s reach and effectiveness.
The Building and Strengthening Healthy Households’ Order (BAHO) project was tested on 540 couples (1,000 individuals) with the aim to change attitudes towards violence and control over women’s mobility and finances, promoting positive behaviors such as communication, positive masculinity, shared chores, and joint decision-making.
The study employed a mix of quantitative and qualitative data collection methods including survey questionnaire, Key Informant Interviews (KIIs), Focus Group Discussions (FGDs) and Desk review. Data was collected from all categories of project beneficiaries and partners including trained couples (both using traditional and blended curricula), community activists, opinion leaders, project staff and implementing partners.
A comparative analysis of the findings from both baseline and endline evaluation was performed to examine the project’s impact compared to the situation when it started. Overall, a comparative view of the baseline and endline evaluation findings demonstrate commendable achievements of the BAHO/Indashyikirwa project at both the output and outcome levels, exceeding the initial targets. At the outcome level the project successfully met its target by training 480 couples, totaling 960 individuals, with an equal distribution of 480 males and 480 females. The digital curriculum trained 60 couples (120 individuals) equally divided between males and females. Most importantly, 100% of participants passed all the quizzes, and 100% completed at least 75% of the digitized content. The project trained 228 individuals as community activists (CAs), exceeding the target of 200. This included 124 females and 104 males, with a majority trained through traditional curriculum (192) and the rest (24) through digital curriculum. The project trained 249 community and religious leaders, beyond the initial target of 60 participants. The trained group comprised 147 females and 102 males. Read More...

Women Empowerment for Climate Resilience (WECR) in Laos

The CARE International in Laos’ project entitled: “Women Empowerment for Climate Resilience” (WECR) aims to enhance the capacity of women, particularly in ethnic minorities, to become more resilient to climate change. The project plan defines three pathways to empowerment; increased locally led adaption, increased food and nutrition security, and defining a village-level action plan to increase women’s participation in improving climate resiliency at the local level.

Project Background:
The project takes place in 20 ethnic minority, rural agricultural communities of Khoua, Samphan and Mia Districts in the province of Phongsaly and involved 1,800 ethnic minority women, 1,400 children and their families. Most of the target populations’ livelihoods primarily depend on upland agriculture of cash crops, livestock, and non-timber forest products (NTFPs) for export. Many villages have limited or no access to basic services such as electricity, running water, phone service, healthcare, and education.

The purpose of the evaluation is to determine the system changes achieved by WERC. The evaluation aims to assess the project’s effect and potential effect on the lives of the target population.
Evaluation questions:
• What impact did the WERC activities have on system level pathways to improve livelihoods?
Systems and structural effects:
• What system changes in social norms pathways were successful in improving livelihood?
• What system changes through social accountability pathways were successful?
Impact:
• What level of impact has been achieved in the empowerment of women in decision-making of improving their livelihoods through climate resilience? Read More...

Adolescent Mothers Against All Odds Learning Report

Adolescent Mothers against All Odds (AMAL) Initiative was designed to meet the immediate needs of pregnant adolescents and first-time mothers in crisis-affected settings, while simultaneously addressing community consciousness and engagement around gender, power, and social norms. Using Syria’s context as a frame, this program was developed through an iterative process of adapting global approaches for humanitarian crisis-affected settings. Read More...

LEFTEMAP SISTA II: PROMOTING WOMEN’S ECONOMIC JUSTICE AND ENDING VIOLENCE AGAINST WOMEN AND GIRLS IN VANUATU

The Leftemap Sista II (LS2) project has been implemented by CARE Vanuatu since 2017 with funding from the Department of Foreign Affairs and Trade (DFAT) Australia NGO Cooperation Program (ANCP). The project purpose is “to support women, young women and girls, including those with disability, in rural and remote areas of Vanuatu to realise their rights to live free from violence, have increased economic opportunity and capacity to participate meaningfully in decisions that affect their lives in peace time and disaster.”1 CARE International in Vanuatu (CARE Vanuatu) commissioned a formative evaluation of the project in November 2021. The formative evaluation was required to assess progress against project outcomes for promoting women’s economic empowerment and reducing tolerance of VAWG and to produce actionable recommendations to inform the design of follow-on programming in line with the CARE Australia ANCP Design Framework.

The LS2 project has been implemented in Tafea - the southern-most province of Vanuatu – in 11 communities on the islands of Tanna and Futuna. The Tafea islands are characterised by their geographical isolation, environmental vulnerabilities, including a high risk of natural and geological hazards as well as slow onset hazards such as drought, strongly traditional culture, and limited service delivery by national government across all sectors – especially on the outer islands. Since the project Mid-Term Review in 2019, the LS2 project has been implemented to deliver two long-term outcomes, focussed on:
Outcome 1 – Women, young women and girls in Women’s Economic Livelihoods (WEL) groups in Tafea have increased access to and control over decision-making on economic resources at the household level.
Outcome 2 – Reduced tolerance of Violence Against Women and Girls (VAWG) and better access to services for survivors. Read More...

“In the Eye of the Storm”: Assessment of how Culture, Customs and Conflict are Deepening Protection Risks in Northwest Syria

Across Syria, there are estimated to be 6.9 million IDPs and a total of 14.6 million people in need of humanitarian assistance – an increase of 1.2 million from 202113 in NWS, around 4 million people, including around 3 million IDPs14, need regular humanitarian aid to meet their basic needs. This includes 1.72 million people residing in 1,397 last-resort sites, of whom 80 percent are women and children15.
According to OCHA’s Multisectoral Needs Assessment (MSNA) data from August 2021, the income gap has widened everywhere in Syria, with average household expenditure exceeding income by fifty per cent. Only 10 percent of households have an income above the cost of Syria’s Minimum Expenditure Basket. Across the country, food insecurity remains extremely high – with an estimated 12 million severely food-insecure people, Syria ranked amongst the ten most food-insecure countries globally in mid-202116. More recent data, from Humanitarian Situation Overview in Syria (HSOS)17 in May 2022, and from Mercy Corps’ research18 into the wider impacts of the conflict in Ukraine, suggest a significant deterioration in 2022.

Additionally, in September 2022, Government of Syria declared the Cholera outbreak. As of the 29th of October, a total of 4526 suspected cholera cases have been reported from NWS with 1517 (33.5%) suspected cases reported from IDP camps.26
It is essential to note that these emerging pressures have specific – and different – impacts on men and women; CARE’s commitment to Gender Equality as both a goal and an impact area (Vision 2030 Gender Equality Impact Strategy) reflects an understanding of the differing social positions of men and women, and the disproportionate impacts of conflicts, crises and disasters on women and girls27. Aligned with CARE’s commitment to Gender Equality, Gender is the primary axis of disaggregation and as such, this PNA recognizes that the consequences of increasing food insecurity, increasing prices, and the on-going impact of public health crises have implications for women and girls, not least their increased exposure to gender-based violence28. This PNA, therefore, gives dedicated attention to the specific vulnerabilities of women and girls.
The PNA is further disaggregated by age, and diversity, in alignment with CARE’s commitment to accounting for intersecting vulnerabilities, inequalities and diversity, and recognizing the varying protection needs that arise from these. The data is also analysed through the lenses of age and disability particularly, to ensure that the distinct risks and needs of different groups are both identified and addressed. This means, for example, that the specific needs of boys (gender + age) are recognized and articulated, with the acknowledgement that child labour has a particular impact on adolescent boys, ending their education and putting them at risk of injury, recruitment into criminal activity, and isolating them from support. Child marriage is recognized as a specific concern for adolescent girls as both a mechanism of attempted ‘protection’ and as a way of reducing the resource needs of a family. Women and men with disabilities have protection needs related to their gender, in relation to care (the giving and receiving of), to employment and income-generating opportunities, and to their exposure to sexual exploitation and abuse. These risks and needs are explored throughout this report.

CARE Türkiye has been providing humanitarian programs in NWS since 2013.To deliver its programs in NWS CARE currently works in partnership with five Syrian NGOs and implements directly in Jarablus, Aleppo governorate. CARE’s expertise lies in emergency response (implemented via cash, vouchers, and in-kind assistance); water, sanitation, and hygiene services; shelter and settlement; sexual and reproductive health services; protection and gender- based violence response, prevention, and risk mitigation; livelihoods and economic recovery assistance.

In December 2021, CARE Türkiye commissioned SREO Consulting to conduct a comprehensive protection needs assessment (PNA) in NWS. The main goal of this PNA was to assist CARE, as well as other protection and non-protection actors, in developing protection-responsive humanitarian interventions and addressing NWS's complex humanitarian situation. The assessment aimed to include an age, gender, and diversity (AGD) lens to better understand critical protection concerns and needs of the diverse groups in the targeted communities. Particularly, the specific protection needs, concerns, and service access barriers of adolescents and youth, as well as persons with disabilities, have been assessed to inform well-tailored and well-targeted humanitarian responses. In July 2022 CARE engaged with Heather Cole, an independent technical writer to propose a revised analysis and the final shape of this report. Read More...

Menstrual Hygiene and Health Development Impact Bond

This report is focused on the experience, knowledge, attitude, and practices of menstrual health and hygiene. This involved generating understanding about the MHH knowledge, attitude, and practices among schoolgirls and adult women. It also aimed at creating an understanding of the experience of women and girls within the social norms and economic constraints and forwarding recommendations for future improvement. 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...

A Baseline Study and Social Norms Analysis using SNAP for the project BERHAN: Sexual and Reproductive Health and Rights Initiative in Amhara Region, Ethiopia

Background: BERHAN – Sexual and Reproductive Health and Rights initiative in Amhara region of Ethiopia seeks to support women and girls in Fogera and Estie woredas to safely exercise their sexual and reproductive health rights, leading to improved wellbeing (impact).

Objective: The purpose of this study was to understand the social norms that are associated with the practices of female genital cutting (FGC) and early marriage (EM), and to establish a baseline for all project indicators.

The quantitative survey was conducted on a randomly selected sample of 375 respondents comprising of men, women, girls, and boys (adults and adolescents). Quantitative data were collected using an interviewer administered structured questionnaire. Qualitative data were collected by masters and PhD degree holders, and quantitative data were collected by trained and experienced BSC level data collectors.

Results: The results revealed that FGC and EM were common practices in the community with a prevalence of 85.0% and 64.0% respectively. The community held the practices because of various reasons among which are cultural preservation and lack of knowledge. The community members were highly influenced by the sanctions that made them change their initial positions. Generally, women could not use contraceptive methods without permission from their partners or family members and this applies to all modern contraceptive methods.Only 3.7% of girls and women in the age group of 15-49 were able to use a modern contraceptive of their choice and, only 30.5% were able to decide on their own reproductive health care use. Read More...

Promoting Healthier Lifestyles among Youth in Bosnia and Herzegovina by Challenging Gender Stereotypes – Young Men Initiative Project II (YMI) External Evaluation

Young Men Initiative – “Promoting Healthier Lifestyles among Youth in Bosnia and Herzegovina (BiH) by Challenging Gender Stereotypes II project’s overall goal is to increase the uptake of healthy, nonviolent and gender equitable lifestyles among young men and women in Bosnia and Herzegovina. Young Men Initiative II (YMI II) project builds upon CARE´s comprehensive and programmatic effort to fight interpersonal and gender based violence (GBV) as well as to improve gender equality in Bosnia and Herzegovina and address preventative issues related to youth extremism and violence. This project aims at scaling up and mainstreaming earlier achievements related to the implementation of the Gender Transformative Life Skills program, or short Program Y, via targeted advocacy and a close cooperation with relevant stakeholder through the support of movement/coalition building through the development of new alliances that engage parents and citizens in supporting gender equality focused life skills education program. Through a comprehensive analysis both of the project documentation and the information provided the individual interviews with over 20 project participants, this evaluation drew a set of conclusions, both from the perspective of best practices and key challenges, which consequently led to a set of recommendations for CARE International Balkans on how to continue making this important social change [31 pages]. Read More...

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