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Final Evaluation Report: Gender-sensitive WASH, Nutrition and Health Support to vulnerable communities in South and East Darfur

CARE has been implementing the WASH ,Health and Nutrition project from which aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 174,504 individuals (87,077 males and 87,427 females) in East Darfur and South Darfur through the GAC-funded 2019-2021 project (“the GAC project”).The program aimed to benefit refugees in camp and out of camp settings, out of camp IDPs and host communities by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for children under five and pregnant and lactating women (PLWs). End line evaluation was conducted for the ended project.

Water: from the survey result it shows that 85.8% responded that their primary source of water is safe throughout the year, compared to the baseline survey which shows that 66% of the respondents still use unsafe drinking water sources.

Sanitary practices: 73.9% of survey participants indicated that they use family toilets for defecation, where in the base line survey show that 34% of the respondents having access to adequate sanitation.

Practice Of Hand Washing: 60.9 % of interviewees (Female: 61.0%, Male: 60.8%) know three critical moments, where in base line survey 65% of the respondents being able to mention at least 3 critical times to perform hand washing.

WASH satisfaction: The end line survey for HHs reported that with WASH regarding relevance, timely and accountability, (75.3%)- (70.6% f,77.9%m) reported that it was relevant

Nutrition: 72.9%% of respondents were satisfied with the nutrition assistance provided.
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COVID-19 Vaccination Uptake: A study of Knowledge, Attitudes and Practices of Marginalized Communities in Iraq

CARE Iraq conducted a study to better understand community acceptance of COVID-19 vaccination and existing barriers to vaccine uptake. The objectives of the study were to create an understanding of people’s knowledge, attitudes and perceptions about COVID-19 and the vaccines, establish what reasons undermine the COVID-19 vaccination campaign and inform about the status of vaccine uptake among marginalized communities. The results of the study can inform policy makers and health actors to design awareness campaigns and address barriers to vaccine uptake to increase the vaccination rate.

CARE found that:
• Vaccine hesitancy is high.
• Women have less access to, knowledge of, and willingness to accept the COVID-19 vaccine then men.
• Barriers to access are still high, and higher for women than for men.
• Fear of side effects is the biggest obstacle.
• There is little trust in the vaccination process.
• Many people do not believe vaccines are important.
• People are not confident they have enough accurate information.

Key recommendations
• Social media can be a primary channel for vaccine messaging.
• It’s critical to counteract misinformation.
• Multiple sources of information are critical.
• Focus messaging for women and religious leaders.
• Develop different messages in different areas.
• Build on people’s willingness to be convinced with good information. Read More...

Community Scorecard for COVID-19 Vaccines in Malawi

The significant amount of misinformation surrounding COVID-19 has deteriorated trust in governments and health systems, leading the World Health Organization to claim it as an “infodemic.” As the massive vaccine roll-out efforts launch, systematic trust-building and social accountability approaches are vital to ensure that civil society can hold governments accountable for equitable and people-centered vaccine roll-out that reaches the last mile. CARE knows that epidemics, like COVID-19 and Ebola, start and end with communities, which is why we are working to build meaningful citizen engagement into national vaccine roll-out frameworks to increase trust, accountability, and information dissemination.
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...

Empowering Women to Claim their Inheritance Rights: Post-Project Impact Analysis

Between January 2013 to June 2016, CARE International Egypt implemented a project addressing “Empowering women to claim Inheritance Rights (WIN)”. This project was funded by the European Commission under the Gender Equality Programme and aimed to strengthen the access of women particularly those in Upper Egypt to gain access and control over their economic rights, resources and opportunities through their lawful inheritance.

The objectives of this impact evaluation was to:
1. Quantify the Impact achieved as the result of the Amended Inheritance Law in terms of people whose rights to a life free from (economic) violence is being fulfilled to a greater degree than before the amended Inheritance law.
2. Assess and analyse if/how the introduction of criminalization and penalties in the Inheritance Law have enhanced the application of the amended Inheritance Law to date and provide recommendations on how its application can be further improved/strengthened.
3. Identify and analyse non intended effects both positive or negative, of the Amended Inheritance Law with regards to women property rights through inheritance.

Extrapolating the model to the published data on vital statistics, agricultural statistics and income expenditure published by the Central Agency for Public Mobilization and Statistics of 2016 through 2019 reveals that the application of the new amendment of the law potentially results in nearly 34,000 more women who can have access to their inheritance annually.

Based on feedback from women’s’ activists interviewed, the effect of COVID-19 and the closure of courts on the number of women affected was believed to be negligible. Many of these cases are extremely complex and usually take many years in courts and hence would not be significantly affected by this delay.

As inferred from the feedback of key informants, it is too early to to identify positive impacts of the law amendment, however, they highlighted some threats that might hinder the achievement of the desired impact of the law amendment.
- The long duration of the legal dispute and associated legal costs
- Procedural pitfalls
- Socio cultural barriers Read More...

Rapid Gender Analysis, Drought in Afghanistan July 2021

Afghanistan has experienced periodic drought over the past 30 years, but none occurring simultaneously with widespread insecurity and a global pandemic—until now. The combined effects of this “triple crisis” are gravely affecting people throughout the country. Knowing that crises affect different groups of people in different ways, CARE Afghanistan conducted a Rapid Gender Analysis (RGA) from June–July 2021 to assess the gendered effects of the drought, using primary and secondary data. CARE conducted in-person surveys with 352 participants (63.5% female, 36.5% male) in Balkh, Ghazni, Herat, and Kandahar; focus group discussions with 220 women; and key informant interviews with 20 people (20% women and 80% men). Read More...

Host Community Situation Analysis Impact of Rohingya Influx on Host Communities in Ukhia and Teknaf

Bangladesh became host to what is now the biggest refugee camp in the whole world. By November 2017 836,487 FDMN (Forcefully Displaced Myanmar Nationals) fled across the Myanmar-Bangladesh border to settle here mostly in two Upazilas:Ukhia and Teknaf of Cox's Bazar district. By January 2018, it became clear that this would be a prolonged crisis lasting years as the Myanmar government continued dithering about taking them back, and as also the FDMN expressed their unwillingness to go back fearing persecution. As a result of this huge and sudden influx, lives and livelihoods of the host communities have been affected in many ways. Therefore, this Situational Assessment aims to assess both the visible economic and the subtle social impacts of the recent influx on the host communities. Using Oxford’s integration conceptual framework, this assessment has been conducted to chalk out CARE Bangladesh’s future response to the refugee crisis by involving the host communities in the process and addressing their concerns so that the tension between the two communities is defused rather than intensified.
Presence of the refugees has brought about many social and economic changes creating massive pressure on the host communities. Economic activities in the two upazilas have gone through transitions, leading to the emergence of a new market system and reducing employment opportunities for the host communities.
On one hand prices of essentials have shot up almost twice as much, and on the other, due to an unpredictably large number of refugees entering the local labor market wages for day laborers have gone down. Though refugees are living in highly congested camps, they are getting aid materials as well as economic opportunity in the local market. On the contrary, the host communities are finding themselves pitted against the refugees as either their work have been taken away or their earnings significantly reduced. It is true that a few locally influential people owning large tracts of land and businesses are benefitting from the availability of cheap labor, but the poor and the ultra-poor from the host communities are bearing the brunt of these changes. Access to administrative, educational and healthcare needs has diminished. Reduced access and availability of CPR-resultant scarcity of timber, bamboo for shelter, food & cooking fuel created insecurity of accessing resources. Due to security risk of woman and girls mobility has goes down, women income earning opportunity getting reduced; all of this has evidently created tension between the host and the refugee communities and within host community households. If left unaddressed, this tension is likely to rise to the extent of creating potential threats of ethnic conflicts.
In response to these findings of the situational analysis possible types of interventions could be Gender specific livelihoods strengthening initiatives based on diversification of off/on farm activities, Transformative approach to build life free from GBV, Promoting youth leadership and Strengthening service delivery and demand side functions through Inclusive governance.
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Tabora Maternal & Newborn Health Initiative (TAMANI): Year 4 results

The Tabora Maternal and Newborn Health Initiative (TAMANI) is a five-year project led by CARE in partnership with the Government of Tanzania’s Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the Prime Minister’s Office for Regional and Local Government (PO-RALG). Implementing partners include the Society of Obstetricians and Gynecologists of Canada (SOGC), the Association of Gynecologists and Obstetricians of Tanzania (AGOTA), the Canadian Society for International Health (CSIH), McGill University’s Institute for Health & Social Policy, and Ifakara Health Institute (IHI). The project is financially supported by the Government of Canada and is closely aligned to Government of Tanzania (GoT) health polices, strategies and guidelines.
The Annual Report covers the period of April 1, 2020, to March 31, 2021.The report provides an analysis on operations to date against the Year Four Annual Work Plan. This report also highlights how the project
pivoted to respond to the COVID-19 global pandemic and includes reporting on COVID response programming as approved by GAC in March 2020. Read More...

COVID-19 Response in Tabora Tanzania (Bloomberg)

CARE Tanzania builds on its successful partnership with the Government of Tanzania’s Regional Health Management Team (RHMT) in Tabora Region. Leveraging funding from the Government of Canada as part of the Tabora
Maternal Newborn Health Initiative (TAMANI), CARE’s Bloomberg-funded COVID-19 activities builds on efforts to improve access of and quality of health services across health facilities and communities to challenge harmful gender norms.
In partnership with the Government of Tanzania, activities cover all 8 districts in Tabora Region. CARE provides technical support and training to Community Health Workers, who are supported by the government in their duties.With the onset of COVID-19, CARE Tanzania quickly implemented a digital survey to understand the impacts of COVID-19. The majority of female respondents reported increases in gender-based violence and harassment, with COVID-19 restricting women’s access to resources and decision-making. Read More...

The Final Evaluation of the Opportunities for Mother and Infants Development Project

The Opportunities for Mother and Infant Development (OMID) is a three year project (from 2018 to 2021), funded by The Glaxo Smith Kline (GSK). The current phase of the project has been implemented in the two districts (16th and 17th) in Kabul city. The main purpose of the project is to improve the health and reduce the mortality among mothers, newborns and children in the most vulnerable communities through community-based interventions facilitated and delivered by Community Health Workers (CHWs) and Community Midwives (CMWs).

Overall, the project has been effective in achieving the intended outcomes. Access and utilization of Maternal and Neonatal Child Health (MNCH) services have improved as demonstrated by achievement of the project’s key performance indicators across the continuum of care.

This included increases in the %:
- of women reporting ANC utilization
- of women who undertook the first ANC visit before by the 3rd trimester of their pregnancy
- of those who knew the date that the baby was expected to arrive
- of those women who had a plan where she would deliver the baby
- of those women who believed health facility is safer to deliver there

And decreases in the %:
- of those who didn’t go for ANC and believed it is not important
- of those who didn’t go for ANC and indicated the high cost of care as reason

The community systems strengthening undertaken by the project through establishment of community based health facilities and CHWs was effective in increasing health awareness and adoption of positive MNCH behaviors and practices. Read More...

FEASIBILITY STUDY FOR THE PROJECT “NEW ECONOMIC OPPORTUNITIES FOR RETURNEES AND LOCAL PEOPLE IN SOUTH-EAST SERBIA”

This study has been elaborated in order to respond to the needs of CARE International Balkans for the design of the project “New economic opportunities for returnees and local marginalised local people in South-East Serbia”. The research is comprised of several approaches with the aim to deliver sufficient information and data on prospects for the successful implementation of the planned action: information on possibilities for socio-economic inclusion of returnees (in Serbia) and prospects of economic improvement for other groups of citizens vulnerable to migration to western countries.
Purpose of this study is to provide a sound basis for developing a project concept and proposal, by identifying project preconditions, opportunities and risks for its implementation. This study provides relevant information on the socio-economic status of returnees and vulnerable local population, their capacity for economic engagement and employment, access to the labour market, as well as economic potential of local business environment.
CARE International Balkans as the lead organization has selected two partners from civil society organizations, ENECA and NEXUS, as project partners which are situated in the regions in which the project would be implemented. The initial project idea has defined geographical coverage which would include 6 administrative districts in Serbia, concentrated in South East Serbia (districts of Pcinj, Jablanica, Nis, Pirot, Bor and Timok). According to the Population Census conducted in 2011 in Serbia, the population of 6 identified districts totals to 1 089 142 inhabitants of which 481 576 are females. These 6 districts make up 15.15% of the overall population of Serbia according to the 2011 Census. Of the 32 local self governments, 21 are classified in the 4th category of development, 5 are in the 3rd category of development, 4 are in the 2nd category and only 2 (Nis and Bor) are in the 1st category of economic development defined by the Regional Development Agency of Serbia. Additionally, a large number of the LSGs in the 4th category are additionally classified into the group of devastated areas/LSGs.
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