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Who pays to deliver vaccines? An Analysis of World Bank Funding for COVID-19 Vaccination and Recovery
The World Bank is one key source of funding in the global push to vaccinate 70% of the world’s population against COVID-19. Many actors point to this as the funding that will cover any additional delivery needs for COVID-19 vaccines that national governments cannot meet. With $5.8 billion in funding already approved out of a $20 billion commitment, the World Bank funding is an important part of the picture, but the World Bank alone cannot cover the full gap in vaccine delivery needs.
Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
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Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
Read More...
TAMANI (Tabora Maternal and Newborn Health Initiative) Impact Evaluation
According to the 2015-2016 DHS survey, Tabora region has the highest percentage population (45.8%) in the lowest wealth quintile in the country, which reflects high levels of structural inequality that have a direct bearing on reproductive, maternal, newborn, child, and adolescent health outcomes.(2) Polygamy is most prevalent in the Western zone with approximately one-third of marriages polygamous, contributing to high fertility rates. Tabora has a low contraceptive prevalence rate of 21.9%, and the Western Zone has the highest levels of teenage childbearing in Tanzania (38%). The latest DHS survey (2015-2016) indicated that 44.3% of women in Tabora deliver at home.
Given this context, the international aid organization CARE began reproductive health programming in Tabora in 2012 with the aim of improving maternal and reproductive health. This paper presents an impact evaluation of CARE’s second stage of reproductive, maternal and newborn health programming in Tabora, the Tabora Maternal and Newborn Health Initiative (TAMANI), which builds on the experience of CARE in the region and spans from 2017-2021. Read More...
Given this context, the international aid organization CARE began reproductive health programming in Tabora in 2012 with the aim of improving maternal and reproductive health. This paper presents an impact evaluation of CARE’s second stage of reproductive, maternal and newborn health programming in Tabora, the Tabora Maternal and Newborn Health Initiative (TAMANI), which builds on the experience of CARE in the region and spans from 2017-2021. Read More...
Learning to Listen: Regional Partnerships and Impacts
In 2017, CARE asked, “What will it take to scale our impact by 10 times more than we currently do? What about 100 times?” Part of the answer to that, with significant unrestricted investments from 2017-2020, were CARE’s Impact Growth Strategies. These aim to address the “missing middle” by supporting the skills, staff, and connections needed to bring our work together across regions and partners.
A recent review of these 4 regional platforms—Equal value, equal rights (EVER) in LAC; Women on the move (WoM) in West Africa; Her harvest, our future (HHOF) in Southern Africa; Made by Women in Asia Pacific—shows significant return on the investment. These returns merit continued investment in regional platforms that take creative approaches to partnership, local leadership, and the evolution of CARE’s operating models.
• Contributing to impact for 12 million people, with potential impact for 78 million more people impacted over the coming years.
• Paving the scaling pathways by demonstrating different models of partnership, design, evidence, impact, and fundraising. These experiences provide valuable experience and evidence of what works (and doesn’t) and how to continue our ambition of sustainable impact at scale.
• Demonstrating concrete tools and ability to center the voices of the people we serve, in new partnership models, feedback systems, power structures, and evidence. This includes crucial lessons on how to live out our strategic goal of being locally led and globally connected.
• Mobilizing resources by contributing to roughly $100 million in new restricted and flexible funding.
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A recent review of these 4 regional platforms—Equal value, equal rights (EVER) in LAC; Women on the move (WoM) in West Africa; Her harvest, our future (HHOF) in Southern Africa; Made by Women in Asia Pacific—shows significant return on the investment. These returns merit continued investment in regional platforms that take creative approaches to partnership, local leadership, and the evolution of CARE’s operating models.
• Contributing to impact for 12 million people, with potential impact for 78 million more people impacted over the coming years.
• Paving the scaling pathways by demonstrating different models of partnership, design, evidence, impact, and fundraising. These experiences provide valuable experience and evidence of what works (and doesn’t) and how to continue our ambition of sustainable impact at scale.
• Demonstrating concrete tools and ability to center the voices of the people we serve, in new partnership models, feedback systems, power structures, and evidence. This includes crucial lessons on how to live out our strategic goal of being locally led and globally connected.
• Mobilizing resources by contributing to roughly $100 million in new restricted and flexible funding.
Read More...
Final Report for the Final Evaluation of OFDA Response program
This report presents the final evaluation of the United States’ Agency for International Development (Office of Foreign Disaster Assistance ( Response Program implemented by CARE Turkey and its partners in Aleppo and Idleb governorates of Northwest Syria. The evaluation aimed to assess the program’s relevance, efficiency, effectiveness, impact, sustainability and coordination using the Organization for Economic Co operation and Development's Development Assistance Committee (OECD DAC) evaluation criteria and was carried out from July to October 2021.
“I am very satisfied with this assistance in terms of gravelling the road, providing the camp with water and upgrading the tents for the entire camp. All of those interventions were desperately needed. People are satisfied because the situation has improved within the camp.”
-Camp Manager
“I can say that this service is very important in all aspects because it is securing clean and safe water for the neighborhood (…). Everyone in the neighborhood is satisfied with the services.”
-FGD participant Read More...
“I am very satisfied with this assistance in terms of gravelling the road, providing the camp with water and upgrading the tents for the entire camp. All of those interventions were desperately needed. People are satisfied because the situation has improved within the camp.”
-Camp Manager
“I can say that this service is very important in all aspects because it is securing clean and safe water for the neighborhood (…). Everyone in the neighborhood is satisfied with the services.”
-FGD participant Read More...
Water for Food Security, Women’s Empowerment and Environmental Protection (SWEEP) Project
CARE, with the financial support from the Austrian Development Agency (ADA), has been implementing a three-year project titled "Water for Food Security, Women's Empowerment and Environmental Protection (SWEEP)" Project in East and West Belesa Woredas of Central Gondar Zone, Amhara Regional State. The SWEEP project was designed to address the socio-economic and environmental problems causing food insecurity, including inadequate access to water supply and environmental degradation, social barriers and gender inequality, limited livelihood opportunities and low productivity. Therefore, the final evaluation aims to evaluate the project's impact in terms of changes for the intended beneficiaries and provide evidence for future decisions demonstrating accountability to the project beneficiaries, stakeholders, and donors. [135 pages] Read More...
ASHAR Alo Project (Action for Supporting the Host Communities: Adaptation and Resilience)
ASHAR Alo (Action for Supporting the Host Communities: Adaptation and Resilience), meaning ‘Light of Hope’ in Bangla.
The project activities are focused on Jaliyapalong, Haldiapalang,Ratna Palong, PalongKhali union of Ukhiya Upzila and Dakshin Mithachari and Chakmarkul union of Ramu Upazila. CARE aims to strengthen host communities' resilience by enhancing community-based disaster risk reduction (DRR), upgrading infrastructure, and providing livelihoods opportunities across shelter, settlement, and WASH sectors. The project also responds to the urgent protection and gender-based violence needs in the host community. Activities are being undertaken in collaboration with government and community stakeholders and UN and NGO actors.
Cox’s Bazar is amongst the poorest districts of Bangladesh. In Ukhia, 33% of people live below the poverty line, and 17% below extreme poverty. This is linked to the region's poor land quality and high risk of natural disaster. Since the Myanmar refugee influx in the fall of 2017, over 902,984 refugees or 201,150 households (HH)s have settled in Ukhiya, and Teknaf.1 Despite limited resources, the local host community population welcomed the arriving refugees during the fall of 2017, sharing food, shelter, and supplies. However, the refugees’ extended presence has strained the community’s already scarce resources. Within the sub-region, Ukhia and Teknaf have been particularly affected, with 336,000 residents directly impacted by the refugee influx,2 leading to a deterioration of relations between these host community members and the refugees.
The region is highly prone to natural disasters; it experiences regular cyclones, floods, and landslides with triple global average precipitation3. Both individual homes and community shelters are weak and in disrepair. Over 40% of households do not meet Sphere standards; they are overcrowded, fragile and highly susceptible to damage and destruction by strong winds, rain, and flooding4. Land degradation, including the daily removal of over 700 metric tons of firewood from the area, has led to a loss of topsoil, coupled with the heightened risk of flash flooding, which has increased the potential destruction5. The accumulation of improperly disposed waste and poor pre-existing drainage systems aggravate these risks and increase the likelihood of damage to host communities6. Furthermore, community response plans and structures are ill-equipped to safeguard or offer substantive protection. [19 pages] Read More...
The project activities are focused on Jaliyapalong, Haldiapalang,Ratna Palong, PalongKhali union of Ukhiya Upzila and Dakshin Mithachari and Chakmarkul union of Ramu Upazila. CARE aims to strengthen host communities' resilience by enhancing community-based disaster risk reduction (DRR), upgrading infrastructure, and providing livelihoods opportunities across shelter, settlement, and WASH sectors. The project also responds to the urgent protection and gender-based violence needs in the host community. Activities are being undertaken in collaboration with government and community stakeholders and UN and NGO actors.
Cox’s Bazar is amongst the poorest districts of Bangladesh. In Ukhia, 33% of people live below the poverty line, and 17% below extreme poverty. This is linked to the region's poor land quality and high risk of natural disaster. Since the Myanmar refugee influx in the fall of 2017, over 902,984 refugees or 201,150 households (HH)s have settled in Ukhiya, and Teknaf.1 Despite limited resources, the local host community population welcomed the arriving refugees during the fall of 2017, sharing food, shelter, and supplies. However, the refugees’ extended presence has strained the community’s already scarce resources. Within the sub-region, Ukhia and Teknaf have been particularly affected, with 336,000 residents directly impacted by the refugee influx,2 leading to a deterioration of relations between these host community members and the refugees.
The region is highly prone to natural disasters; it experiences regular cyclones, floods, and landslides with triple global average precipitation3. Both individual homes and community shelters are weak and in disrepair. Over 40% of households do not meet Sphere standards; they are overcrowded, fragile and highly susceptible to damage and destruction by strong winds, rain, and flooding4. Land degradation, including the daily removal of over 700 metric tons of firewood from the area, has led to a loss of topsoil, coupled with the heightened risk of flash flooding, which has increased the potential destruction5. The accumulation of improperly disposed waste and poor pre-existing drainage systems aggravate these risks and increase the likelihood of damage to host communities6. Furthermore, community response plans and structures are ill-equipped to safeguard or offer substantive protection. [19 pages] Read More...
DE GÉNERO EN HONDURAS ANÁLISIS RÁPIDO Un panorama ante COVID-19 y Eta / Iota
La población hondureña, multiétnica y esencialmente femenina (51.7%), cohabita en un país que ha sido catalogado como uno de los países del área latinoamericana con mayor desigualdad en cuanto al desarrollo (Índice de desigualdad de género de 0.479 versus un IDH 0.611), y con una brecha de género de 27.8 %, según el Foro Económico Mundial. Esta condición de desigualdad afecta especialmente a las mujeres y niñas, pero también a la población viviendo en situación de pobreza, y a la población que está expuesta a alguna condición de vulnerabilidad ya sea física, psicológica, social, ambiental, económica o estructural.
Como resultado, esta población vive en condiciones de pobreza y desigualdad que influyen directamente en la profundización de aspectos relacionados con la feminización de la pobreza; las limitaciones en el acceso a servicios básicos, recursos, oportunidades económicas y empleo digno (medios de vida); la vulnerabilidad ante la violencia, especialmente la Violencia Basada en Género (VBG); y la continuidad en la brecha de género que existe en cuanto a la participación a nivel organizativo o político.
Esta situación ha sido agravada por las circunstancias generadas en Honduras por la pandemia de la COVID_19, que ha registrado 164,495 casos a nivel nacional, y por la devastación causada por Eta e Iota —que afectó a más de 4 millones de personas—, y que han dejado al descubierto las condiciones de violencia y vulnerabilidad a las que están expuestas las mujeres y niñas en Honduras.
Entre los efectos adversos provocados por ambas crisis, preocupa especialmente aquellos que afectarán a indicadores o condiciones estructurales relacionados con la feminización de la pobreza o que inciden directamente en los factores de riesgo o protectores para la violencia basada en género. Read More...
Como resultado, esta población vive en condiciones de pobreza y desigualdad que influyen directamente en la profundización de aspectos relacionados con la feminización de la pobreza; las limitaciones en el acceso a servicios básicos, recursos, oportunidades económicas y empleo digno (medios de vida); la vulnerabilidad ante la violencia, especialmente la Violencia Basada en Género (VBG); y la continuidad en la brecha de género que existe en cuanto a la participación a nivel organizativo o político.
Esta situación ha sido agravada por las circunstancias generadas en Honduras por la pandemia de la COVID_19, que ha registrado 164,495 casos a nivel nacional, y por la devastación causada por Eta e Iota —que afectó a más de 4 millones de personas—, y que han dejado al descubierto las condiciones de violencia y vulnerabilidad a las que están expuestas las mujeres y niñas en Honduras.
Entre los efectos adversos provocados por ambas crisis, preocupa especialmente aquellos que afectarán a indicadores o condiciones estructurales relacionados con la feminización de la pobreza o que inciden directamente en los factores de riesgo o protectores para la violencia basada en género. Read More...
Análisis Rápido de Género ETA e IOTA Guatemala, diciembre 2020
La situación que enfrenta Guatemala en la actualidad es de una complejidad enorme. Aparte de las condiciones de desigualdad histórica y altos niveles de pobreza que marcan la realidad del país, desde marzo de 2020 se ha tenido que enfrentar los impactos de la pandemia de COVID, y recientemente las emergencias generadas por las tormentas ETA e IOTA, que han azotado a gran parte del territorio nacional. El país se encuentra en una situación excepcional de emergencia sobre emergencia y en donde las acciones de prevención y respuesta han resultado insuficientes para la magnitud de la tragedia.
ONU Mujeres y CARE Guatemala, como parte del Grupo de Trabajo de Género en la Acción Humanitaria del Equipo Humanitario País (EHP), consideran esencial aportar información que permita entender la situación que enfrentan las poblaciones afectadas, y en especial, información con análisis de género, que permita reconocer el impacto diferenciado en las mujeres y niñas, identificando sus necesidades específicas para fortalecer los esfuerzos de mitigación y recuperación, así como para asegurar una respuesta efectiva que garantice sus derechos. Es por ello que realizan este Análisis Rápido de Género (RGA por sus sigla en inglés), como una herramienta para la orientación de la respuesta humanitaria a las tormentas ETA e IOTA, y en el marco de la pandemia de COVID 19.
Objetivo: Identificar y analizar las afectaciones, necesidades e impactos de la emergencia generada por la tormenta ETA en la situación de las mujeres y niñas en Guatemala, y proporcionar recomendaciones prácticas para el trabajo de respuesta y recuperación; cubriendo las áreas más afectadas por la tormenta y priorizadas por CARE y ONU Mujeres, que son los departamentos de Alta Verapaz, Baja Verapaz, Izabal, Chiquimula, Quiché, Huehuetenango, Jalapa, Zacapa y Petén. Read More...
ONU Mujeres y CARE Guatemala, como parte del Grupo de Trabajo de Género en la Acción Humanitaria del Equipo Humanitario País (EHP), consideran esencial aportar información que permita entender la situación que enfrentan las poblaciones afectadas, y en especial, información con análisis de género, que permita reconocer el impacto diferenciado en las mujeres y niñas, identificando sus necesidades específicas para fortalecer los esfuerzos de mitigación y recuperación, así como para asegurar una respuesta efectiva que garantice sus derechos. Es por ello que realizan este Análisis Rápido de Género (RGA por sus sigla en inglés), como una herramienta para la orientación de la respuesta humanitaria a las tormentas ETA e IOTA, y en el marco de la pandemia de COVID 19.
Objetivo: Identificar y analizar las afectaciones, necesidades e impactos de la emergencia generada por la tormenta ETA en la situación de las mujeres y niñas en Guatemala, y proporcionar recomendaciones prácticas para el trabajo de respuesta y recuperación; cubriendo las áreas más afectadas por la tormenta y priorizadas por CARE y ONU Mujeres, que son los departamentos de Alta Verapaz, Baja Verapaz, Izabal, Chiquimula, Quiché, Huehuetenango, Jalapa, Zacapa y Petén. Read More...
Final evaluation of the FFP III program 2021
Jouri for Research and Consulting was commissioned by CARE International (CARE) to undertake a final evaluation of the Food for Peace project, “Emergency and Regular Food Assistance in Syria” implemented in Aleppo and Idleb in Northwest Syria (NWS), funded by USAID’s Food for Peace (FFP) program. The project is implemented through four local partner organizations as well as CARE’S area office in Jarablus.
The project consisted of cash distribution (both one-off as well as multi-round cash for food (MRCFF) support and livelihoods activities, which included wheat value chain support (wheat purchase from selected farmers, milling into flour, distribution to bakeries for subsidized bread and infrastructure rehabilitation) and cash for work (CFW) activities. The project was implemented through the local partners Shafak, Ihsan, Syria Relief (SR) and Insani Yardımlaşma Derneği (IYD), as well as CARE’s area office (AO) in Jarablus.
The evaluation addressed the key evaluation questions organized under the Organization for Economic Co-operation and Development's Development Assistance Committee (OECD DAC )evaluation criteria, including Relevance, Efficiency, Effectiveness, Impact and Sustainability. The impacts of coordination among other actors and between partners was also investigated. In total, Jouri conducted 587 surveys, nine focus group discussions (FGDs) and 40 key informant interviews (KIIs). Data was collected face to face and in some cases, remotely due to COVID-19. The evaluation was conducted between July and September 2021. Data was collected in August and September 2021. Read More...
The project consisted of cash distribution (both one-off as well as multi-round cash for food (MRCFF) support and livelihoods activities, which included wheat value chain support (wheat purchase from selected farmers, milling into flour, distribution to bakeries for subsidized bread and infrastructure rehabilitation) and cash for work (CFW) activities. The project was implemented through the local partners Shafak, Ihsan, Syria Relief (SR) and Insani Yardımlaşma Derneği (IYD), as well as CARE’s area office (AO) in Jarablus.
The evaluation addressed the key evaluation questions organized under the Organization for Economic Co-operation and Development's Development Assistance Committee (OECD DAC )evaluation criteria, including Relevance, Efficiency, Effectiveness, Impact and Sustainability. The impacts of coordination among other actors and between partners was also investigated. In total, Jouri conducted 587 surveys, nine focus group discussions (FGDs) and 40 key informant interviews (KIIs). Data was collected face to face and in some cases, remotely due to COVID-19. The evaluation was conducted between July and September 2021. Data was collected in August and September 2021. Read More...
Lesson Learned from the use of Cash plus in the support of Agricultural and Fishery inputs in Khanfar, Sarar and Rusad districts in Abyan Governorate
The seed security and fishery sector production inputs are largely affected in Yemen as a result of prolonged conflict in the country. The lack of access to these critical agricultural inputs has been attributed to the heavily weakened purchasing power. In response, CARE Yemen through Yemen Humanitarian Fund provided support to 2500 most vulnerable and food in-secured farming and fishing households with cluster-approved cereal/vegetable seeds, farm tools and fishing kits in Khanfar, Sarar and Rusad districts in Abyan Governorate. The same households receiving the production inputs were also provided with cash aid of 50$ per month for 3 months. The cash aid also known as Cash plus was utilized by the farmers and the fisherfolk to bridge the food gap faced before a harvest. Read More...