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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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Youth Skills Development Impact Brief

Globally, an estimated 282 million young people (aged 15-24) are not employed, in education, or in training (defined as NEET),1 and young people are three times as likely as adults to be unemployed.2 Nearly 75% of the world’s 1.8 billion young people lack the skills needed for the labor market.3 Strong economies hinge upon youth having the skills to secure meaningful, well-paid work. CARE’s programs help young people succeed in jobs, entrepreneurship, and ongoing career learning. CARE provides comprehensive strategies that support and collaborate with national governments, employers, educators, parents, and youth to develop the workforce for today and tomorrow. We build our programs to connect
young people with mentors, training providers, and employers. We train youth in soft skills (such as critical thinking, time management, decision making, self-confidence, and others), financial literacy, and market-demanded technical vocational skills to meet the needs of the labor market.

CARE’s youth skills & workforce development programs primarily support Sustainable Development Goal 8 - Promote inclusive and sustainable economic growth. Since 2020, CARE’s programs have supported 22 million people in increasing their economic empowerment and participation in dignified work in 67 countries. Read More...

KEYSTONE PARTNER SURVEY 2023 CARE International

In 2023, CARE expressed its interest in conducting a Keystone Partnership Survey to understand how 304 local partners assessed their experience of working with CARE in an international development partnership. This report provides credible perceptual data from a partner perspective on how well CARE performs its role in the partnership.
Keystone’s partnership survey enables INGOs to benchmark their performance ratings against the experiences and perceptions of over 8,000 local partners of more than 90 INGOs (listed below in Table 1) that have taken the
survey.
Thematically, the survey explores the most important operational dimensions to international development partnerships – learning, monitoring & reporting, communications, financial support, and non-financial support.
CARE’s technical competence is further assessed through a series of questions about its sector-specific knowledge, leadership reputation, and value adding abilities. Overall relationship dynamics are captured through questions
about how well CARE learns and adapts, how CARE compares to other international partners, and the extent to which the local partner would recommend working with the CARE.
The report presents overall results for each survey question in a single graphic chart. For rating questions, Keystone employs Net Promoter Analysis (see Annex 6), allowing it to compare and benchmark CARE’s current responses against a benchmark drawn from Keystone’s global cohort of social change organizations.
Respondents indicated their region of work, budget size, type of organization, the type of work they do, and whether they were women-led. This enables us to analyse the data by these respondent characteristics without compromising anonymity. Where organizations of a particular characteristic (e.g., location or size of budget) vary from the average, we do not present it in a separate chart, but highlight these variations in the text accompanying
the charts. Read More...

Call to Action Field Implementation (CAFI) II

CAFI seeks to catalyze the Call to Action on Protection from Gender-Based Violence in Emergencies (CTA) on the ground. The project works with women-led organizations (WLOs) to drive change and foster Gender-Based Violence (GBV) prevention, risk mitigation, and response in humanitarian emergencies.

In 2013, governments, donors, and humanitarian organizations launched the CTA, to fundamentally transform how GBV prevention, risk mitigation, and response are addressed. The CTA aims to strengthen accountability in policies, systems, and mechanisms.
The partnership has grown to more than 100 members, but consolidating CTA implementation in the field is a key gap that needs to be addressed. As a result, CAFI was launched to advance the Call to Action 2021- 2025 Road Map on the ground.
What are the main objectives of CAFI?
● Catalyze increased representation and leadership of women and girls, specifically WLOs, in decision making structures and humanitarian assistance
● Amplify GBV expertise: scaling existing capacity of WLOs
● Address GBV root causes and coordinate effective response and risk mitigation
How does CAFI work?
CAFI aims at contributing to WLO strengthening through capacity-sharing approaches between partners. WLOs are engaged from the beginning, allowing them to co-create and adapt the project according to their needs and contexts and ensuring
accountability and women’s voice and leadership throughout the whole project cycle.

CAFI works through a consortium of 10 WLOs across Latin America and the Caribbean, West and Central Africa, the Middle East/North Africa, and Europe, who coordinate national networks of WLOs: Arab Women Organization (AWO) of Jordan, Baghdad Women Association (BWA) in Iraq, Center Women’s Perspectives (CWP) in Ukraine, Comité des Jeunes Filles Leaders (COJEFIL) in Niger, Dynamique des Femmes Juristes (DFJ) in the Democratic Republic of the Congo, Fundación
para el Desarrollo en Género y Familia (GENFAMI) in Colombia, Global Media Campaign (GMC) in Mali, Himaya Daeem Aataa (HDA) in Lebanon, and Tinta Violeta in Venezuela. In Iraq, Lebanon, and Venezuela, project activities are co-led by WEO, Sama for Development, and Uniandes, respectively. Read More...

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...

Final Evaluation: MACP Project – Disaster Ready Communities in Vulnerable Rural Areas of Guatemala

CARE Guatemala implemented during 2020 to 2023 the “Disaster Ready Communities in vulnerable rural areas of Guatemala MACP” project financed by the Margaret A. Cargill Philanthropies Foundation, donating US$2,300,000.00 (Two million three hundred thousand dollars) for its execution. The initiative was executed in municipalities of Joyabaj, San Bartolomé Jocotenango and Sacapulas in the Department of Quiché; Aguacatán and Chiantla in the Department of Huehuetenango and Salamá, in the Department of Baja Verapaz.

Its general objective was increased empowerment and leadership of vulnerable communities, to provide an efficient, gender-sensitive emergency response, in a context of natural disasters and health crises at the end of the project.

Specific objectives were:

a) Communities after the first year of the project implement social measures to reduce vulnerability and risks. b) Communities execute social actions together with municipal governments to address the COVID-19 pandemic.

Additionally, the project defined five results:

1. During the first year of the project, communities have a well-informed and adequately trained, inclusive, and self-organized group responsible of leading disaster preparedness. 2. Communities have greater capacities for disaster response with the respective plans and inclusive systems implemented and updated, incorporating what they learned at the end of the project. 3. Communities are connected, for a second year, with the project, to municipal governments and have access to technical and financial assistance. 4. The project contributes to increase the capacity of nearby communities and local government units in disaster preparedness. 5. Communities respond efficiently to health crises and coordinate with health services for appropriate use of the respective protocols.

The team hired for this purpose carried out a series of capacity-building activities, investment in infrastructure, providing support and technical training to leaders. The project was executed by a multidisciplinary staff and some activities were implemented by hiring temporary, external consultants with expertise on related topics.

Upon completion, CARE Guatemala requested a final evaluation. This process has allowed us to identify a series of important findings related to the project cycle. Among them, a design and execution with a high level of pertinence, coherence, relevance, efficiency/effectiveness, impact and sustainability. A process to strengthen the capabilities of the Local Coordinators for Disaster Reduction COLRED was successfully carried out in 60 communities from 6 municipalities benefited.

As an immediate result of the strengthening process, 60 COLRED have the capabilities to identify, monitor and act during emergencies caused by disasters and have higher levels of cohesion compared to the beginning of the project. They have also complied with all the steps to obtain CONRED accreditation and have prepared and received approval of its Local Response Plans. They are articulated to community and municipal processes through the Municipal Instances of

Comprehensive Disaster Risk Management IMGIRD, spaces that have different levels of development based on their management and formalization, starting as units to Municipal Directorates. This municipal space was strengthened by COMRED whose members were trained and strengthened. Participating communities received support to renovate facilities that could potentially become shelters, School Committees were trained and organizational support that will allow them to adequately manage disaster risks in the context of their educational process.

Since its formulation, the project had a solid approach and was committed to promoting equity in participation processes including women and men. However, disaggregated analysis tools and specific gender action plans were prepared after the project had begun. This caused, in part, that gender implementation suffered some limitations during activities. However, it has been satisfying to note that, despite these limitations, the women involved in the process are empowered, have an understanding, defend the importance of their participation and identify the basic actions related to community management and mobilization for disaster reduction and emergency action.

The findings documented in this report were verified by implementing a comprehensive work methodology that reviewed documents produced by the project, analyzed the activity cycle, reviewed the financial and administrative aspects of the project, as well as documents and systematizations prepared, carried out interviews with three levels of execution involved in the project (senior management, middle management and operational team), with focus group, and made field visits to execute direct observation and interviews with participants. At the end of the document, there are pertinent conclusions and recommendations. Read More...

Strengthening Productive Safety Net Program (PSNP) Institutions and Resilience II (SPIR II) Gender Analysis

Ethiopia’s current estimated population is around 123 million; out of which, approximately 50% are women, and 41% are under the age of 15 (The World Bank). Despite Government's efforts to close the gender gap, women and girls still do not have the same opportunities as men and boys. For instance, in Ethiopia girls and women aged 10 and above spend about 19.3% of their time on unpaid care and domestic work in comparison to only 6.6% spent by men (UN Women). This situation limits their ability to enter and remain in the labor force, which in turn hinders economic growth and development.

World Vision (WV), CARE Ethiopia, IFPRI, and ORDA Ethiopia are jointly implementing Strengthening Productive Safety Net Program (PSNP) Institutions and Resilience II (SPIR II) – a five- year program funded by the USAID. SPIR II's goal is aligned with the Government of Ethiopia’s Productive Safety Net Program 5 (PSNP 5), that aims to address the pervasive issues of food and nutrition insecurity in Ethiopia’s Amhara, Oromia, and Tigray regions. SPIR II targets 531,788 PSNP clients in nine, eight and fours woredas in the Amhara, Oromia and Tigray, respectively.

In March 2023, SPIR II conducted a Gender Analysis (GA) to identify gender and social inequalities that could negatively affect the achievement of SPIR II project objectives and to ensure that the design and interventions to increase women’s empowerment, equity for women, men, boys and girls, and other vulnerable groups (including the elderly, PWDs1, IDPs2) do not exacerbate existing power or abusive gender relations. SPIR II was not implementing in Tigray at that time, so the results generated are from Amhara and Oromia only. Read More...

IPC & Rapid Gender Analysis Pilot – Somalia: Gender, Food Insecurity & Drought

Acute food insecurity (AFI) in Somalia has deepened amidst a prolonged humanitarian crisis that is further amplified by the climate crisis, conflict, disease outbreaks, and the ripple effect of government instability. The interconnection between gender equality and food security on the local, national, and global level is well established; wider gaps in gender inequality in the public and private sphere heighten the likelihood of food insecurity within a country.1 Yet most global data sets on food insecurity are not disaggregated by sex. Primarily, gender-disaggregated approaches have been applied most consistently regarding indicators related to women’s reproductive role – such as anemia in women of childbearing age – and overlook key questions around women’s access to resources, safety,mobility,andparticipation. Thesespheresbroadenthelensofdatatoprovideamoreholistic understanding of the experience of food insecurity, and most importantly, can inform strategic responses that target the needs of the most vulnerable. Thus, this objective Rapid Gender Analysis (RGA) is to strengthen and operationalize mixed methodologies that integrate gender analysis into global food security measurement systems, such as the Integrated Food Security and Nutrition Phase Classification (IPC), to account for the differential vulnerabilities of men and women and provide concrete and actionable recommendations that inform both the process of data collection and the implementation of more effective humanitarian programming. This study was conducted from February 25 to March 11, 2023 and focused on four districts in Somalia, each situated within two distinct pastoralist Livelihood Zones.

The Integrated Food Security and Nutrition Phase Classification (IPC) serves as a pivotal analytical instrument, guiding decision-makers in understanding the magnitude and extent of both acute and chronic food insecurity as well as acute malnutrition.2 This assessment, which aligns with international standards, demonstrates a shortfall in the absence of consistently incorporating gender- disaggregated data and analysis, an aspect that is crucial for fostering a more inclusive approach to addressing food and nutrition insecurities globally. The IPC analytical approach comprises of data from governments, UN agencies, NGOs, and other stakeholders that have applied the most rigorous and technical methodologies aligned with the IPC Technical Manual 3.1.3 Recognizing the profound impact of gender dynamics on the escalating global acute food and nutrition crises, CARE implemented an adapted strategy that combined both quantitative and qualitative instruments and disaggregated by sex as well as individual and household level data. This pilot study engaged 1,708 respondents, encompassing both women and men, and incorporated quantitative surveys and qualitative data gathering techniques such as key informant interviews, focus group discussions, and individual stories. This synergistic fusion of methods illuminated the complex and diverse experiences of men and women, as well as the underlying themes associated with acute food insecurity in the specified two Livelihood Zones (LZs) and the subsequent four districts. The quantitative component incorporated IPC-approved indicators such as the Food Insecurity Experience Scale (FIES), the Household Hunger Scale (HHS), and the reduced Coping Strategies Index (rCSI), complemented by the WFP's adapted Gender Equality for Food Security (GE4FS) questions. Meanwhile, the qualitative analysis primarily utilized CARE's proven Rapid Gender Analysis (RGA) toolkit. Triangulation across quantitative and qualitative data sources underscores the importance of mixed method approaches and enables a more comprehensive understanding of the impacts of the prolonged drought on men and women and the development of more targeted programming that meets the needs of the most vulnerable crisis-affected populations.

Gender inequalities are both a cause of and the result of the differentiated experiences of acute food insecurity. Gender norms and dynamics impact men and women’s social, economic, and political participation, as well as their access to resources and services. When shocks hit, they can both reinforce and exacerbate existing barriers and discriminatory practices and/or create new opportunities and pathways for resilience, adaptation, and recovery. This report notes multiple shifts in gender dynamics that have occurred since the start of the drought that have shaped the capacity of men and women to participate in the drought response and recovery.

Structural inequalities in Somalia are based on the patriarchal clan-based system that is the foundation of social systems. Numerous indicators demonstrate how - from an early age - women are socially positioned to face risks and barriers that significantly reduced their agency in accessing opportunities, participating in household and community decision making and improving living conditions. Simultaneously, men’s roles towards their family defined by customary law and clan systems has been challenged due to the loss of livelihoods that has created increased vulnerability in accessing food and asserting their traditional roles.

The study explores nuanced gender disparities in acute food insecurity experiences within these LZs, highlighting the vulnerabilities exacerbated by the recent drought. The following highlight key findings:

• Gender Disparities in Acute Food Insecurity: There were distinct gender-based discrepancies, particularly in the Hawd LZ. In this LZ, the data indicated that men are facing a higher degree of acute food insecurity compared to women; the majority of women are grappling with conditions corresponding to IPC phase 3 (Crisis) or worse, whereas men are predominantly experiencing hardships consistent with indicative IPC phase 4 (Emergency). Conversely, in the Addun , both groups are contending with similar levels of acute food insecurity, at indicative IPC phase 4 (Emergency).
• Gender Analysis and Cultural Factors: Remarkably, the gender disparity observed in Hawd contradicts the traditional, cultural, and social norms that are prevalent in Somalia, which typically favor men. Thus, gender analysis of qualitative and secondary data provides critical nuance, with qualitative interviews indicating that men and women both generally perceive women as more vulnerable to acute food insecurity. Likewise, interviewees surfaced trends and cultural factors that may have influenced how men and women experienced or perceived acute food insecurity, such as customary eating habits, khat consumption, and humanitarian assistance. Further study is warranted to determine to what extent these factors are shaping IPC analysis in Somalia writ large.
• Severe Acute Food Insecurity: The findings from the study confirm a dire scenario, where over 70% of the population in the surveyed LZs are facing IPC phase 3+ (Crisis) or worse conditions, as confirmed by FIES, HHS, and rCSI outcome indicators. Disturbingly, there are households and individuals within these LZs confronting even more dire acute food insecurity circumstances consistent with IPC phase 5 (Catastrophe) levels.
• Collapse of Livelihoods Impacts Gender Roles: Drought conditions and the associated collapse of core livelihood pathways due to the loss of livestock has severely impacted traditional roles. The near total collapse of pastoralist livelihoods associated with the drought has threatened men’s traditional role of “provider” and has led some men to report strong feelings of mental health distress. Women have increasingly expanded outside of their traditional roles in the home to seek income opportunities, however, disparities remain that continue to limit their decision-making power at the household and community levels.
• Health Access: Respondents frequently drew connections between the food insecurity and malnutrition situation in their area to the lack of access to basic and life-saving health services. Health services, particularly for pregnant women, were noted by many to be dire, as was the need for better access to clean water to mitigate risks of increased diseases from contaminated sources.
• Protection: Increased tensions within the household due to growing limitations around access to resources heightens risks for gender-based violence within the household, especially as the scope of women’s roles expand around income generation and increased access to humanitarian aid. Culturally accepted practices around early and forced child marriage, as a coping method, also creates added stressors for women and families. Read More...

Variations in Village Savings and Loan Association (VSLA) Practices: An Assessment of Dynamics and Impacts in Zomba and Mangochi Districts – Titukulane Project

This assessment investigates variations in the practices of Village Savings and Loan Associations (VSLAs) in Zomba and Mangochi districts. While the VSLA model has been transformative in promoting financial inclusion and community empowerment in rural areas, there have been noticeable deviations from the CARE VSL methodology, commonly referred to as the standard methodology. With Titukulane's support for these VSLAs, it becomes imperative to comprehend the reasons and implications behind these changes.

The rapid assessment was instrumental in understanding the VSLA practices across selected districts. Qualitative data on the VSLA methodology variations were randomly drawn from 8 out of the 19 Traditional Authorities (TAs) where Titukulane is implementing interventions. Within this sample, the assessment encompassed diverse voices from VSLA members, Community Development Agents, Village Agents, and Titukulane staff. The research utilized a rapid assessment approach to gain a comprehensive overview of the VSLA practices in Zomba and Mangochi in a time-efficient manner. This methodology was chosen for its ability to capture immediate, relevant insights without necessitating the extended time frame typical of more intensive research methods. The rapid assessment prioritized direct interactions with participants, ensuring their experiences and perspectives were central to the data collected. This direct engagement proved invaluable, especially when exploring sensitive topics related to financial practices and internal group dynamics. Through this approach, the assessment aimed to offer a nuanced understanding of current VSLA practices and the motivations underpinning their variations. In the context of this study, variations refer to the distinct differences in approaches, outcomes, or practices observed among the groups, while deviations denote departures from the expected or standard methods prescribed by Titukulane, potentially indicating unique adaptations or challenges faced by certain groups.
Key Findings: VSLAs in both districts have adopted varied practices. Some VSLAs, for example, emphasize equal shares for every member, while others note disparities in contributions. Lending strategies, such as offering loans to non-members, also emerged, aiming to bolster financial inclusivity. However, such innovative strategies sometimes come with their own set of challenges, like difficulties in accurate record-keeping or financial strains from settling older debts using newer contributions. External influences, cultural beliefs, and regional dynamics also play key roles in these variations. Below is a complete list of the variations and deviations noted in the two districts:

• Shares and Savings: While some VSLAs continue to advocate for standardized shares per member to ensure equality, others experience disparities due to inconsistent contributions. For instance, in some groups members are allowed to purchase more than 5 shares at a time, with some purchasing up to 100 shares.
• Loan Practices: Innovative loan practices, including lending to non-members, aim to enhance financial inclusivity.
• Documentation and Record-Keeping: Challenges in maintaining accurate records are pervasive, with different approaches to record-keeping observed.
• Emergence of Digital Financing Platforms replacing cashboxes: In younger VSLA demographics, there's a rising adoption of digital financing platforms, such as Airtel Money and TNM Mpamba. However, this shift poses challenges for older members, who are less familiar with digital technologies.
• Religious and Cultural Adjustments: Deep-seated religious beliefs influence some VSLAs to refrain from charging interest.
• Influence of External Entities: VSLAs display adaptability and responsiveness to external influences, including NGOs and community initiatives.
• Group Dynamics: Many VSLAs have larger membership counts than recommended, possibly reflecting community resource pooling. Read More...

Community-led Resource Mobilization & Early Warning Systems Process Assessment: Titukulane Project

This report examines the motivation and willingness of Village Civil Protection Committees (VCPCs) and communities to mobilize resources at community level for Disaster Risk Management (DRM). To do this, a participatory action research (PAR) approach was utilized, facilitated by SWOT analyses, in combination with focus group discussions (FGDs) and key informant interviews (KIIs). The findings revealed that communities had prepositioned resources to prepare for disaster response as part of risk reduction. Participants identified their ability to mobilize themselves as a community; to mobilize funds and food; well trained and knowledgeable structures, good agricultural practices, and good governance as major strengths. Opportunities for resource mobilization included enterprise, piece work (ganyu), irrigation farming, access to safety net programs, and youth participation. Weaknesses included the disorganization of some community structures, lack of support or political will from community leaders and the government, lack of accountability from VCPC members, and reluctance to adopt improved agricultural practices. Community-based early warning systems, although available, are insufficient to provide effective risk reduction for natural disasters. There is a lack of documentation concerning indigenous early warning systems, which impedes the development of effective and contextual strategies for risk reduction. The recommendations include increasing awareness among traditional leaders, defining resource mobilization structures, documenting guidelines and transactions for transparency, investing in early warning infrastructure and capacity building, documenting indigenous early warning signs, and intensifying watershed restoration and conservation to increase disaster preparedness. Read More...

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