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Our Best Shot: Frontline Health Workers and COVID-19 Vaccines
Fully realizing the social and economic benefits of halting COVID-19 requires investing in a fast and fair global rollout of COVID-19 vaccines. CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5.00 in delivering the vaccine.
Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.
Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.
Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.
As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
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Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.
Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.
Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.
As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
Read More...
Gender, Disability and Inclusion Analysis for COVID-19 and Tropical Cyclone Harold
When Tropical Cyclone Harold hit on the 2nd April, the Solomon Islands was among the first countries forced to grapple with the complex intersection of COVID-19 and disaster. While the country has managed to contain the spread of COVID-19 and prevent community transmission to date, the pandemic is still having a major impact on everyday life for men, women, boys and girls. Lock-down measures, the abrupt cessation of tourism, severe disruptions to international trade and other flow-on effects of the global pandemic (combined with the effects of TC Harold and pre-existing vulnerabilities) are resulting in widespread income and job losses, heightened stress and tension, increased family violence, displacement, and disrupted access to education, health, and water and sanitation.
If community transmission of COVID-19 occurs, there will be a public health crisis with complex contextual challenges. These include a population dispersed across isolated islands and limited resources, including limited access to quality health services.
The current COVID-19 impacts are disproportionately affecting women, girls and people with disabilities in the Solomon Islands, and this will be exacerbated in the case of a wider COVID-19 outbreak. All humanitarian programming must consider gender roles and responsibilities and the existing patterns of community participation and leadership, in order to ‘do no harm’ and help facilitate a gender and disability inclusive approach to COVID-19 prevention and recovery.
This gender, disability and inclusion analysis has the following objectives:
* To analyse and understand the different impacts that COVID-19 and TC Harold is having on women, men, girls, boys, people living with disabilities and other vulnerable groups in the Solomon Islands;
* To inform humanitarian programming in the Solomon Islands based on the different needs of women, men, boys, girls and people living with disabilities with a particular focus on gender-based violence (GBV) and livelihoods. Read More...
If community transmission of COVID-19 occurs, there will be a public health crisis with complex contextual challenges. These include a population dispersed across isolated islands and limited resources, including limited access to quality health services.
The current COVID-19 impacts are disproportionately affecting women, girls and people with disabilities in the Solomon Islands, and this will be exacerbated in the case of a wider COVID-19 outbreak. All humanitarian programming must consider gender roles and responsibilities and the existing patterns of community participation and leadership, in order to ‘do no harm’ and help facilitate a gender and disability inclusive approach to COVID-19 prevention and recovery.
This gender, disability and inclusion analysis has the following objectives:
* To analyse and understand the different impacts that COVID-19 and TC Harold is having on women, men, girls, boys, people living with disabilities and other vulnerable groups in the Solomon Islands;
* To inform humanitarian programming in the Solomon Islands based on the different needs of women, men, boys, girls and people living with disabilities with a particular focus on gender-based violence (GBV) and livelihoods. Read More...
Papua New Guinea COVID-19 RGA
The impacts – direct and indirect – of the COVID-19 pandemic fall disproportionately on the most vulnerable and marginalized groups in society. PNG presents a range of contextual challenges, including difficult geography. Access to quality health services is limited, due to a lack of infrastructure, equipment, and qualified personnel3. Services are easily stretched or overwhelmed, and provision of specialised services and intensive care is limited. In the current situation, this can pose a problem of access to care if the number of infected people increases4. Coupled with gender inequality, which remains pervasive across the Pacific, in particular in the critical domains of leadership and decision making, access to and control of resources and gender-based violence5, the public health response to COVID-19 can become immeasurably more complex. Read More...
Support for Service Delivery Integration- Services (SSDI-Services) Endline
SSDI-Services was the flagship project for USAID/Malawi’s health office. The project was implemented from November 8, 2011 to March 7, 2017 under a cooperative agreement, valued at USD 89 million. Active project implementation occurred over a 4.5-year period from April 2012 to December 2016, with the preceding and following months focused on startup and closeout activities respectively.
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
Udaan II Nepal Final Evaluation
Udaan II “Catching the Missed Opportunity”, funded by the OPEC Fund for International Development, was one of the most important initiatives under the LEAD program of CARE Nepal. The LEAD program envisions education and economic prosperity as an instrument to women and girls’ empowerment, through transforming harmful social norms, building life skills and advocating related policy reforms. Under the LEAD Program, the Udaan initiative provided an intensive, 11-month high-quality condensed curriculum for adolescent girls (Dalit, Muslim and other marginalized groups) aged 9-14 of Kapilvastu District, who were unable to either start or complete primary school. The program also helped them to get enrolled in community schools, named “mother school”, where Udaan graduates continued their higher study. Working together with nine formal mother schools of Krishannagar and Maharajgunj Municipalities of the Kapilvastu district, as well as with the girls and their parents, the Udaan II project focused on addressing the economic factors affecting girls’ families, and the harmful social norms acting as barriers to girls’ education. This helped to create an enabling and safe learning environment for girls, and provided opportunities for livelihood and vocational skill development. The Project was implemented over two years and 10 months (January 2018 to October 2020) by Care Nepal in Krishannagar Rural Municipality, Kapilvastu Municipality and Maharajgunj Rural Municipality of Kapilvastu district in cooperation with local partner Siddhartha Social Development Centre (SSDC).
The objective of the final evaluation study was to measure both the intended Read More...
The objective of the final evaluation study was to measure both the intended Read More...
SUAAHARA II GOOD NUTRITION PROGRAM Annual Survey Year 3
Nepal’s reductions in maternal and child undernutrition since the mid-1990s have been remarkable, but the high burden persists. Among children under five years, 36% are stunted, 10% are wasted, and 27% are underweight. Additionally, 17% of women of reproductive age (WRA, 15-49 years) are underweight while 41% are anemic (Nepal DHS Survey, 2016). The Government of Nepal (GoN) is rolling out the second phase of their national Multi-Sector Nutrition Plan (MSNP), with support of external development partners (EDPs). Suaahara II (SII) is a USAID-funded multisectoral nutrition program, aligned with Nepal’s MSNP, and is being implemented in all communities of 42 of Nepal’s 77 districts from April 2016 to March 2021. SII’s overall aim is to reduce the prevalence of stunting, wasting, and underweight among children under five years of age and to reduce the prevalence of anemia among WRA and children 6-59 months of age. SII works across thematic areas including nutrition, health and family planning (FP), water, sanitation and hygiene (WASH), agricultural/homestead food production (HFP), and governance, using a gender equality and social inclusion (GESI) approach for all interventions.
SII has a large, rigorous monitoring, evaluation, and research system. Annual monitoring surveys, a key component of SII’s monitoring system, primarily serve to monitor progress over time related to key SII inputs, outputs, and outcomes in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017 among a representative sample of households with a child under five years by New ERA, a local survey firm. At the household level, mothers were the primary survey respondents. A primary male (or female, if male unavailable) household decision maker, the youngest child’s grandmother, and an adolescent girl (10-19 years), if residing in the same household, were also interviewed. Data was also collected from Female Community Health Volunteers (FCHVs) and 1 key informant from each health facility in the sampled areas. The household surveys included questions related to exposure, knowledge and practices for each of the thematic areas mentioned above. Anthropometric status was assessed for all female respondents and children. FCHV and health facility surveys collected information on exposure to training, motivation, supervision, and work-related activities. In 2017, the final survey sample included 3,642 households. Read More...
SII has a large, rigorous monitoring, evaluation, and research system. Annual monitoring surveys, a key component of SII’s monitoring system, primarily serve to monitor progress over time related to key SII inputs, outputs, and outcomes in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017 among a representative sample of households with a child under five years by New ERA, a local survey firm. At the household level, mothers were the primary survey respondents. A primary male (or female, if male unavailable) household decision maker, the youngest child’s grandmother, and an adolescent girl (10-19 years), if residing in the same household, were also interviewed. Data was also collected from Female Community Health Volunteers (FCHVs) and 1 key informant from each health facility in the sampled areas. The household surveys included questions related to exposure, knowledge and practices for each of the thematic areas mentioned above. Anthropometric status was assessed for all female respondents and children. FCHV and health facility surveys collected information on exposure to training, motivation, supervision, and work-related activities. In 2017, the final survey sample included 3,642 households. Read More...
STOP Southeast Asia Impact Reflections
Sexual harassment is any unwanted, unwelcome or uninvited behaviour of a sexual nature which could be expected to make a person feel humiliated, intimidated or offended. Female garment workers experience sexual harassment in their workplace, generally have limited legal protections, lack job security and work in an environment where there is often impunity for the harassment they experience. In Cambodia alone, sexual harassment costs in the garment industry USD $89 million per annum in lost productivity.
After four years of work, independent evaluations found the STOP project had assisted factory management to set up clearer guidelines and mechanisms for dealing with and preventing sexual harassment. It also empowered female workers to be confident to report sexual harassment incidents and become more aware of their rights. Read More...
After four years of work, independent evaluations found the STOP project had assisted factory management to set up clearer guidelines and mechanisms for dealing with and preventing sexual harassment. It also empowered female workers to be confident to report sexual harassment incidents and become more aware of their rights. Read More...
ENDLINE EVALUATION COVER PAGE Adolescent Empowerment Project (AEP) IN KAJIADO & MUKURU
CARE implemented the Adolescent Empowerment Project (AEP) in Kenya, funded through the Patsy Collins Trust Fund Initiative from 2015 to 2020. The project aimed to empower adolescent girls and boys from chronically insecure households to fully exploit their potential, take advantage of opportunities, and fulfil their aspirations. Over a 5-year implementation period, the project targeted adolescents (aged 10-19) in urban Mukuru (within Nairobi county) and rural Kajiado county with a suite of activities and services delivered through partners Hope Worldwide Kenya (HWWK) and Neighbors Initiative Alliance (NIA). Inputs were designed to expand life choices and empower participants to become engaged citizens and include activities on leadership skills development, adolescent sexual and reproductive health (ARSH), economic empowerment, ICT skills, and quality education.
This report is 70 pages long. Read More...
This report is 70 pages long. Read More...
Improving Sexual and Reproductive Health through Reducing Early Marriage in Remote Ethnic Communities in Sekong Province, Lao PDR
Lao PDR has the highest rates of early marriage in the region, even though the law sets the age of marriage at 18. Young brides are more vulnerable to sexual abuse from their partners and to unintended pregnancy. Lao PDR has the highest adolescent pregnancy rate in the region due to early marriage, limited knowledge of sexual & reproductive health, and limited access to appropriate services. The overall goal of the project is improved sexual reproductive and maternal health (SRMH) in remote ethnic communities in Sekong Province. The action contributes to reduced child marriage, as well as providing SRMH knowledge and developing youth friendly health infrastructure. The action engages the whole community to reflect on harmful traditions and their negative impact on the development of girls, and to create an enabling environment for girls. CARE also provides organizational and technical capacity development to local governments and partners to enable them to deliver key messages on the link between child marriage and pregnancy risk to the targeted ethnic minorities.
This report is 17 pages long. Read More...
This report is 17 pages long. Read More...
Baseline Study on “Improving lives of Rohingya refugees and host community members in Bangladesh through sexual and reproductive healthcare integrated with gender-based violence prevention and response” Project
In response to the health and protection needs of the Rohingya refugees and the host communities in Cox ́s Bazar, CARE is implementing the project “Improving lives of Rohingya refugees and host community members in Bangladesh through sexual and reproductive healthcare integrated with gender-based violence prevention and response” with funding support by German Federal Foreign Office. This is a two year project targeting Rohingya refuges of camp 11, 12, 15 and 16 and vulnerable host communities of Jaliapalong union for GBV and SRH services.
To achieve improved sexual and reproductive health, GBV survivor support and protection from GBV of Rohingya Refugees in Cox ́s Bazar in Bangladesh, this project works across three outcomes. Firstly general and sexual and reproductive (SRH) health services will be provided through decetralised health centers which will rove around the target areas to provide services to people at their doorsteps. Improved Menstrual Hygiene management (MHM) is the second outcome of this project. There is an absence of space for washing and drying menstrual hyiene materials, leading women and girls to risk their health by drying their materials indoors. Through this project, therefore, two MHM spaces will be constructed next to CARE’s existing women and girls’ safe spaces (WGSS) in camps 12 and 16. The construction will be accompanied with training to ensure that the spaces are used appropriate. The third project outcome focuses on prevention of and response to gender-based violence. Services include psychosocial counselling, referral of GBV survivors, life-skills training, information and awareness-raising and recreational activities. These activities are complemented by community outreach activities, conducted through Rohingya volunteers, to ensure that the communities know about and can access the WGSS, and challenging harmful social norms associated with GBV. Community outreach will take place in camps 12 and 16 amongst refugee populations.
This report is 22 pages long. Read More...
To achieve improved sexual and reproductive health, GBV survivor support and protection from GBV of Rohingya Refugees in Cox ́s Bazar in Bangladesh, this project works across three outcomes. Firstly general and sexual and reproductive (SRH) health services will be provided through decetralised health centers which will rove around the target areas to provide services to people at their doorsteps. Improved Menstrual Hygiene management (MHM) is the second outcome of this project. There is an absence of space for washing and drying menstrual hyiene materials, leading women and girls to risk their health by drying their materials indoors. Through this project, therefore, two MHM spaces will be constructed next to CARE’s existing women and girls’ safe spaces (WGSS) in camps 12 and 16. The construction will be accompanied with training to ensure that the spaces are used appropriate. The third project outcome focuses on prevention of and response to gender-based violence. Services include psychosocial counselling, referral of GBV survivors, life-skills training, information and awareness-raising and recreational activities. These activities are complemented by community outreach activities, conducted through Rohingya volunteers, to ensure that the communities know about and can access the WGSS, and challenging harmful social norms associated with GBV. Community outreach will take place in camps 12 and 16 amongst refugee populations.
This report is 22 pages long. Read More...