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CARE Malawi COVID Vaccine Delivery Situation January 2022

“The vaccines are here but support for delivery is most needed, especially at the last mile.” – District Health Management Team member, Ntcheu
As of January 10, 2022, Malawi had delivered 1.84 million doses of vaccine out of the 3.12 million doses it has received so far.1 Many doses in country have rapidly approaching expiration dates, and if they do not get to people fast, they risk expiring on the shelves. To make sure the 1.26 million doses left go to the people who need them most, we must invest more in communication, engagement, and delivery. The $37M granted by the World Bank over the past year is sufficient for covering only 8% of Malawi’s total population. What is more, as the highly contagious Omicron variant spreads worldwide, it is even more critical that more people are vaccinated now. We cannot assume that the Government of Malawi and its current health system can do it alone.

The government and other health actors in Malawi are working tirelessly to vaccinate people, while facing multiple health crises. The health system is building on a base of committed (if overstretched) health workers, an openness to community feedback, and a long expertise of delivering The government is coordinating closely with many actors to reduce gender gaps, get vaccines to the last mile, and keep existing health services open. Nonetheless, the Ministry of Health is under-resourced, and operating in a global system where the vaccine supply that arrives may be close to expiring. For example, doses of the Astra-Zeneca vaccine had to be destroyed in the spring, after arriving in Malawi with only two and a half weeks left before their expiration date.

More investment is needed. To take just one example, the national government has been able to provide one van per district to support mobile vaccination sites, to get vaccines to the last mile. Mobile vaccinations are the most effective way to serve people who live far away from health centers and do not have access to easy forms of transportation. That means that in Ntcheu, one van is expected to serve a target population of 214,929 people living over 3,424 square kilometers. One van cannot serve those people fast enough to make sure vaccines get where they need to in time, especially when an inconsistent and unpredictable vaccine supply could have doses expiring at any time. Read More...

CARE Rapid Gender Analysis Latin America & the Caribbean – Ciudad Juárez, Mexico

Asylum seekers and migrants traveling through Central America and Mexico to the U.S. border face a range of risks, but women, girls, and other vulnerable groups—such as members of the LGBTQIA community—are confronted with additional threats to their health, safety, and well-being in their countries of origin, countries of transit, and in the U.S. As a result, asylum seekers and migrants who arrive at the U.S.–Mexico border often carry a heavy burden of trauma from experiences with violence. The lack of a system to appropriately support people on the move deepens pre-existing inequalities and exposes already vulnerable groups to additional, unnecessary, risks.
The U.S. Government’s Migrant Protection Protocols (MPP), also known as the “Remain in Mexico” policy, returns asylum seekers and migrants from U.S. custody to Mexican territory, compelling them to face months of risk and uncertainty as they wait to complete their asylum processes. The asylum process itself is challenging and unclear, liable to change without warning, and largely opaque to affected populations. The asylum seekers and migrants waiting in Mexico’s Ciudad Juárez city, along the Mexico–U.S. border, face ever-present threats of extortion, gender-based violence (GBV), and kidnappings, which compound their trauma and restrict their freedom of movement and access to critical resources and services. Trauma and fear were the norm of the population that CARE surveyed, not the
exception.
The female asylum-seekers and migrants in Ciudad Juárez that CARE spoke with reported feeling profoundly vulnerable and isolated. They consistently relayed a lack of trust in authorities and an increasing level of anti-migrant sentiment in the city. The lack of either confidential GBV screenings or formal complaint mechanisms left survivors with almost no one to turn to for support and services. Asylum seeking and migrant women, girls, and LGBTQIA individuals who feared for their safety reported remaining inside shelters as much as possible, leaving only when absolutely necessary. In Ciudad Juárez, some asylum seekers and migrants have found refuge in overwhelmed and
underfunded informal shelters. These shelters are largely run by local faith-based organizations, and could meet only a fraction of the need. Despite these efforts, the humanitarian response to the migration crisis is characterized by a haphazard and uncoordinated approach that is devoid of reference to the humanitarian standards that would be the norm in other emergencies. The shelters did not have appropriate intake procedures, such as vulnerability screenings. Few had sufficient water and sanitation facilities for the number of residents, and many shelters housed residents together in common spaces regardless of age or gender, amplifying the risk of harm to vulnerable persons. Asylum seekers and migrants in the shelters frequently lacked information about available health and legal services. Read More...

DIAGNÓSTICO SITUACIONAL SOBRE EL TRÁFICO Y LA TRATA DE PERSONAS EN EL CONTEXTO DE LA CRISIS HUMANITARIA EN LA ZONA TRANSFRONTERIZA DE PERÚ Y ECUADOR

En el año 2000 se aprobó el Protocolo para prevenir, reprimir y sancionar la trata de personas, especialmente mujeres y niños, que complementa la Convención de las Naciones Unidas contra la Delincuencia Organizada Transnacional que entró en vigor el 25 de diciembre de 2003. Desde esa fecha el desarrollo normativo de la trata de personas es permanente tanto en el Perú como en el Ecuador, países que comparten una amplia frontera común. Paralelamente se han creado nuevos servicios para la protección y asistencia a las víctimas, así como para la persecución y sanción del delito. En ese contexto, diversos fenómenos han ocurrido con particular intensidad, sobre todo en la zona fronteriza entre Perú y Ecuador. Dos en particular han marcado el desarrollo de la trata de personas en esa zona. La crisis humanitaria producto de la migración masiva de ciudadanos venezolanos y el contexto actual de emergencia sanitaria por el COVID-19, que obligó a ambos países a cerrar sus fronteras, abriéndose más de un circuito clandestino por el cual el flujo migratorio ha continuado discurriendo sin solución de continuidad a pesar del control militar implementado por el Perú desde el 26 de enero del 2021, lo que ha merecido un pronunciamiento conjunto de las Defensorías del Pueblo de Ecuador, Colombia y Perú exhortando a sus autoridades a tener como premisa la dignidad humana de las personas migrantes con necesidad de protección internacional, observar las normas universales y regionales de derechos humanos en este campo, así como evitar actos que promuevan el rechazo por parte de las comunidades de acogida. En ese contexto, las vulnerabilidades propias de las personas migrantes, así como de adolescentes y jóvenes de las regiones contiguas a la zona de frontera, se vieron potenciadas por la crisis económica generada a causa de la pandemia, así como por la pauperización de las condiciones del empleo marcadamente informal. Esas circunstancias que han agravado las necesidades de las personas han sido aprovechadas para la comisión de diversos delitos de explotación de seres humanos. Paralelamente la respuesta pública se ha visto impactada por la crisis sanitaria que ha reducido su capacidad para enfrentar el problema, además de las limitaciones que ya presentaba. En ese escenario, la sociedad civil y las organizaciones de cooperación han jugado un papel importante para paliar las necesidades. Por otra parte, el panorama de la trata de personas en la zona de frontera presenta varios desafíos que están descritos a lo largo del presente estudio y que sugieren un modelo de
gestión más eficiente para poder enfrentarla de manera eficaz, así como para atender el creciente número de personas vulnerables producto de la crisis humanitaria y de la realidad resultante como consecuencia de la emergencia sanitaria. El cierre de la frontera y su permeabilidad hacen evidente la necesidad de implementar una estrategia migratoria integralen cada país, así como en conjunto. Para la elaboración del presente informe se ha recogido información de fuentes documentales, así como de las instituciones públicas y privadas de ambos lados de la frontera, incluyendo a personas migrantes. Dicha información ha permitido describir las conductas, medios y finalidades del delito de trata; las características de los autores del delito de trata y tráfico de personas, las características de las víctimas; las principales rutas de la trata y tráfico de personas, así como las actividades en las que podría estar presente; los servicios de protección para víctimas; el estado de los mecanismos de sanción del delito de trata y tráfico de personas, así como la relación entre la migración, la trata y tráfico de personas. [46 Pages] 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.
Read More...

CROSS-BORDER MIGRATION INTO INDIA AND DEVELOPMENT – Advocacy Paper

The migration discourse has not remained confined to focusing upon the mobility of people from low income countries to high income countries. There has been growing attention to migration from higher-income countries to lower-income countries. The current literature, however, is increasingly taking note of human movements within any of the two regions – the higher income countries and the lower income countries, also described as the global north and the global south respectively. Based on the level of development of the countries of origin and destination, the United Nations has therefore identified a typology of two inter-regional and two intra-regional streams of contemporary international migration: south-north and north-south, south-south and north-north (United Nations 2013). This typology also subsumes the category of a transit country in its roles of being an origin and a destination country at the same time. [26 Pages] Read More...

Rapid WASH Assessment: Key Findings IDP sites in North West Syria

Between March 17th and 21st, CARE conducted a Rapid WASH assessment across 78 IDP sites in Idlib and Aleppo Governorate, together with partners IYD, Shafak and Syria Relief.
The displacement of close to one million people since December 2019 has resulted in a very high number of IDP-sites being setup by families on the move. These sites are not planned and many of them do not have the most basic services or infrastructure available. Other sites have grown significantly as new arrivals have settled next to existing camp-like facilities. Increasingly, reports from the areas have highlighted massive gaps in WASH services across these sites and particularly the lack of safe WASH facilities has been reported as a protection concern for girls and women. Simultaneously, the global COVID-19 outbreak has increased the urgency for gaps in WASH services to be addressed. The lack of access to clean water, handwashing facilities and soap undermines any initiative to prevent large scale outbreaks in North West Syria.
CARE, with its partners, therefore conducted a Rapid WASH Assessment across IDP-sites focusing mainly on two basic aspects: availability/usage/status of latrines and availability/usage of clean water, handwashing facilities and soap.
The assessment highlights that:
 Adequate access to sanitation facilities is available in only 10% of the assessed locations. 45% of sites do not have any latrines. For the 55% of sites with latrines, average is 240 individuals per latrine.
 The assessed IDP sites are critically lacking access to clean water, handwashing facilities and soap. Only 37% of the sites have sufficient and regular access to water supplies. As many as 83% of the sites have no access to handwashing facilities. A catastrophic 91% does not have access to soap.
 Very limited, if any, WASH support has reached the assessed locations. Only 44% of the sites report having received any WASH NFI’s in the past two months. Read More...

KNOWLEDGE, ATTITUDES AND PRACTICE SURVEY SOUTH EAST TURKEY

CARE International in Turkey began responding to the needs of Syrian refugees in Southern Turkey in October 2014. As of 27 November 2019, Turkey hosts 3,691,333 Syrian registered refugees, accounting for around 5% of total resident population in Turkey and over 365,000 refugees of other origins. Of that total, around 45.8% are females, with 21.4% of those female refugees are below the age of 18. A total of 62,216 individuals are hosted in 7 camps.

The impact of the now nine-year old conflict on Turkey’s economy, livelihoods, public infrastructure and services have been so profound that it is starting to affect inter-community cohesion. Off-camp refugees face several challenges linked to their ability to meet basic needs and are especially vulnerable to protection risks, forced to resort to negative coping mechanisms such as early marriage, child labour and reduction of meals since their original displacement.

CARE's experience in South East Turkey illustrated numerous gaps in access to services (education, health, legal), financial security, protection risks (child labour, sexual and GBV) and access to sufficient current information for the refugee population. Building on this CARE’s prior experience, we embarked on the Knowledge Attitude and Practice (KAP) Survey to provide additional context and aims to understand the changes in the community as a result of CARE’s protection programming.

The overall purpose of the KAP/base-line assessment is to provide valid reliable information focusing on Syrian refugees’ knowledge, attitudes, perceptions and behaviors related to some crucial topics such as; child/early/forced marriage; gender-based violence; child protection; information and access to services and sexual and reproductive health. Read More...

The NGO Health Service Delivery Project 2012 – 2018

Bangladesh is the tenth most densely populated country in the world.3 Despite its growing economy—it is expect- ed to become a middle-income country by 2020—the Government of Bangladesh (GOB) has not been able to invest sufficient resources in its health system. To close the gap, the Ministry of Health and Family Welfare (MOHFW) has formally integrated the non-governmen- tal organization (NGO) sector into the national health system. A significant proportion of this plan has included the Surjer Hashi (SH), or Smiling Sun, network, a group of NGOs supported by the United States Agency for In- ternational Development (USAID) and its implementing partners since 1997.
From 2012 to 2017, USAID supported the SH network through the NGO Health Service Delivery Project (NHSDP). The UK Department for International Devel- opment (DfID) provided additional funding beginning in the second project year. Led by Pathfinder International, NHSDP provided material and technical support to 25 NGOs, who served a catchment area of 26.3 million peo- ple through a network of 399 static and 10,872 satellite clinics and 11,842 community service providers.

This is the final report for this project and outlines the results from the project. Read More...

Food and Nutrition Security Programme (FNSP) in Malawi (2015 – 2022): Midline Evaluation

Over 800 million people worldwide suffer from hunger and two billion do not meet their micro nutrient requirements (Global Nutrition Report, 2016). While the global starving population has gone down in recent decades, the number of people suffering from hunger in sub-Saharan Africa today is higher than ever. Malnutrition is particularly prevalent in developing countries, where it has an impact not only upon the development prospects of an entire country, but also of each individual affected. If a child does not receive sufficient nutrients up to its second year, i.e. over its first 1,000 days beginning with the early embryonic phase, the impact on growth, mental faculties and therefore learning and work¬ing potential will endure a lifetime.

This midline survey outlines important information to understand whether the project is on track. The overall objective was improving the nutrition situation of women of reproductive age (15-49) and children under two (6-23 months) in Dedza and Salima. This report outlines how well the project is meeting this goal. Read More...

Food and Nutrition Security, Enhanced Resilience: Nutrition Baseline Survey Malawi

Over 800 million people worldwide suffer from hunger and two billion do not meet their micro nutrient requirements (Global Nutrition Report, 2016). While the global starving population has gone down in recent decades, the number of people suffering from hunger in sub-Saharan Africa today is higher than ever. Malnutrition is particularly prevalent in developing countries, where it has an impact not only upon the development prospects of an entire country, but also of each individual affected. If a child does not receive sufficient nutrients up to its second year, i.e. over its first 1,000 days beginning with the early embryonic phase, the impact on growth, mental faculties and therefore learning and work¬ing potential will endure a lifetime.

The German Ministry of Economic Co-operation and Development (BMZ) launched an Initiative “On World – No Hunger” to improve food and nutrition security (https://www.bmz.de/webapps/hunger/index.html#/de). Within this initiative GIZ implements the program “Food and nutrition security, enhanced resilience” in 11 countries in Africa and Asia.

The project‘s main target group includes women of childbearing age, pregnant women, breastfeeding mothers and infants. The project‘s objective is to improve the nutritional situation of approximately 880000 women, 235000 young children and 4.000 households. Structural measures to combat hunger and malnutrition, particularly among mothers and young children, are one of the most effective ways of investing in the future of a society. Read More...

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