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Tropical Cyclone Gita Response Program Evaluation

Tropical Cyclone (TC) Gita, a Category 4 cyclone, struck Tonga in February 2018. CARE, Live and Learn, and MORDI (‘the partnership’) responded to the immediate needs of communities on Tongatapu and ‘Eua islands, delivering emergency shelter and hygiene kits. In the recovery phase the partnership supported communities with shelter, repairs to water, sanitation and hygiene (WASH) infrastructure, and food security and livelihood recovery efforts, including a specific project focused on the recovery priorities of seven women’s groups on ‘Eua island.

CARE commissioned this evaluation to assess the assistance provided through the response and recovery program in the first six months (February – August 2018). The evaluation focused on four main areas of enquiry: the partnership, the response, gender and inclusion, and localisation.

This report documents the findings from the evaluation and provides forward-looking recommendations for the partnership and for preparedness and future emergency response in Tonga. Read More...

Renewing a Long-Term Strategic Partnership: Lessons learned from 20 years of collaboration in global health and development between CARE and Emory University

Over more than 20 years, CARE USA (CARE) and Emory University (EU) – principally within the Rollins School of Public Health (RSPH) – have collaborated across global health and development sectors, including water and sanitation (WASH), maternal and child nutrition, food security, HIV/AIDS, and women’s empowerment. This collaboration has included joint research projects, training for CARE field staff, student employment and training, guest lectures by CARE staff at Emory, and employment opportunities at CARE for former Emory students following graduation.
Several high-profile joint research projects have included SWASH+ (Kenya: 2006-2019) and the Tipping Point Project (Nepal: 2019-pres). School Water, Sanitation and Hygiene plus Community Impact (SWASH+) was a 13- year project that is an exemplar of the impact of CARE and Emory collaborations. It has resulted in over 20 publications from both institutions, including policy papers that have contributed significantly to increasing the scale, impact, and sustainability of school WASH interventions in Kenya. The Tipping Point project aims to empower adolescent girls and their communities to delay marriage and to promote girls’ rights in Nepal and
Bangladesh.
RSPH researchers commenced a four-year partnership with CARE to strengthen the rigor and visibility of the impacts of this program. These projects have resulted in co-funded grants, peer-reviewed manuscripts, and conference presentations (see Appendix A for a complete list). [21 pages] Read More...

Provision of lifesaving and sustainable WASH services for Vulnerable Populations in South Darfur and South Kordofan states, and emergency WASH services to Tigray refugees in Gedarif State Baseline

This baseline survey was conducted internally by CARE staff, led by the MEAL coordinator. The main objective is to collect information on the project's indicators and to provide baseline data generated for the intervention areas in South Darfur and South Kordofan States. The baseline data was collected in SD using both quantitative and qualitative methods. In SK, the project used endline data from the recently ended ECHO project as a baseline, as that dataset covers the same areas and same indicators. The data collection and consultation involved 253 individuals (118 females, 135 males). 123 people were consulted in SD (34 females, 89 males) while 130 were consulted in SK (84 females, 46 males).
All consulted households have no water inside houses, and they have to go to collect water from external sources. The distance to water sources varies between communities, and takes considerable time they spend fetching water. Most of households confirmed they collect more than 5 Jerri Cans of water per day, but this is not available all year. This water is not only for human consumption and use; they use it also for animal consumption and irrigating trees.
There are many problems in water sources affecting participants' access to safe water. The top rated problems are the high cost of water, continuous breakdown of water points, congested water sources, and far distance to the sources.
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Vertical Expansion of Social Protection Program

For the last nine years, Malawi has been supporting on average 1.73 million people each year with emergency food assistance, i.e. about 10% of its population. With widespread chronic poverty and high vulnerabilities, even predictable, recurrent lean seasons and minor weather variations develop into emergencies. Humanitarian actors including UN agencies and NGOs, repeatedly step-in to cover needs.

Poor households are often some of the most vulnerable to disasters. Poor people are among the groups most exposed to and suffering from shocks, including drought or floods: Limited livelihood options, resources, and access to services, mean that these households are often the least able to withstand shocks, and therefore prone to food insecurity, especially without resorting to negative coping mechanisms.

New and more sustainable ways of preventing and addressing recurrent food crises have to be found. An international humanitarian system, which is under strain by ever longer lasting crises, affecting more people, cannot sustainably respond to needs that largely result from chronic poverty. It is designed to support countries overwhelmed by a shock, to save lives, alleviate suffering and maintain human dignity during and in the aftermath of disasters. It also aims at preventing and supporting preparedness for the occurrence of such situations, through Disaster Risk Reduction measures.[24 page case study] Read More...

Provision of life-saving WASH services for Rohingya Refugees in Bagghona/Potibonia (Camp 16), Ukhiya Upazila, Cox’s Bazar District: END LINE SURVEY REPORT

Provision of life-saving WASH services to the Rohingya refugee and host population project for Ukhia Upazila, Cox's Bazar district was implemented in Moynarghona (camp 16) by CARE Bangladesh with funding from UNICEF for twelve (12) months (February, 2019 to February, 2020). The goal of the project was to improve the quality of integrated WASH service delivery to support the well-being of children under 5 years, women, girls, men, boys the elderly and persons with disability in emergency situation. The project targeted 21,883 refugees (52% women and 48% men) with water, sanitation and hygiene promotion interventions.

CARE conducted the midterm assessment in February 2020. The survey involved both quantitative and qualitative data collection tools and approaches. The samples were drawn systematically, with the sample size determined following most common statistical formula. A total of 300 respondent/households from camp 16 participated and the data collection. The questionnaires were uploaded in tablets with KoBo data collection application for accuracy and timeliness.

The objectives of the study are as follows:
- To understand water access situation for the beneficiary households in the camp 16.
- To know the sanitation status and use by households in the camp 16.
- To identify current Knowledge, Attitude and Practice (KAP) of targeted respondent on water sanitation and hygiene practices.
- To identify water, sanitation and hygiene challenges for the households in camp 16. Read More...

South Sudan: The True Cost of COVID-19 Vaccines

By July 18, South Sudan was able to administer the nearly all of the 60,000 doses of COVID-19 vaccine they had in stock through a series of smart investments in delivery, training, and social mobilization coordinated with several different partners. As new doses are projected to arrive in country in August, South Sudan continues to reinforce gaps in the health systems to make COVID-19 vaccinations possible without disrupting existing health services.

CARE’s estimated delivery costs from “tarmac to arm”1 for vaccines in these areas are $9.97 per dose of vaccine administered, or $22.22 per person fully vaccinated.

This is six times more expensive than current global estimate for delivery costs. For some actors providing vaccinations in South Sudan, the cost has been as high as $20 per dose administered when they include all costs. That’s because the health system in South Sudan is fragile, and it was already struggling to deliver even routine services. South Sudan is one of many health systems around the world that will need additional personnel, resources, and infrastructure to effectively deliver COVID-19 vaccines to at-risk populations, especially in hard-to-reach areas. The exact cost will continue to evolve as new vaccines arrive in country and the country vaccinates new groups of people. 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...

Learning From Failure 2019

Driven by a wish to learn more from what goes wrong in our programming, and to examine where changes to the broader organization and system can improve our programming and impact globally, in 2019 CARE undertook its first evaluations-based failure meta-analysis. This analysis draws learning and evidence from 114 evaluations of CARE’s work from 2015-2018 to understand the patterns and trends in what goes wrong. This helps us take a data-driven approach to strategic investments and action plans to live out CARE’s commitment to high program quality and continuous improvement across the board.
The review draws from project specific data, but deliberately anonymizes the data and focuses on overarching trends to remove blame for any specific project team or set of individuals. This exercise is designed to help us learn more about how we can change our processes and patterns of support and engagement around weak areas to improve our work. CARE is using this data to build action plans and next steps to continuously improve our programming.
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Multi-Purpose Cash Assistance (MPCA) Post-Distribution Monitoring Report

CARE implement an emergency funding funded by Humanitarian Response in Afghanistan ERPF –CARE International to respond to urgent humanitarian crisis including drought, displacement, conflict and COVID through provision of MPCA and NFI. CARE distributed cash to 522 households of which 75% were female-headed, in Kabul and in Kandahar. The activity directly assisted around 3660 people in the two provinces of Kabul and Kandahar. The distribution was done directly to the registered beneficiaries from CARE’s team female and male staff. The distribution went on smoothly without any interruptions.
CARE conducted a need assessment prior to provide cash assistance in the target areas to identify most vulnerable female headed households and disabled male headed household for this assistance.
In second week of November 2021, CARE’s Program Quality Unit (PQ) conducted a Post Distribution Monitoring (PDM) – on a randomly selected beneficiary to ascertain area including but limited to cash receipt, cash utilization, decision level for cash expenditure and assess monitoring and accountability measures – satisfaction levels from the response. 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...

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