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Final Evaluation Report: Gender-sensitive WASH, Nutrition and Health Support to vulnerable communities in South and East Darfur
CARE has been implementing the WASH ,Health and Nutrition project from which aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 174,504 individuals (87,077 males and 87,427 females) in East Darfur and South Darfur through the GAC-funded 2019-2021 project (“the GAC project”).The program aimed to benefit refugees in camp and out of camp settings, out of camp IDPs and host communities by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for children under five and pregnant and lactating women (PLWs). End line evaluation was conducted for the ended project.
Water: from the survey result it shows that 85.8% responded that their primary source of water is safe throughout the year, compared to the baseline survey which shows that 66% of the respondents still use unsafe drinking water sources.
Sanitary practices: 73.9% of survey participants indicated that they use family toilets for defecation, where in the base line survey show that 34% of the respondents having access to adequate sanitation.
Practice Of Hand Washing: 60.9 % of interviewees (Female: 61.0%, Male: 60.8%) know three critical moments, where in base line survey 65% of the respondents being able to mention at least 3 critical times to perform hand washing.
WASH satisfaction: The end line survey for HHs reported that with WASH regarding relevance, timely and accountability, (75.3%)- (70.6% f,77.9%m) reported that it was relevant
Nutrition: 72.9%% of respondents were satisfied with the nutrition assistance provided.
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Water: from the survey result it shows that 85.8% responded that their primary source of water is safe throughout the year, compared to the baseline survey which shows that 66% of the respondents still use unsafe drinking water sources.
Sanitary practices: 73.9% of survey participants indicated that they use family toilets for defecation, where in the base line survey show that 34% of the respondents having access to adequate sanitation.
Practice Of Hand Washing: 60.9 % of interviewees (Female: 61.0%, Male: 60.8%) know three critical moments, where in base line survey 65% of the respondents being able to mention at least 3 critical times to perform hand washing.
WASH satisfaction: The end line survey for HHs reported that with WASH regarding relevance, timely and accountability, (75.3%)- (70.6% f,77.9%m) reported that it was relevant
Nutrition: 72.9%% of respondents were satisfied with the nutrition assistance provided.
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Strengthening Resilience and Inclusive Governance (STRENPO) Mid-term Review
The Strengthening Resilience and Inclusive Governance Program (STRENPO) is a 4-year programme in the nexus between humanitarian and development work, managed by CARE International in Uganda, in partnership with four Ugandan civil society organisations. The programme commenced in April 2018 for the years 2018-2021.
The overall objective of STRENPO is: Women and youth in vulnerable, natural resource-dependent communities, including refugee settlements, are resilient to shocks and stresses arising from natural resources degradation, climate change, and conflict & displacement.
The overall impression generated from the documents review and the consultations in Uganda is that programme implementation is largely on track compared with work plans; this includes individual partner projects carried out by three ‘old’ partner organisations and RICE-WN as the new partner in the programme. Interventions are well-managed and the STRENPO team in CARE as well as staff in the partner organisations appear dedicated to the implementation of the programme in general and to their particular contribution.
A baseline survey was undertaken in late 2018 and is assessed as a well-planned and executed activity. The study focused on measuring resilience and the result was a sophisticated framework of criteria for categorising indicators of capacity to anticipate and respond appropriately to climate changes. Important information also came out from the Gender Sensitive Climate Vulnerability and Capacity Analysis (G-CVCA) that were undertaken by mid-2019.
- It is therefore recommended to introduce a more diversified approach to the interventions that targets impact groups directly, building on findings from the baseline survey and the G-CVCAs.
- It is recommended that STRENPO continues a strong follow-up to the CAAPs in order to facilitate funding of activities of priority to the involved communities and relevant to the programme’s objectives.
- It is therefore recommended that STRENPO during the coming two years increases the focus on using potential avenues for best practices replication and other catalytic effects.
- It is recommended that the STRENPO partners together selects a handful of the outlined ‘strategic actions’ for further development and specification.
- It is recommended that some of the capacity gaps that have key relevance for the programme are selected, so that it can be decided what type and how much support to the capacity development interventions the programme is able to offer.
- It is recommended that STRENPO in early 2020 reviews its potentials for engaging in stronger partnerships with the private sector, using a market driven analytical approach to determine appropriate interventions and relevant value chain and private sector actors to engage with.
- It is recommended that the STRENPO team engages in a discussion with CARE Danmark to further clarify their understanding and expectations regarding the programme’s inclusion of innovative climate change prevention solutions and a transformative approach to resilience.
- It is recommended that STRENPO undertakes a quick review of its results framework, with the intention to reduce the number of indicators, but also to allow a breakdown on some indicators into refugees and hosts. The revision should also aim at reducing and/or combining the qualitative indicators and progress markers. It is furthermore recommended to review and revise the phrasing of result areas and the Theory of Change, taking note of the suggestions made during the MTR workshop.
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The overall objective of STRENPO is: Women and youth in vulnerable, natural resource-dependent communities, including refugee settlements, are resilient to shocks and stresses arising from natural resources degradation, climate change, and conflict & displacement.
The overall impression generated from the documents review and the consultations in Uganda is that programme implementation is largely on track compared with work plans; this includes individual partner projects carried out by three ‘old’ partner organisations and RICE-WN as the new partner in the programme. Interventions are well-managed and the STRENPO team in CARE as well as staff in the partner organisations appear dedicated to the implementation of the programme in general and to their particular contribution.
A baseline survey was undertaken in late 2018 and is assessed as a well-planned and executed activity. The study focused on measuring resilience and the result was a sophisticated framework of criteria for categorising indicators of capacity to anticipate and respond appropriately to climate changes. Important information also came out from the Gender Sensitive Climate Vulnerability and Capacity Analysis (G-CVCA) that were undertaken by mid-2019.
- It is therefore recommended to introduce a more diversified approach to the interventions that targets impact groups directly, building on findings from the baseline survey and the G-CVCAs.
- It is recommended that STRENPO continues a strong follow-up to the CAAPs in order to facilitate funding of activities of priority to the involved communities and relevant to the programme’s objectives.
- It is therefore recommended that STRENPO during the coming two years increases the focus on using potential avenues for best practices replication and other catalytic effects.
- It is recommended that the STRENPO partners together selects a handful of the outlined ‘strategic actions’ for further development and specification.
- It is recommended that some of the capacity gaps that have key relevance for the programme are selected, so that it can be decided what type and how much support to the capacity development interventions the programme is able to offer.
- It is recommended that STRENPO in early 2020 reviews its potentials for engaging in stronger partnerships with the private sector, using a market driven analytical approach to determine appropriate interventions and relevant value chain and private sector actors to engage with.
- It is recommended that the STRENPO team engages in a discussion with CARE Danmark to further clarify their understanding and expectations regarding the programme’s inclusion of innovative climate change prevention solutions and a transformative approach to resilience.
- It is recommended that STRENPO undertakes a quick review of its results framework, with the intention to reduce the number of indicators, but also to allow a breakdown on some indicators into refugees and hosts. The revision should also aim at reducing and/or combining the qualitative indicators and progress markers. It is furthermore recommended to review and revise the phrasing of result areas and the Theory of Change, taking note of the suggestions made during the MTR workshop.
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CARE Afghanistan Multi-Sectoral Needs Assessment MULTI SECTOR NEEDS ASSESSMENT – KEY FINDINGS February 2022
The purpose of this MSNA was to identify key gaps and needs where CARE operates, with the view to inform future programming priorities and better understand the impacts of the current situation on humanitarian needs.
A total of 364 households were interviewed from 20 districts across 8 provinces (Herat, Kandahar, Ghazni, Khost, Paktia, Parwan, Kapisa, and Balkh) in December 2021. An average of 18 interviews were collected per district. The survey administered a household questionnaire and a focus group discussion (2 per community –female and male) in each district.
Key Findings on Education, Gender, Humanitarian Access, and Food Insecurity are presented here. For more data and information, please refer to the full MSNA report.
The top 5 concerns raised by the communities were all related to the consequences of Afghanistan’s current economic and humanitarian crisis:
1. food security (72% of respondents),
2. lack of employment opportunities (66%),
3. livelihood and economic empowerment (56%),
4. lack of access to humanitarian aid (36%), and
5. lack of access to shelter/ housing options (36%). Read More...
A total of 364 households were interviewed from 20 districts across 8 provinces (Herat, Kandahar, Ghazni, Khost, Paktia, Parwan, Kapisa, and Balkh) in December 2021. An average of 18 interviews were collected per district. The survey administered a household questionnaire and a focus group discussion (2 per community –female and male) in each district.
Key Findings on Education, Gender, Humanitarian Access, and Food Insecurity are presented here. For more data and information, please refer to the full MSNA report.
The top 5 concerns raised by the communities were all related to the consequences of Afghanistan’s current economic and humanitarian crisis:
1. food security (72% of respondents),
2. lack of employment opportunities (66%),
3. livelihood and economic empowerment (56%),
4. lack of access to humanitarian aid (36%), and
5. lack of access to shelter/ housing options (36%). Read More...
The Impact of the Food Crisis on Women and Girls in Afghanistan
CARE conducted a study on how the food crisis in Afghanistan affects women and girls differently to better understand the gendered economic, cultural, and practical barriers to food security. This research highlights key findings on household food security, negative coping strategies women and families adopt, and shortcomings of humanitarian actors in gender-responsive aid delivery. The study is based on a comprehensive desk review of existing data since August 2021, a household survey comprising of 345 women respondents, completed in both urban and rural communities, a series of qualitative interviews with 18 women, 9 focus group discussions (FGDs) with men, and key informant interviews (KIIs) with food security specialists and humanitarian actors. The data was collected in urban and rural districts in 9 provinces in the north, west, south, and center of the country. Read More...
Community Scorecard for COVID-19 Vaccines in Malawi
The significant amount of misinformation surrounding COVID-19 has deteriorated trust in governments and health systems, leading the World Health Organization to claim it as an “infodemic.” As the massive vaccine roll-out efforts launch, systematic trust-building and social accountability approaches are vital to ensure that civil society can hold governments accountable for equitable and people-centered vaccine roll-out that reaches the last mile. CARE knows that epidemics, like COVID-19 and Ebola, start and end with communities, which is why we are working to build meaningful citizen engagement into national vaccine roll-out frameworks to increase trust, accountability, and information dissemination.
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...
SUAAHARA II GOOD NUTRITION PROGRAM ANNUAL SURVEY YEAR ONE (2017)
The Government of Nepal (GoN) is currently rolling out the second phase of a national Multi-Sectoral Nutrition Program (MSNP), with the support of external development partners. Suaahara II is a USAID-funded multisectoral nutrition program, aligned with Nepal’s MSNP, being implemented in 42 of Nepal’s 77 districts from 2016 to 2021. Suaahara II aims to reduce the prevalence of stunting, wasting and underweight among children under 5 years of age and to reduce the prevalence of anemia among WRA and children 6-59 months of age. CARE is sub-grantee to Helen Keller International on this project.
Annual surveys are a key component of Suaahara II’s monitoring system. The primary purpose is to monitor progress over time related to key Suaahara II inputs, outputs, outcomes and impacts 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. Read More...
Annual surveys are a key component of Suaahara II’s monitoring system. The primary purpose is to monitor progress over time related to key Suaahara II inputs, outputs, outcomes and impacts 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. Read More...
The Cost of Delivering COVID-19 Vaccines in Zambia
While Zambia aims to deliver COVID-19 vaccines to 70% of its people by June 30, 2022, the road to getting there is uncertain. The Zambian Ministry of Health reports that, as of February 21, 2022, 21.6% of people were fully
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...
Mid-Term Strategic Review of the Livelihoods for Resilience Activity
CARE commissioned a Mid-Term Strategic Review (MTSR) of the Livelihoods for Resilience Activity to formulate recommendations for the remaining life of the project to increase effectiveness in achieving sustainable impact. The Livelihoods for Resilience Activity is being implemented in 27 Woredas in the three regions of Tigray, Amhara, and Southern Nations, Nationalities and Peoples and is just over the midway point in its five-year life from December 5, 2016, through December 3, 2021. The purpose of the Livelihoods for Resilience Activity is to reduce food insecurity and increase resilience for 97,900 chronically food insecure households that are enrolled in the fourth cycle of the Government of Ethiopia’s Productive Safety Net Program (PSNP4), enabling them to graduate with resilience from the PSNP4.
The MTSR for the Livelihoods for Resilience Activity was a formative evaluation exercise intended to provide guidance on ways to improve the effectiveness of the program in achieving intended impact.
Relative to the four global learning questions for the MTSR (see page 4), the MTSR found that the model that the Livelihoods for Resilience Activity is implementing is effective for achieving graduation with resilience, but because frontline delivery is constrained by the number of staff, their technical capacities and the degree of supervision and support that they receive, interventions are not always going deeply enough to ensure behavioral change. The program is empowering women both economically and socially through the VESA platform, but there are significant variations between regions; and outside of the VESA, there is some evidence to suggest that women’s empowerment has not yet been well incorporated, especially in value chain participation and MFI linkages. Progress is certainly being made in transferring ideas and knowledge to PSNP counterparts, but that has not yet translated into practice mainly because of resource constraints. Key approaches that need to be added or strengthened in the coming two years include expanding frontline delivery capacities, expanding efforts to ensure that strategies and approaches are well understood by implementation staff at all levels in all partners, ensuring that women’s empowerment is included in all approaches by all partners, and looking for new ways to facilitate access to jobs, either through self-employment or wage employment, for youth from PSNP households.
The Livelihoods for Resilience Activity is already doing some very nice work in starting to achieve sustainable impact. The project has strong potential to be recognized as a “great” project if it can make some adjustments.
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The MTSR for the Livelihoods for Resilience Activity was a formative evaluation exercise intended to provide guidance on ways to improve the effectiveness of the program in achieving intended impact.
Relative to the four global learning questions for the MTSR (see page 4), the MTSR found that the model that the Livelihoods for Resilience Activity is implementing is effective for achieving graduation with resilience, but because frontline delivery is constrained by the number of staff, their technical capacities and the degree of supervision and support that they receive, interventions are not always going deeply enough to ensure behavioral change. The program is empowering women both economically and socially through the VESA platform, but there are significant variations between regions; and outside of the VESA, there is some evidence to suggest that women’s empowerment has not yet been well incorporated, especially in value chain participation and MFI linkages. Progress is certainly being made in transferring ideas and knowledge to PSNP counterparts, but that has not yet translated into practice mainly because of resource constraints. Key approaches that need to be added or strengthened in the coming two years include expanding frontline delivery capacities, expanding efforts to ensure that strategies and approaches are well understood by implementation staff at all levels in all partners, ensuring that women’s empowerment is included in all approaches by all partners, and looking for new ways to facilitate access to jobs, either through self-employment or wage employment, for youth from PSNP households.
The Livelihoods for Resilience Activity is already doing some very nice work in starting to achieve sustainable impact. The project has strong potential to be recognized as a “great” project if it can make some adjustments.
Read More...
HBCC (Hygiene and Behavior Change Coalition) Project: Inclusive Communities – Changing behaviors to respond to COVID-19
The “Promoting safer hygiene practices for women and girls to remain safe and live better lives project has been implemented between the 23rd of July 2020 and the 31st of August 2021 through CARE International in Jordan and funded by Unilever-UKAID HBCC (Hygiene Behaviour Change Coalition). The project’s overall objective was to support the most vulnerable women and girls in conflict communities, refugee, asylum and host populations within the Syrian crisis region to improve their key hygiene behaviours and be better equipped to protect themselves from COVID-19 transmission through mass awareness, interpersonal communication and digital media communication.
CARE Jordan implemented a package of multiple interventions which includes mass media, digital communication, and in some cases targeted face-to-face interactions complemented by the provision of hygiene and dignity kits to promote key hygiene behaviours of the targeted beneficiaries. The mass media and digital campaign, which targeted community members who live in Amman, Zarqa/Azraq town, Irbid, Mafraq, and Azraq Refugee Camp, but also reached beyond these areas in particular with the mass media intervention; focused on a variety of messages in line with the national/local Health Service approved guidelines as well as some of the Unilever Global assets like the PASSWORD Campaigns, Snake and Ladder game, and Mobile Doctorni. Messages covered issues of prevention, protection, safety, security and where to seek early support when showing signs and symptoms of COVID-19. Read More...
CARE Jordan implemented a package of multiple interventions which includes mass media, digital communication, and in some cases targeted face-to-face interactions complemented by the provision of hygiene and dignity kits to promote key hygiene behaviours of the targeted beneficiaries. The mass media and digital campaign, which targeted community members who live in Amman, Zarqa/Azraq town, Irbid, Mafraq, and Azraq Refugee Camp, but also reached beyond these areas in particular with the mass media intervention; focused on a variety of messages in line with the national/local Health Service approved guidelines as well as some of the Unilever Global assets like the PASSWORD Campaigns, Snake and Ladder game, and Mobile Doctorni. Messages covered issues of prevention, protection, safety, security and where to seek early support when showing signs and symptoms of COVID-19. Read More...
Tabora Maternal & Newborn Health Initiative (TAMANI): Year 4 results
The Tabora Maternal and Newborn Health Initiative (TAMANI) is a five-year project led by CARE in partnership with the Government of Tanzania’s Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the Prime Minister’s Office for Regional and Local Government (PO-RALG). Implementing partners include the Society of Obstetricians and Gynecologists of Canada (SOGC), the Association of Gynecologists and Obstetricians of Tanzania (AGOTA), the Canadian Society for International Health (CSIH), McGill University’s Institute for Health & Social Policy, and Ifakara Health Institute (IHI). The project is financially supported by the Government of Canada and is closely aligned to Government of Tanzania (GoT) health polices, strategies and guidelines.
The Annual Report covers the period of April 1, 2020, to March 31, 2021.The report provides an analysis on operations to date against the Year Four Annual Work Plan. This report also highlights how the project
pivoted to respond to the COVID-19 global pandemic and includes reporting on COVID response programming as approved by GAC in March 2020. Read More...
The Annual Report covers the period of April 1, 2020, to March 31, 2021.The report provides an analysis on operations to date against the Year Four Annual Work Plan. This report also highlights how the project
pivoted to respond to the COVID-19 global pandemic and includes reporting on COVID response programming as approved by GAC in March 2020. Read More...