Here in CARE International’s Evaluation e-Library we make all of CARE’s external evaluation reports available for public access in accordance with our Accountability Policy.

With these accumulated project evaluations CARE International hopes to share our collective knowledge not only internally but with a wider audience.

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MÁS DERECHOS Y MENOS PREJUICIOS: Guía de buenas prácticas en comunicación para el desarrollo y salud mental, en el contexto de la migración venezolana

Ante la crisis migratoria venezolana en Perú y la pandemia por la COVID-19, en Tumbes, Piura, La Libertad, Lima y Callao, el Proyecto Alma Llanera se planteó al objetivo general de mejorar la autosuficiencia y la integración de personas refugiadas y migrantes venezolanas vulnerables en Perú, a través de un mayor acceso a los servicios de protección, salud mental y a los medios de vida.
Esta guía se centra en los servicios de salud mental. Particularmente, identifica las mejores prácticas de comunicación para el desarrollo en la promoción de la salud mental. Las mismas que responden a estas dos preguntas clave: (1) ¿Cómo derribamos el estigma asociado a la salud mental entre las personas migrantes para convertirlos en agentes de cambio?, y (2) ¿Cómo evitamos las generalizaciones y transformamos la eventual xenofobia en empatía y confianza? La guía cuenta con cinco capítulos. El primero narra los antecedentes de la intervención. El segundo la describe. Para ello, presenta sus conceptos clave, los territorios en los que operó y los criterios y las dimensiones sobre las que se calificaron las buenas prácticas. El tercer capítulo presenta las cuatro buenas prácticas seleccionadas. Al final de la guía encontrará tanto las conclusiones como las recomendaciones para promover la salud mental, a través de iniciativas de comunicación para el desarrollo.
Las cuatro buenas prácticas destacadas en esta publicación se centran en las personas y adoptan una comprensión integral de la salud mental que, para empoderar tanto a las comunidades venezolanas como de acogida, responde a los determinantes sociales, incluye la continuidad y calidad de cuidados integrales y requiere del trabajo interdisciplinario e intercultural. A través del arte, la música, la cocina y las historias personales, las buenas prácticas de esta guía generaron un espacio (físico o virtual) de divertimento, encuentro e intercambio.
Con el objetivo de promover la salud mental en el país, desde una perspectiva humana y de derechos, la guía tiene como uno de sus propósitos contribuir a que distintas iniciativas también sean culturalmente apropiadas y efectivas promoviendo el bienestar de las poblaciones migrantes y de acogida. Read More...

SISTEMATIZACIÓN DE LA ESTRATEGIA DE SALUD DEL PROYECTO ALMA LLANERA DE CARE PERÚ

El presente documento sistematiza la estrategia de salud del proyecto “Alma Llanera” de CARE Perú que se viene implementando en las regiones de Tumbes, Piura, La Libertad, Lima y Callao desde septiembre del 2019 hasta agosto de 2023. Dicha estrategia busca promover el acceso a servicios de salud de personas migrantes y refugiadas en sus ámbitos de intervención. Esta sistematización, enmarcada en un enfoque comunitario y participativo, consideró las miradas de las diferentes personas involucradas en la estrategia de salud del proyecto: equipo central y regional, consultores, agentes comunitarios de salud y beneficiarios del proyecto. Para ello, se recolectó la información a través de grupos de discusión, entrevistas individuales y encuestas, a la par de la revisión de documentos concernientes al programa y a la estrategia en particular; a fin de recoger buenas prácticas, lecciones aprendidas y procesos innovadores, que permitan generar aprendizajes internos e interinstitucionales. Los temas de salud y bienestar están atravesados por variables estructurales de pobreza, violencia, discriminación y corrupción aunados al limitado acceso de la población a los servicios de salud, en especial la refugiada y migrante. La pandemia por COVID-19, agudizó estás problemáticas y evidenció la importancia y necesidad de atender adecuadamente la salud física y mental. Para el proyecto “Alma Llanera” este contexto género una reorganización de su diseño y presupuesto para la priorización de la salud en la población migrante, a través de las ferias integrales, la entrega de vales de salud y la derivación a establecimientos de salud, considerando la vulnerabilidad de la población de refugiados y migrantes.
Entre las lecciones aprendidas resalta el que la estrategia de salud ha permitido acercar a la población refugiada y migrante a los servicios de salud, siendo esta una necesidad básica, sobre todo en situaciones de emergencia como ha sido la pandemia por la COVID-19. En este sentido, los vales permitieron atender situaciones de emergencia, pero evidenciaron las dificultades para la sostenibilidad del tratamiento producto de otras necesidades (alimentación, vivienda) que, en consecuencia, requieren igual atención inmediata. Read More...

Ecological Assessment and Detailed Scoping Study in the Sundarbans and Hakaluki Haor Ecologically Critical Areas (ECA) for Nature-based Solutions (NbS) and Locally Led Adaptation (LLA)

The Ecologically Critical Areas (ECAs) in Bangladesh, notably the Sundarbans and Hakaluki Haor are vital for biodiversity and livelihoods. The UK government’s Adaptation in Ecologically Critical Areas known locally as NABAPALLAB- (Nature Based Adaptation towards Prosperous and Adept Lives & Livelihoods in Bangladesh) project aims to enhance resilience of the ecosystem and livelihoods through Nature-based Solutions (NbS) and Locally Led Adaptation (LLA). The project has conducted three separate assessments (Ecological Assessment and Detailed Scoping study; Stakeholder Mapping and Political Economy Analysis; and Baseline Study) simultaneously during its inception stage. This report synthesizes findings from the ecological assessment and detailed scoping study. Insights were gathered to understand ecological status, community needs, and intervention opportunities in the Sundarbans and Hakaluki Haor. The report further highlights current and emerging threats, drivers and complexities in both ECAs. The status of the natural resource base, degradation pattern and ecosystem health were also analysed and documented using physical data and recent satellite imagery.
In the Sundarbans, the study found different ecosystems, including wetlands, low-lying lands, riverside areas, homesteads, croplands, and coastal embankments. All of these ecosystems are affected by various climatic stressors such as salinity, tidal inundation, erratic rainfall, and cyclones. They are also impacted by anthropogenic drivers such as shrimp farming, water logging, overharvesting, illegal fishing, deforestation, poaching. For example, the study shows that shrimp cultivation has a profound effect on agriculture with changes in land use and intrusion of saline water, which lead to decreased soil fertility, crop failure and lower productivity. Shrimp cultivation also contributes to surface water pollution, leading to scarcity of drinking water and negative impacts on WASH. The study also highlights significant threats to important endangered wildlife species in the Sundarbans ECA, including the Masked Finfoot and White-Rumped Vulture. In addition to the anthropogenic threats, the study has identified other problems such as fishing with poison, bird hunting, use of illegal fishing equipment, canal siltation, and intrusion of saline water into freshwater wetlands. These issues result in decreased fish population, depletion of wildlife and reduced agricultural productivity.
The Hakaluki Haor, encompassing 276 interconnected beels (wetland lakes) over an area of 18,000 hectares, faces significant threats from both anthropogenic and climate change stressors. Extensive sedimentation and agricultural expansion have led to the conversion of over 20 beels to agricultural production, impacting wetland productivity, aquatic vegetation, fish populations, and local livelihoods. Degradation of rivers, canals, and hill streams within the Haor has further exacerbated these problems and challenges, affecting crop production, fish yields, and biodiversity. Encroachment on protected swamp forest areas after phase-out of previous projects, wide-ranging deforestation, and conversion of raised land (Kandas) for agriculture have negatively impacted the habitats of fish and birds, and other wetland-dependent wildlife as well as waterfowl migratory routes. Furthermore, elite capture excludes poor fisher folk and landless individuals from fishing and accessing natural resources, while agricultural expansion in Kanda areas raises concerns about increased use of chemical pesticides and fertilizers that pollute wetlands. Read More...

McGovern-Dole Food for Education and Child Nutrition Program in Timor-Leste HATUTAN Sustainability Study Liquica

The United States Department of Agriculture (USDA) has supported Timor-Leste through the McGovern-Dole Food for Education and Child Nutrition Initiative since 2018. The McGovern-Dole funded Hahán ne’ebé Atu fó Tulun ho Nutrisaun no Edukasaun/ Food to Support Nutrition and Education program – HATUTAN - supported 455 schools and surrounding communities in four of Timor-Leste’s most disadvantaged municipalities: Ainaro, Ermera, Liquica, and Manatuto. Between 2018 and 2023, HATUTAN reached 431,244 students, out of whom 109,065 received school meals.

HATUTAN’s final evaluation show that the integrated intervention has achieved remarkable results, including:
-A gain of 4.8 percentage points in literacy scores, over and above the comparison group.
-A major reduction in teachers’ use of traditional practices: the proportion of students who spent the class copying from the board declined by 15 percentage points over and above the comparison group, while the proportion of students repeating after the teacher declined by 25 percentage points; and
- A major improvement in infant feeding practices, reducing by 13.6 percentage points in the proportion of mothers feeding formula to babies under six months of age.

In 2023, the schools14 in the municipality of Liquica – 101 in total, out of which 35 receiving the full intervention15 - graduated out of the program following demonstrated improvements in school management, SFP delivery, increased use of participatory teaching practices and reduction in negative teaching practices, and improvements in hygiene and sanitation. Among other results, the final evaluation showed that 91% of the schools in Liquica had reading corners in grade 2, compared to HATUTAN’s 65% average; the average attendance rate reached 78%, compared to a 64% average; and teacher attendance rate reached 85%. The second phase of the program has continued to support schools in Ainaro, Ermera, and Manatuto since 2023, and expanded operations to Oé-cusse in 2024. Read More...

Examining Barriers to Family Planning Information, Products, and Services Among Ukrainian Refugees and Host Communities in Poland (English)

Cash and Voucher Assistance for Family Planning in Poland Assessment Report: This report examines barriers Ukrainian refugees and Polish host communities face in accessing family planning (FP) services. Refugees struggle with financial obstacles like transportation and private healthcare costs, compounded by Poland’s restrictive sexual and reproductive health (SRH) policies. The report highlights the potential of cash and voucher assistance (CVA) to improve access to FP services, with the need for contextual adaptation to Poland’s healthcare system.

Poland SRHR Stakeholder Workshop Learning Brief (August 2024): This brief shares insights from a workshop on sexual and reproductive health rights (SRHR) for Ukrainian refugees and Polish communities. It identified financial barriers, restrictive policies, and stigma as major challenges, and explored how CVA could improve SRH access by partnering with local stakeholders and adapting to Poland's restrictive policy environment. Read More...

Community Nutrition and Health Activity Equity Gap Analysis

The Community Nutrition and Health Activity (CNHA) conducted an equity gap analysis to investigate the existing inequities in health and nutrition outcomes within its target areas in Bangladesh. This analysis aimed to identify not only the current inequities but also the underlying reasons for these disparities. Using USAID’s Unofficial Guidance to an Equity Gap Analysis, the CNHA team defined desired outcomes, assessed differential health and nutrition outcomes among various population groups through secondary data, and conducted stakeholder consultations with marginalized groups to understand the reasons behind these inequities. The findings highlighted that individuals in the two lowest wealth quintiles face significant barriers to accessing health care services, with persons with disabilities particularly excluded. Stakeholder consultations revealed issues such as lack of respectful care from community health care providers, restrictions on women's mobility, and inadequate participation in government safety net programs.

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Rapid Assessment of the FBMT Family Business Management Training

This rapid review was commissioned by CARE to evaluate the Family Business Management Training (FBMT) in Côte d’Ivoire using a qualitative approach.
The relevance of the FBMT in relation to the objectives of the W4C (Women for Change) program was analyzed by comparing the FBMT content and the evidence from the interviews with the objectives and indicators of the W4C logframe.
It becomes clear that the FBMT was most effective in increasing IGAs, balancing decision making and improving relationships. The effect of IGAs on household income not entirely clear yet. Access to the training is determined by participation in VSLAs. While this is not detrimental in the first place, potential entry barriers to VSLAs need to be kept in mind when scaling up.
For men the main challenges to participate in the FBMT are a perceived loss of power and possibly the available time to attend. Yet, those who participated were attracted by potential economic gains and finally recognized the advantages of improved relationships.
A mapping of training courses that are related to the FBMT and are applied in the W4C program revealed that the couple dialogues, the gender strategy interventions and FBMT overlap in some areas but the FBMT goes beyond the objectives of the other two courses. The IGA training courses, which are complementary to the FBMT, overlap with some of the contents of the FFBS1 (Farmer Field and Business School). The FFBS also overlaps with some of the FBMT contents on gender and also addresses the couple rather than just the women. However, it comprises of about double the number of training modules of the FBMT.
Training application is divided between technical advisors and field supervisors. This arrangement was not evaluated in detail but might not be the most effective and should be reviewed critically. The FBMT sustainably changed some of the behaviour of participating couples, confirming the sustainability of some of the effects of the training. The provision of the training still depends on external funding and cannot be considered fully sustainable yet. Change plans and their follow up by CARE staff are time consuming, resource intensive and might reduce the ownership of these plans by the couple that developed the plan.
The FBMT has been successful in changing household economies and relationships. Specifically the daily calendar, the income and expenditure tree and the prioritization of expenditures as practiced in the NEEDS and WANTS exercise have proven to be very effective. The perceived economic advantages of the training attract men eventually they discover the rewards of an improved relationship. The benefits of the FBMT have motivated some community members to spread its concepts to other households, which is as an opportunity for future programming. Read More...

How Can Approaches that Achieve Gender Equality Help Advance all the SDGs: Impact Evaluations Evidence from CARE Programs

Approaches that achieve gender equality, that move beyond the individual level to address greater interpersonal, socio-cultural, and community factors that influence gender attitudes and behaviors, have been shown by rigorous impact evaluations to be impactful in promoting gender-equitable attitudes (e.g., SASA! Program in Uganda), reducing gender-based violence (e.g., Stepping Stones and Creating Futures program in South Africa), and decreasing social acceptance of intimate partner violence (e.g., RESPECT program in Tanzania).
Key Findings Summary:
What are the Impacts of Approaches that Achieve Gender Equality?
• Empowerment of women and girls: 8 out of 8 programs have positive impacts on increasing women’s and girls’ self-efficacy, mobility, sexual and reproductive agency, egalitarian gender attitudes, and economic situations; 5 out of 8 programs have positive impacts on reducing early marriage rates and intimate partner violence (IPV), and increasing women’s intrahousehold decision-making power; 6 out of 8 programs have positive impacts on changing community traditional gender norms and increasing women’s community leadership.
• Increased impact on other SDGs, such as poverty reduction (SDG 1), food security (SDG 2), health (SDG 2), education (SDG 4), access to clean water and sanitation (SDG 6), decent work (SDG 8), and reduced inequalities (SDG 10).
How Did These Changes Happen?
• Village Savings and Loan Associations (VSLAs).
• Active engagement of men and boys, community members and leaders.
• Couples’ curriculum and gender dialogues.
• Community-level social norms intervention: Social analysis and action (SAA)
• Life skills and financial management training. Read More...

Baseline Study Report of Flash Flood and Lightning

The baseline study concerning the impact of flash floods and lightning on the SUFAL-II project aims to analyze the context of flash floods and lightning, assess the scopes of the Early Warning System, and examine current trends of of hazard-specific responses taken by individual, community, and institutional levels. The objective of this project is to bolster the capabilities of vulnerable communities and institutions in Bangladesh to implement forecast-based early actions. The study employed a mixed-method approach, amalgamating both quantitative and qualitative data collection and analysis techniques. This was done to assess the context, accessibility, usage, and potential of early warning systems and early actions for mitigating the risks associated with the flash floods and lightning hazards.
The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For the treatment group areas, the selected Upazilas were Gowainghat, Dharmapasha, and Khaliajuri and for control group areas, the selected areas were Sylhet Sadar, Sunamganj Sadar, Madan.
Data was collected from 502 households, 12 focus group discussions, and 19 key informant interviews. The study's findings indicate that flash floods and lightning are recurrent and severe hazards that pose significant threats to the communities lives, assets, and livelihoods. These hazards are disproportionately affect women, individuals with disabilities and farmers. The study also identified several shortcomings in the existing early warning systems, including issues related to timeliness, quality, coverage, accessibility, comprehension, and trust.

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Adolescent Girls’ Education in Somalia (AGES) Post Project Evaluation Summaries

The Adolescent Girls’ Education in Somalia (AGES) project is an ambitious six-year initiative (2018-2024) funded by FCDO and USAID, which sought to enable 83,925 ultra-marginalized girls and female youth living in conflict-affected areas of Somalia to access quality education responsive to their needs. AGES combines the provision of three education modalities with financial literacy, youth savings groups, life skills, mentorship, and girl-led civic action. AGES enrolled a total of 90,698 girls in education, including 21,945 in primary education; 1244 in formal special needs schools; 13,276 in accelerated basic education (ABE); and 54,233 in non-formal education classes (NFE). This series of briefs highlights results on different components of results from the post-project evaluation.
Additionally, The Adolescent Girls’ Education in Somalia (AGES) project worked to improve learning outcomes and positive transitions for 90,698 extremely vulnerable girls and female youth in South Somalia. AGES research showed that vulnerable girls’ limited self-confidence and voice hinders participation in class, with a negative impact on learning, particularly among girls with disabilities and displaced youth. To address this barrier, AGES
formed school-based clubs known as Girls’ Empowerment Forum (GEF). Through the GEF, vulnerable students participate in activities to develop leadership skills with support from mentors and are linked to resource
persons within the community. They are trained to act as peer mentors within their schools and community, reaching out to other girls to provide support, and engaging in joint advocacy and action. GEF participants
work together to develop plans to address issues of their choice through girl-led action. GEF mentors and peer mentors are also trained on psychosocial first aid, providing support to those affected by shocks. In 2020-2024, AGES established 911 Girls’ Empowerment Forums with a total of 9,110 members. The GEFs were connected through 18 district-level networks. Read More...

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