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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RANO WASH Rural Access to New Opportunities in Water, Sanitation, And Hygiene Mid-Term Review Report
The $33 million USAID-funded Rural Access to New Opportunities in Water, Sanitation and Hygiene (RANO WASH) program seeks to increase equitable and sustainable access to WASH services to maximize impact on human health and nutrition and preserve the environment in 250 rural communes of Alaotra Mangoro, Amoron'i Mania, Atsinanana, Haute Matsiatra, Vakinankaratra, and Vatovavy Fitovinany regions of Madagascar. RANO WASH has three strategic objectives:
1) To support governance and monitoring at national, regional, and communal levels for sustainable WASH services;
2) To increase access to water and sanitation supply through supporting private sector capacity and public-private partnerships for sustainable water and sanitation supply across several regions in Madagascar; and
3) To increase good hygiene and sanitation behaviors by identifying and addressing multiple behavioral determinants.
The project was designed using the Sanitation and Water for All (SWA) Collaborative Behaviors and is guided by a system strengthening approach that establishes the building blocks for sustainable delivery of WASH services. This report presents findings from the midterm review, which evaluated the project's performance from 2018 to 2020 across five criteria, benchmarked progress and contribution towards WASH building blocks, and assessed the effectiveness of the consortium team. Read More...
1) To support governance and monitoring at national, regional, and communal levels for sustainable WASH services;
2) To increase access to water and sanitation supply through supporting private sector capacity and public-private partnerships for sustainable water and sanitation supply across several regions in Madagascar; and
3) To increase good hygiene and sanitation behaviors by identifying and addressing multiple behavioral determinants.
The project was designed using the Sanitation and Water for All (SWA) Collaborative Behaviors and is guided by a system strengthening approach that establishes the building blocks for sustainable delivery of WASH services. This report presents findings from the midterm review, which evaluated the project's performance from 2018 to 2020 across five criteria, benchmarked progress and contribution towards WASH building blocks, and assessed the effectiveness of the consortium team. Read More...
Nepal COVID-19 Vaccine Costing Study
By December 6, 2021, 19.2 million doses of COVID-19 vaccines have been administered in Nepal, enough for 36% of the population to have gotten at least one dose of vaccine. After a rough road with unpredictable vaccine supply, the government has been able to procure several million vaccine doses. Now delivery at the last mile is the biggest hurdle they face. Nepal’s Minister of Health says, “We are not going have shortages of vaccines anymore, but our main concern and focus now is on getting these vaccines to all corners of the country, including the remote mountain areas.”
Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
Read More...
Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.
This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.
70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
Read More...
Don’t Leave Them Behind: Global Food Policies Continue to Fail Women (December 2021)
811 million people in the world are going hungry, half a million of whom are on the brink of starvation. Clearly, current approaches are simply not enough to meet the scale of the crisis we are facing. If we continue to do what we have always done, we will continue to see the same problem: people going to bed hungry. We must find better solutions to prevent and end hunger—especially if we are going to meet the Sustainable Development Goal of Zero Hunger by 2030.
One of the first things we can do is consider who is going hungry. Using the term “people” hides part of the problem: gender inequality. Globally, women are 10% more likely to go hungry than men, and that gap is growing. In Somalia, for example, men are eating smaller meals; women are skipping meals altogether. We see this inequality play out at the international level, too—global solutions consistently ignore women, their rights, and the critical role women play in food systems.
Of 84 global policies and plans designed to address hunger released between September 2020 and December 2021, only 4% refer to women as leaders who should be part of the solution or provide funding to support them. 39% overlook women entirely. This is unacceptable. Ending hunger will take everyone’s talents, opinions, and work. It requires promoting equality, respecting rights, and truly listening to the people who are on the frontlines of the problem. Local food producers and leaders—especially women—must be a core part of the solution.
Read More...
One of the first things we can do is consider who is going hungry. Using the term “people” hides part of the problem: gender inequality. Globally, women are 10% more likely to go hungry than men, and that gap is growing. In Somalia, for example, men are eating smaller meals; women are skipping meals altogether. We see this inequality play out at the international level, too—global solutions consistently ignore women, their rights, and the critical role women play in food systems.
Of 84 global policies and plans designed to address hunger released between September 2020 and December 2021, only 4% refer to women as leaders who should be part of the solution or provide funding to support them. 39% overlook women entirely. This is unacceptable. Ending hunger will take everyone’s talents, opinions, and work. It requires promoting equality, respecting rights, and truly listening to the people who are on the frontlines of the problem. Local food producers and leaders—especially women—must be a core part of the solution.
Read More...
Impact Evaluation of the G-SAM Project in Ghana: Midline Report
USAID/Ghana’s Strengthening Accountability Mechanisms program (G-SAM) focuses on the district level of governance in Ghana, the Metropolitan, Municipal, or District Assemblies (MMDAs) democratically elected by residents. The following two activities are currently ongoing:
• Performance audits: The central government collects revenue and shares it with MMDA governments based on a revenue sharing formula. Prior to G-SAM, the Ghana Audit Service (GAS) conducted only a financial audit to ensure that this money was properly spent. Over the course of 2015 and with G-SAM funding, the GAS engaged in performance audits of 50 districts. In these audits the auditors went well beyond checking for receipts for purchases to assess the nature of project planning and contracting, the quality of service delivery outcomes and development
project outputs. This information has been used to develop citizen scorecards that were presented at district assemblies in April and May 2016; the scorecards are now being presented and discussed in public forums across the 50 districts.
• Civil society-led information campaign: Citizens struggle to hold their MMDA officials accountable, partially because they have very limited information about MMDA-level government budgets and activities. As such, a civil society-led effort under contract to CARE International and a coalition of Ghanaian CSOs has been conducting social audits on district capital projects and education and health service quality. This information will be used to develop citizen scorecards that will be presented and discussed in public forums over the course of the summer of 2016.
THE MIDLINE RESEARCH DESIGN
The G-SAM research design involves random assignment of 150 districts into one of three groups: a treatment group that has now received central government performance audits; a second treatment group that is now receiving civil-society led social audit; or a control group that will not receive either intervention. Given delays in the civil society organization (CSO)-led programming, this midline report only covers the 50 GAS performance audit districts and the 50 control districts. Moreover, while the baseline report provided data on citizen attitudes toward district governance and capital projects, the midline was carried out before any of the major citizen outreach efforts that will occur in both treatment arms in Summer 2016. The data collection only occurred among district administrators and politicians with the goal of determining if the GAS audits unto themselves, and without any significant citizen outreach, have had any effect on the planning, contracting and implementation of district capital projects.
Read More...
• Performance audits: The central government collects revenue and shares it with MMDA governments based on a revenue sharing formula. Prior to G-SAM, the Ghana Audit Service (GAS) conducted only a financial audit to ensure that this money was properly spent. Over the course of 2015 and with G-SAM funding, the GAS engaged in performance audits of 50 districts. In these audits the auditors went well beyond checking for receipts for purchases to assess the nature of project planning and contracting, the quality of service delivery outcomes and development
project outputs. This information has been used to develop citizen scorecards that were presented at district assemblies in April and May 2016; the scorecards are now being presented and discussed in public forums across the 50 districts.
• Civil society-led information campaign: Citizens struggle to hold their MMDA officials accountable, partially because they have very limited information about MMDA-level government budgets and activities. As such, a civil society-led effort under contract to CARE International and a coalition of Ghanaian CSOs has been conducting social audits on district capital projects and education and health service quality. This information will be used to develop citizen scorecards that will be presented and discussed in public forums over the course of the summer of 2016.
THE MIDLINE RESEARCH DESIGN
The G-SAM research design involves random assignment of 150 districts into one of three groups: a treatment group that has now received central government performance audits; a second treatment group that is now receiving civil-society led social audit; or a control group that will not receive either intervention. Given delays in the civil society organization (CSO)-led programming, this midline report only covers the 50 GAS performance audit districts and the 50 control districts. Moreover, while the baseline report provided data on citizen attitudes toward district governance and capital projects, the midline was carried out before any of the major citizen outreach efforts that will occur in both treatment arms in Summer 2016. The data collection only occurred among district administrators and politicians with the goal of determining if the GAS audits unto themselves, and without any significant citizen outreach, have had any effect on the planning, contracting and implementation of district capital projects.
Read More...
Somalia Resilience Program (SomRep) Endline Assessment
The Somalia Resilience Program (SomReP) is intended to enhance the resilience of vulnerable households and communities in Southern Somalia against cyclical shocks and stressors. SomReP is a consortium of seven international non-governmental organisations (INGOs). The program’s activities focus on improving livelihoods and increasing adaptive capacities of communities and households in Somalia.
On behalf of SomReP, Forcier Consulting is conducting Third Party Monitoring (TPM) of the program in two districts in South Central Somalia: Baidoa, Bay Region and Afgooye, Lower Shabelle Region. This document represents the initial main findings of the end line of the TPM. The end line report will report trends in program results after the program’s completion. Further, the status of the indicators will be compared to the baseline and midline values.
The data collection for this midline study was collected in August 2019. All data was collected, cleaned, and analysed by Forcier Consulting. Analyses compare midline and baseline data to end line results to identify trends among the results. This report follows the structure of the midline and baseline assessments, which was conducted by Forcier Consulting in 2017 and 2018.
A total of 1,590 program beneficiaries were surveyed, including 58% female and 42% male respondents. Respondents were sampled in urban/peri-urban, pastoral, agro-pastoral, and IDP livelihood zones. The vast majority of respondents were household heads, with an average age of 37 years. A large majority of participants had attended madrasa only (70%), and the average household size was 4.3 members.
Overall, the findings are positive for many program areas, however conditions varied over the period of the study; there was some recovery from the very severe 2016/2017 drought in 2018, but deterioration into 2019. These poor conditions created challenges for program beneficiaries. As a result, the analyses in the end line study show some mixed results. One limitation of the study is that the negative effects of the drought cannot be differentiated from the positive effects of the program. Read More...
On behalf of SomReP, Forcier Consulting is conducting Third Party Monitoring (TPM) of the program in two districts in South Central Somalia: Baidoa, Bay Region and Afgooye, Lower Shabelle Region. This document represents the initial main findings of the end line of the TPM. The end line report will report trends in program results after the program’s completion. Further, the status of the indicators will be compared to the baseline and midline values.
The data collection for this midline study was collected in August 2019. All data was collected, cleaned, and analysed by Forcier Consulting. Analyses compare midline and baseline data to end line results to identify trends among the results. This report follows the structure of the midline and baseline assessments, which was conducted by Forcier Consulting in 2017 and 2018.
A total of 1,590 program beneficiaries were surveyed, including 58% female and 42% male respondents. Respondents were sampled in urban/peri-urban, pastoral, agro-pastoral, and IDP livelihood zones. The vast majority of respondents were household heads, with an average age of 37 years. A large majority of participants had attended madrasa only (70%), and the average household size was 4.3 members.
Overall, the findings are positive for many program areas, however conditions varied over the period of the study; there was some recovery from the very severe 2016/2017 drought in 2018, but deterioration into 2019. These poor conditions created challenges for program beneficiaries. As a result, the analyses in the end line study show some mixed results. One limitation of the study is that the negative effects of the drought cannot be differentiated from the positive effects of the program. Read More...
Dignified and Violence-Free World of Work: A Study on Women Working in Informal Sectors in Nepal
A significant percentage (66.5%)1 of women in Nepal work in informal sectors and are vulnerable to all forms of violence and exploitation. The violence experienced by women in informal sectors ranges from physical, sexual, and verbal harassment to labor and economic exploitation by employers, co-workers and family members. Existing legal provisions such as Sexual Harassment (Elimination) at Workplace Act, 2015 do not have specific provisions for informal sectors whereas other mechanisms to address violence against women, in general, remain ineffective in implementation. In addition, socio-cultural norms and structures limit women’s access to justice-seeking mechanisms. Despite pervasive instances of violence and harassment experienced by women in informal sectors, there is a dearth of comprehensive documentation and evidence building on this issue. In this light, the paper examines the existing status, nature and experiences of violence faced by women working in diverse areas of the informal economy. It also critically analyses key gaps in existing legal provisions/policies and barriers to implementation from the perspective of informal sector workers.
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
The paper is based on the findings from 36 case studies of women working in 15 different informal sectors, Gendered Political Economy Analysis (GPEA) with community and policy stakeholders and desk review of relevant policies/legal provisions. The paper shows that women’s gendered social roles, lack of collectivisation and representation in decision-making bodies puts them in a weaker bargaining position to voice against instances of violence or to make it a priority agenda of advocacy for policymakers. Similarly, the findings of the paper indicate that lack of adequate and effective polices/provisions on safe working conditions and their implementation leads to invisiblisation of violence at the workplace, enabling powerholders to continue cycles of violence and exploitation without accountability. The paper contributes towards mainstreaming discourses around dignified work for women in the informal economy. It also serves as an evidence-based advocacy document to influence governments to ratify ILO Violence and Harassment Convention No. 190, which is a binding international treaty that protects all workers in formal and informal economy. Read More...
Sugu Yiriwa etude de base (Baseline for Mali’s Sugu Yiriwa project)
L’étude de base pour l’établissement de la situation de référence des indicateurs de performance est une investigation initiée par Feed the Future Mali Sugu Yiriwa dans les cercles des régions de Mopti (Tenenkou, Youwarou, Douentza, Koro, Bankass, Bandiagara, Djenné et Mopti) et Tombouctou (Tombouctou, Goundam, Niafounké et Diré) dans le but de disposer d’une base de référence de certains indicateurs de performance afin de mieux suivre leur évolution ou changement.
Spécifiquement, il s’agit de connaître le niveau de référence de :
● L’indice de la capacité à se remettre des chocs et stress de la zone d’intervention ;
● La valeur des ventes annuelles des exploitations et des entreprises recevant l’assistance du Gouvernement Américain ;
● Pourcentage de changement dans l’offre des produits agricoles sur les marchés ciblés ;
● Pourcentage de changement des prix des produits agricoles sur les marchés ciblés ;
● Le nombre d’hectares sous pratiques de gestion ou de technologies améliorées qui font la promotion des pratiques améliorées de réduction des risques climatiques et/ou de gestion des ressources naturelles avec l’aide du gouvernement américain ;
● Le nombre d’individus dans le système agricole qui ont appliqué des pratiques améliorées de gestion ou des technologies avec l'aide du gouvernement américain ;
● La propriété des actifs ;
● L’accès au crédit et décisions à la matière ;
● Le pourcentage de participants qui déclarent une augmentation des aliments riches en micronutriments sur le marché local au cours des 12 derniers mois
● Augmentation en pourcentage d'aliments riches en micronutriments dans les marchés ciblés ;
● Le pourcentage des participants aux activités agricoles sensibles à la nutrition de l’USG consommant un régime alimentaire d’une diversité minimale.
Au total, 1,301 ménages et 132 structures (organisations des producteurs, associations villageoises d’épargne et de crédit et entreprises incluant les agro-dealers et vendeurs individuels) ont été enquêtées dans les deux régions concernées par l’étude. Read More...
Spécifiquement, il s’agit de connaître le niveau de référence de :
● L’indice de la capacité à se remettre des chocs et stress de la zone d’intervention ;
● La valeur des ventes annuelles des exploitations et des entreprises recevant l’assistance du Gouvernement Américain ;
● Pourcentage de changement dans l’offre des produits agricoles sur les marchés ciblés ;
● Pourcentage de changement des prix des produits agricoles sur les marchés ciblés ;
● Le nombre d’hectares sous pratiques de gestion ou de technologies améliorées qui font la promotion des pratiques améliorées de réduction des risques climatiques et/ou de gestion des ressources naturelles avec l’aide du gouvernement américain ;
● Le nombre d’individus dans le système agricole qui ont appliqué des pratiques améliorées de gestion ou des technologies avec l'aide du gouvernement américain ;
● La propriété des actifs ;
● L’accès au crédit et décisions à la matière ;
● Le pourcentage de participants qui déclarent une augmentation des aliments riches en micronutriments sur le marché local au cours des 12 derniers mois
● Augmentation en pourcentage d'aliments riches en micronutriments dans les marchés ciblés ;
● Le pourcentage des participants aux activités agricoles sensibles à la nutrition de l’USG consommant un régime alimentaire d’une diversité minimale.
Au total, 1,301 ménages et 132 structures (organisations des producteurs, associations villageoises d’épargne et de crédit et entreprises incluant les agro-dealers et vendeurs individuels) ont été enquêtées dans les deux régions concernées par l’étude. Read More...
Who pays to deliver vaccines? An Analysis of World Bank Funding for COVID-19 Vaccination and Recovery
The World Bank is one key source of funding in the global push to vaccinate 70% of the world’s population against COVID-19. Many actors point to this as the funding that will cover any additional delivery needs for COVID-19 vaccines that national governments cannot meet. With $5.8 billion in funding already approved out of a $20 billion commitment, the World Bank funding is an important part of the picture, but the World Bank alone cannot cover the full gap in vaccine delivery needs.
Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
Read More...
Reviewing 60 funding agreements from the World Bank on COVID-19 vaccination and recovery shows the following insights.
• There is still a gap in delivery funding. The World Bank is currently funding $1.2 billion in vaccine delivery—10% of the total funding allocated for COVID-19 recovery. If that trend applies to the rest of the $20 billion commitment, World Bank funding will cover a between $2 and $4 billion—well below the $9 billion that ACT-A estimates as the lowest possible investment to vaccinate 70% of the world’s population. In contrast, $3.1 billion is going to purchase vaccines.
• Health workers remain underfunded. Only 15 of 60 agreements, just 25% detail provisions to pay health workers. Of those, 7 explicitly fund surge capacity, 3 provide for ongoing salaries, and 4 allow for hazard pay to health workers.
• Countries are taking on debt to rollout COVID-19 vaccinations. 86% of the funding in this analysis is in the form of loans. That gives countries debt that may weaken future pandemic preparedness rather than reinforcing health systems.
• All funders should adopt the World Bank’s commitments to investments in gender equality. 90% of the agreements in this analysis refer to gender inequality and many make corresponding investments—like requiring that 60% of vaccine leadership positions are women—to overcome these barriers. Earmarking exact funds going to advance gender equality would provide further transparency. Nevertheless, this consistent and concrete commitment is commendable, and all actors should strive to replicate it.
Read More...
ProJeunes Final Evaluation Prévenir les mariages précoces et forcés au Bénin
Prévenir les mariages précoces et forcés au Bénin (PROJEUNES) est un projet de 3 millions de dollars canadiens destiné à lutter contre les mariages précoces et forcés d'enfants au Bénin, dans 20 villages aux départements de l'Alibori et du Borgou. PROJEUNES est un partenariat entre CARE, Youth Coalition for Sexual and Reproductive Rights et le gouvernement du Bénin (Ministère de la Santé, Ministère des Affaires sociales et de la Microfinance et Ministère des enseignements secondaire, technique et de la formation professionnelle). Le projet est un partenariat de trois ans, d'avril 2018 à mars 2021, financé par le gouvernement du Canada. Ce rapport présente les progrès réalisés pour l’atteinte des résultats ultime, intermédiaires et immédiats du projet. Plusieurs collectes et analyses des données de fin du projet ont été réalisées par l’équipe de projet et un consultant externe entre mars et juin 2021. Les différentes évaluations effectuées sont les suivantes : Revue et analyse documentaires des principales lois, politiques et stratégies béninoises relatives à la SSRD/SSRAJ, aux MPFE et aux VBG; Évaluation de groupements FaFa Wa et de certaines de leurs members; Évaluation de filles à risque/vulnérables et survivantes de MPFE; Enquête auprès des ménages; Analyse qualitative contextuelle et Évaluation de 12 CS et 4 CPS. Read More...
HAFORSA 2 BASELINE Supplementary baseline to support gender indicators.
This baseline survey was conducted by the Gender and Program Quality team of CARE International in Timor-Leste from 14th – 17th September 2021 in the Admin post of Atsabe, Municipality of Ermera. This is a qualitative-based survey and used the Social Analysis and Action (SAA) tools with the objective of collecting information from the farmer groups through a participative Focus Group Discussion (FGDs). The tools were used to analyze the situation related to the roles and responsibilities at home including the decision-making process between women and men, and to understand women’s participation, and their ability to engage in development programs within their community area. Read More...
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