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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If you have an evaluation or study to share, please e-mail the document to ejanoch@care.org for posting.

Host Community Situation Analysis Impact of Rohingya Influx on Host Communities in Ukhia and Teknaf

Bangladesh became host to what is now the biggest refugee camp in the whole world. By November 2017 836,487 FDMN (Forcefully Displaced Myanmar Nationals) fled across the Myanmar-Bangladesh border to settle here mostly in two Upazilas:Ukhia and Teknaf of Cox's Bazar district. By January 2018, it became clear that this would be a prolonged crisis lasting years as the Myanmar government continued dithering about taking them back, and as also the FDMN expressed their unwillingness to go back fearing persecution. As a result of this huge and sudden influx, lives and livelihoods of the host communities have been affected in many ways. Therefore, this Situational Assessment aims to assess both the visible economic and the subtle social impacts of the recent influx on the host communities. Using Oxford’s integration conceptual framework, this assessment has been conducted to chalk out CARE Bangladesh’s future response to the refugee crisis by involving the host communities in the process and addressing their concerns so that the tension between the two communities is defused rather than intensified.
Presence of the refugees has brought about many social and economic changes creating massive pressure on the host communities. Economic activities in the two upazilas have gone through transitions, leading to the emergence of a new market system and reducing employment opportunities for the host communities.
On one hand prices of essentials have shot up almost twice as much, and on the other, due to an unpredictably large number of refugees entering the local labor market wages for day laborers have gone down. Though refugees are living in highly congested camps, they are getting aid materials as well as economic opportunity in the local market. On the contrary, the host communities are finding themselves pitted against the refugees as either their work have been taken away or their earnings significantly reduced. It is true that a few locally influential people owning large tracts of land and businesses are benefitting from the availability of cheap labor, but the poor and the ultra-poor from the host communities are bearing the brunt of these changes. Access to administrative, educational and healthcare needs has diminished. Reduced access and availability of CPR-resultant scarcity of timber, bamboo for shelter, food & cooking fuel created insecurity of accessing resources. Due to security risk of woman and girls mobility has goes down, women income earning opportunity getting reduced; all of this has evidently created tension between the host and the refugee communities and within host community households. If left unaddressed, this tension is likely to rise to the extent of creating potential threats of ethnic conflicts.
In response to these findings of the situational analysis possible types of interventions could be Gender specific livelihoods strengthening initiatives based on diversification of off/on farm activities, Transformative approach to build life free from GBV, Promoting youth leadership and Strengthening service delivery and demand side functions through Inclusive governance.
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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...

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...

Rapid Assessment on COVID-19 Vaccine Uptake by Urban Marginalised Population in Bangladesh

As of 31 March 2021, there have been 127,877,462 confirmed cases of COVID-19 worldwide, including 2,796,561 deaths in 223 countries as reported by WHO. Bangladesh had 6,11,295 confirmed cases of COVID-19 and 9,406 confirmed deaths till the end of March 2021. In response to this situation, the administration of the first dose of the COVID-19 vaccine officially started on 7 February 2021 in the national hospitals and health complexes all over Bangladesh. Despite acute demand for the vaccine, a great deal of misinformation and misconception is also apparent among general people. With the ongoing vaccine administration, it is very important to understand community acceptance of COVID-19 vaccinations.
People’s knowledge, attitudes and perceptions towards COVID-19 are of utmost importance for Government and policymakers to address all barriers to vaccine uptake and ensuring that everyone has access to vaccine. With these contexts, this survey aims to identify the overall COVID-19 vaccination perceptions among the urban marginalized population in Bangladesh based on three main objectives:
 Understanding the knowledge and practice related to COVID-19 prevention
 Assessing the knowledge and perspective regarding COVID-19 vaccination
program
 To know the status of vaccine uptake among marginalized population
The urban marginalized population were purposively selected, as they are more likely to be unaccounted for or have the least access to the COVID-19 vaccine administration process. In this survey, researchers captured only the population that are direct service recipient of the Urban Health Programme (garment workers and people who inject drug) and other groups who are available around the catchment areas of the service centres of the facilities. Read More...

Better Gender Outcomes in Food Assistance through Complementary and Multi-Modal Programing

With an objective of contributing to the knowledge base of promising practice using a combination of modalities to deliver food security and gender outcomes, this study reviews Food for Peace (FFP), DFSA (Development Food Security Activity), EFSP (Emergency Food Security Program), and OFDA projects that explicitly or implicitly incorporated gender-focused programming [55 pages]. Read More...

Bangladeshi Sailors Vulnerability to HIV and AIDs

Enhancing Mobile Populations’ Access to HIV and AIDS Services, Information, and Support (EMPHASIS) is a 5-year initiative funded by the UK’s Big Lottery Fund. The project has been implemented by CARE in three countries,
Bangladesh, India and Nepal. This study was initiated to generate evidence around the vulnerabilities faced by migrant populations traveling to India. Both qualitative and quantitative methods were used to explore the vulnerability of sailors and a standard BCC questionnaire was used to assess knowledge around HIV and AIDS. Qualitative methods were used to compliment quantitative findings to reveal other socio-economic dynamics that can contribute HIV and AIDS related vulnerabilities. Data collection was carried out in both Bangladesh and India. Both qualitative and quantitative data collection was done in Bangladesh,. As entry into the ports in India was restricted, only qualitative methods were used there. A total of 154 were interviewed with a quantitative questionnaire and 24 sailors participated in in-depth interviews. Focus group discussions (FGD) and Key Informant Interviews were conducted with selected community members such as doctors, Noujan Srameek Union members, and vendors. [46 Pages] Read More...

GENDER AND COVID-19 VACCINES Listening to women-focused organizations in Asia and the Pacific

More than a year into the coronavirus pandemic, COVID-19 vaccines are being distributed across at least 176 countries, with over 1.7 billion doses administered worldwide. Combating the pandemic requires equitable distribution of safe and effective vaccines, however, women and girls are impacted by gaps both in the supply side and the demand side that hamper equitable distribution of the vaccine. Evidence reveals that 75 per cent of all vaccines have gone to just 10 countries, and only 0.3 per cent of doses have been administered in low-income countries. Very few of COVID-19 vaccines are going to those most vulnerable. The vaccine rollout in Asia and the Pacific has been relatively slow and staggered amid secondary waves of the virus. India, despite being the largest vaccine developer, has only vaccinated 3 per cent of the population and continues to battle a variant outbreak that, at its peak, was responsible for more than half of the world’s daily COVID-19 cases and set a record-breaking pace of about 400,000 cases per day.5However, the small Pacific nation of Nauru, reported a world record administering the first dose to 7,392 people, 108 per cent of the adult population within four weeks. Bhutan also set an example by vaccinating 93 per cent of its eligible population in less than two weeks. That success could be at risk, given the situation in India and the suspended export of vaccines. Read More...

Rapid Needs Assessment Gaza May/June 2021

CARE conducted a rapid needs assessment in Gaza between May 28 and June 3, 2021 to understand people's evolving needs in the crisis there. This graphic underlines what they found, with a survey of 62 people, including 68% women, 32% men, and 16% people with disabilities. Read More...

Etude de Base en eau, Hygiene Assainissement et Nutrition

The centrally managed USAID / Washington WASHplus project, led by FHI360 with CARE USA and Winrock International, as key partners, creates and supports interventions that lead to improvements in Water, Hygiene and Sanitation. 'Sanitation and explores and encourages innovation in the WASH sector, including the integration of WASH into related sectors such as nutrition. The report is 66 pages long. Read More...

Formative Research for Social & Behavior Change (SBC) in nutrition, reproductive health and WASH

Between July and August 2016 formative research was carried out by HKI with the overall scope to gather evidence about current practices in nutrition, reproductive health and WASH and identify appropriate strategies for achieving project social and behaviour change outcomes. The formative research explored behaviors, focusing on improving the health and nutritional status of pregnant and lactating women as well as children, and improving access to and utilization of WASH infrastructure. The research findings will be used to generate a robust Social and Behavior Change Communication Strategy (SBCC) focused on several key practices. Topics explored by the research were reproductive health, children and maternal nutrition, WASH and media exposure. The report is 80 pages long. Read More...

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