Emergency|Humanitarian Aid
Ecuador: Vouchers for Sexual Reproductive Health and Rights
This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.” Ecuador is both a transit and destination country for refugees and migrants from Venezuela and elsewhere. As of July 2020, over 400,000 Venezuelans were living in Ecuador. Venezuelan refugees and migrants have considerable health, psychosocial, and economic needs. Within these groups, women, adolescents, and LGBTQI people face heightened risks of Gender-Based Violence (GBV), human trafficking, and sexual exploitation as well as challenges to earning an income while in Ecuador. Although the public health system in Ecuador is free to all regardless of migration status, not all health – and especially SRH services – are covered in the public system. Furthermore, safe access to available services without discrimination based on nationality, sexual orientation/gender identity, or age is a barrier to access and uptake of SRH services in Ecuador. Read More...
Colombia: Vouchers for Sexual Reproductive Health (SRH) Services
This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.” As a result of Venezuela’s socioeconomic and political crisis, there have been massive migratory flows of people from Venezuela into Colombia.1 According to the Interagency Coordination Platform for Refugees and Migrants, as of May 2020 over 1.76 million Venezuelans had fled to Colombia with many continuing to walk to and across the Southern Border with Ecuador as caminantes.
CARE Colombia began direct operations in the country in 2019, focusing primarily on the needs of Venezuelan
refugees and migrants in Pamplona, Norte de Santander and, later, Bucaramanga, Santander. Cash and Voucher
Assistance then (CVA) are primary modalities for CARE Colombia, particularly for its SRHR and protection portfolio.
Working with populations on the move as was was the case in this program, together with high levels of unmet SRHR needs resulted in a unique operating environment for a voucher intervention supporting SRHR programming.
This case study focuses on the design of the programming only. Due to the timing of the review, no substantive data on the user experience of the vouchers or outcomes could be captured. Read More...
CARE Colombia began direct operations in the country in 2019, focusing primarily on the needs of Venezuelan
refugees and migrants in Pamplona, Norte de Santander and, later, Bucaramanga, Santander. Cash and Voucher
Assistance then (CVA) are primary modalities for CARE Colombia, particularly for its SRHR and protection portfolio.
Working with populations on the move as was was the case in this program, together with high levels of unmet SRHR needs resulted in a unique operating environment for a voucher intervention supporting SRHR programming.
This case study focuses on the design of the programming only. Due to the timing of the review, no substantive data on the user experience of the vouchers or outcomes could be captured. Read More...
Lebanon: Cash Transfers for Sexual Reproductive Health and Rights (SRHR) within Protection
This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.”
On August 4, 2020, an explosion in the port of Beirut left hundreds killed and thousands injured, damaged numerous neighborhoods – including hospitals and residential buildings – and left 300,000 people homeless. The economic, social, and psychological tolls of the blast were added to an already strained population suffering from an economic crisis and the impacts of COVID-19. The Lebanese Red Cross reported in a post-blast study2 that, of those surveyed, approximately 5% of respondents reported having family members who were pregnant or lactating and, of those households, 40% reported needing Maternal Child Health (MCH) services. A UNFPA report identified a decrease in SRH service availability due to facilities destroyed or damaged in the blast.
Prior to the blast, the Interagency Sexual and Gender-based Violence (SGBV) Task Force conducted an assessment with 562 women and girls across the country on the SGBV impact since the beginning of COVID-19. This assessment found that 51% of respondents felt less safe in their communities and only 30% reported accessing health services.4 Sixty-seven percent of respondents reported that the main barrier to accessing services was lack of money.5 Read More...
On August 4, 2020, an explosion in the port of Beirut left hundreds killed and thousands injured, damaged numerous neighborhoods – including hospitals and residential buildings – and left 300,000 people homeless. The economic, social, and psychological tolls of the blast were added to an already strained population suffering from an economic crisis and the impacts of COVID-19. The Lebanese Red Cross reported in a post-blast study2 that, of those surveyed, approximately 5% of respondents reported having family members who were pregnant or lactating and, of those households, 40% reported needing Maternal Child Health (MCH) services. A UNFPA report identified a decrease in SRH service availability due to facilities destroyed or damaged in the blast.
Prior to the blast, the Interagency Sexual and Gender-based Violence (SGBV) Task Force conducted an assessment with 562 women and girls across the country on the SGBV impact since the beginning of COVID-19. This assessment found that 51% of respondents felt less safe in their communities and only 30% reported accessing health services.4 Sixty-seven percent of respondents reported that the main barrier to accessing services was lack of money.5 Read More...
CASH AND VOUCHER ASSISTANCE FOR SEXUAL REPRODUCTIVE HEALTH AND RIGHTS LEARNINGS FROM ECUADOR, COLOMBIA, LEBANON, AND SOMALIA
CARE is committed to ensuring that projects with cash and voucher assistance (CVA) are designed with and for women and girls, addressing recipients’ needs, challenges, and opportunities. CARE has invested in research on how to make CVA work for women and girls through gender-sensitive approaches to framing processes and outcomes of the modalities. As a widely accepted method of increasing access to services and improving autonomy, dignity, and resilience, programming with CVA has been integrated into numerous sectors to improve the lives of displaced communities, particularly the most underserved. To date, CARE’s CVA has primarily been used for food security and livelihood outcomes and multisectoral outcomes via multipurpose cash (MPC) transfers. Now, aligned with its strategic intent, CARE is investing in sectoral areas where CVA is less often used and that are of primary interest for women and girls, including gender-based violence (GBV) response and sexual and reproductive health and rights (SRHR).
Building on extensive experience with CVA and SRHR programming, CARE conducted a study to investigate how outcomes for the pilot initiatives using CVA for SRHR compare to global learnings, and to identify opportunities for strengthening and expanding pilots for long-term programming. The study reviewed programming in four contexts (Colombia, Ecuador, Lebanon, and Somalia). The initial study was undertaken by two consultants, one focused on Lebanon and Somalia and one focused on Colombia and Ecuador. Data collection included 25 remote key informant interviews (KIIs) with CARE staff at the global and country levels as well as staff from partner organizations, followed by After Action Reviews with each country team and a validation meeting. All activities were undertaken in either English or Spanish and transcripts were analyzed using data analysis software. Analysis was conducted both by country and across contexts to identify commonalities and thematic learning, mostly led by CARE technical advisors. Read More...
Building on extensive experience with CVA and SRHR programming, CARE conducted a study to investigate how outcomes for the pilot initiatives using CVA for SRHR compare to global learnings, and to identify opportunities for strengthening and expanding pilots for long-term programming. The study reviewed programming in four contexts (Colombia, Ecuador, Lebanon, and Somalia). The initial study was undertaken by two consultants, one focused on Lebanon and Somalia and one focused on Colombia and Ecuador. Data collection included 25 remote key informant interviews (KIIs) with CARE staff at the global and country levels as well as staff from partner organizations, followed by After Action Reviews with each country team and a validation meeting. All activities were undertaken in either English or Spanish and transcripts were analyzed using data analysis software. Analysis was conducted both by country and across contexts to identify commonalities and thematic learning, mostly led by CARE technical advisors. Read More...
External ex-post evaluation of the “Multi-sectoral Protection Response for Vulnerable Populations in Ecuador affected by the Humanitarian Crisis” Project executed by CARE, Alas de Colibrí Foundation and Diálogo Diverso between 2019 and 2020
To respond to the migration crisis CARE Ecuador (CARE), Diálogo Diverso (DD) and Alas de Colibrí Fundation (ACF) associated to implement, with funding from the Bureau of Population, Refugees, and Migration (PRM) of the U.S. Department of State (that finances assistance actions for vulnerable refugee and migrant populations around the world), the “Multi-sectoral Protection Response for Vulnerable Populations in Ecuador affected by the Humanitarian Crisis” Project (PRM Project), from September 1, 2019 through August 31, 2020. The Project aimed at improving health and physical and psychological well-being of the forced-to-migrate Venezuelan population (and other nationalities), both migrants and refugees; as well as of the vulnerable local population, particularly LGBTIQ+ individuals and women survivors of gender-based violence, through a multi-sectoral intervention that includes: health care, legal and psychosocial advice, shelter, and comprehensive support interventions for the migrant humanitarian crisis. The project also generated advocacy actions to strengthen the capacities of public officials and institutions related to migratory processes, and to promote the restitution of migrants and refugees’ rights.
This report is 78 pages long. Read More...
This report is 78 pages long. Read More...
FINAL EVALUATION PROJECT: PROTECTION, WASH AND SHELTER SUPPORT FOR VULNERABLE VENEZUELAN REFUGEES IN ECUADOR 2019
The following evaluation corresponds to the 12-month implementation of the project Protection, WASH, and Shelter Support for Vulnerable Venezuelan Refugees in Ecuador, which was funded by the Government of Canada (Global Affairs Canada) and that took place from April 2019 to March 2020. The goal of this process was to analyze the fulfillment of results and strategies used to respond to the urgent needs of the Venezuelan migrant population in the areas of shelter, protection and WASH. The objectives of the evaluation focused on a) determining the relevance, efficiency and effectiveness, as well as the sustainability of actions and results by component; b) identifying milestones and innovations, as well as the main challenges; and, c) identifying recommendations and opportunities for improvement for future interventions. To this end, primary and secondary information, both qualitative and quantitative was collected and analyzed, and was then structured according to the evaluation criteria and the project components.
This report is 59 pages long. Read More...
This report is 59 pages long. Read More...
Tigray Rapid Gender Analysis
The Tigray conflict that began in November 2020 has culminated in widespread displacement of people, with some villages completely emptied. The conflict has resulted in the death of thousands of people as well as the displacement of over 417,152 people predominantly women and children. 4.5million people in Tigray are in need of humanitarian assistance. The conflict has also paralyzed the health system and most infrastructure. All of this comes in a context where Ethiopia is facing over 185,641 COVID-19 cases as of March 20, 2021, decreased food production because of a locust infestation, and a year of school closures due to COVID-19.
This Rapid Gender Analysis draws from focus group discussions and individual and key informant interviews with 94 people (67% of whom are women), secondary data sources, and CARE’s research in the region to understand the specific challenges people of all genders are facing. The RGA was conducted in the Northern Amhara region at sites for internally displaced people (IDPs) in Debark and MayTsebri (Formerly under Tigray region). Read More...
This Rapid Gender Analysis draws from focus group discussions and individual and key informant interviews with 94 people (67% of whom are women), secondary data sources, and CARE’s research in the region to understand the specific challenges people of all genders are facing. The RGA was conducted in the Northern Amhara region at sites for internally displaced people (IDPs) in Debark and MayTsebri (Formerly under Tigray region). Read More...
Beyond four walls and a roof Reflections on the multi-sectoral One Neighbourhood Approach for Syrian Refugees and Host Communities, Tripoli, Lebanon.
The Syrian Civil War, now in its tenth year, has displaced millions of Syrians, both within Syria and into neighbouring countries. Over one million Syrian refugees reside in northern Lebanon, including in the city of Tripoli. This large scale displacement has placed additional strain on housing and services; refugees and vulnerable host communities frequently reside in informal, poor-quality homes in various states of disrepair that are poorly serviced and often damp and damaged. With displacement ongoing, many humanitarian programmes seek to meet the needs of both refugees and address underlying causes of poverty in host communities. These programmes are often multi-sectoral and have social cohesion as an intended outcome and deliver community-wide protection activities alongside housing and WASH support.
With four phases over four years funded by the US Government’s Bureau of Population, Refugees and Migration (PRM), the ONA programme has worked to improve housing conditions for the most vulnerable whilst enhancing individual and community resilience and social cohesion through protection programming and participatory approaches. In Phase IV (2018-19), CARE International in Lebanon (CIL) aimed to build on Phases I to III. In common with previous phases, for Phase IV, CIL worked in partnership with local partner Akkarouna to provide multi-sectoral shelter, WASH and Protection assistance to vulnerable Syrian refugees and the Lebanese host community, including Palestinians returning from Syria (PRS) in five neighbourhoods in Tripoli Read More...
With four phases over four years funded by the US Government’s Bureau of Population, Refugees and Migration (PRM), the ONA programme has worked to improve housing conditions for the most vulnerable whilst enhancing individual and community resilience and social cohesion through protection programming and participatory approaches. In Phase IV (2018-19), CARE International in Lebanon (CIL) aimed to build on Phases I to III. In common with previous phases, for Phase IV, CIL worked in partnership with local partner Akkarouna to provide multi-sectoral shelter, WASH and Protection assistance to vulnerable Syrian refugees and the Lebanese host community, including Palestinians returning from Syria (PRS) in five neighbourhoods in Tripoli Read More...
‘IF WE DON’ T WORK, WE DON’ T EAT’ Syrian Women Face Mounting Food Insecurity a Decade into the Conflict
Ten years ago, the lives of many Syrians changed profoundly as anti-government demonstrations escalated into violent conflict between forces allied to the Government of Syria and armed opposition groups. The resulting humanitarian crisis is one of the worst of our time – 6.7 million Syrians remain internally displaced; an estimated 13 million people are in need1 and 12.4 million live with food insecurity.
In recent months, the situation has deteriorated even further as the COVID-19 pandemic, mass displacements, natural
disaster, economic collapse and ongoing hostilities have combined to create a situation wherein households are
finding it increasingly difficult to meet their basic needs, including for food.
Average food prices in Syria increased by 236% in 2020 – and food prices are more than 29 times higher than the five year pre-crisis average, causing many families to resort to negative coping strategies. This includes eating fewer
or smaller meals to get by. Furthermore, due to the loss or reduced capacity of male heads of household to death, injury, disappearance or emigration in search of work, many Syrian women are now the sole or primary breadwinners for their families, bearing the full burden of providing for their families with limited livelihood opportunities. About 22% of Syrian households are now headed by women; this is up from only 4% prior to the conflict. Even in households where the male head of household is working in some capacity, dire economic circumstances have pushed women to find some source of income to help with household expenses. In both cases, women are thrust into the ‘provider’ role in a way that most had not previously experienced. Read More...
In recent months, the situation has deteriorated even further as the COVID-19 pandemic, mass displacements, natural
disaster, economic collapse and ongoing hostilities have combined to create a situation wherein households are
finding it increasingly difficult to meet their basic needs, including for food.
Average food prices in Syria increased by 236% in 2020 – and food prices are more than 29 times higher than the five year pre-crisis average, causing many families to resort to negative coping strategies. This includes eating fewer
or smaller meals to get by. Furthermore, due to the loss or reduced capacity of male heads of household to death, injury, disappearance or emigration in search of work, many Syrian women are now the sole or primary breadwinners for their families, bearing the full burden of providing for their families with limited livelihood opportunities. About 22% of Syrian households are now headed by women; this is up from only 4% prior to the conflict. Even in households where the male head of household is working in some capacity, dire economic circumstances have pushed women to find some source of income to help with household expenses. In both cases, women are thrust into the ‘provider’ role in a way that most had not previously experienced. Read More...
Our Best Shot: Frontline Health Workers and COVID-19 Vaccines
Fully realizing the social and economic benefits of halting COVID-19 requires investing in a fast and fair global rollout of COVID-19 vaccines. CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5.00 in delivering the vaccine.
Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.
Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.
Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.
As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
Read More...
Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.
Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.
Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.
As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
Read More...