Maternal|Child Health
Development Initiative for Northern Uganda (DINU) End of Project Report
The Development Initiative for Northern Uganda (DINU) was a 38-month project implemented between January 2020 and February 2023, with an aim to improve food security, maternal and child nutrition, and household incomes for smallholder farmers in 11 districts of Kitgum, Katakwi, Kaabong, Karenga, Kotido, Moroto, Napak, Nabilatuk, Nakapiriprit, Amudat, and Abim. The project was implemented by a consortium led by CARE Denmark, alongside partners such as Catholic Relief Services (CRS), Gulu Agricultural Development Company (GADC), Dynamic Agro-Pastoral Development Organization (DADO), and Soroti Rural Development Agency (SORUDA). The project had three major outcomes: increased production of diversified food by both men and women smallholder farmers, enhanced market accessibility for these farmers, and improved nutrition and Family Planning services through gender-responsive community-based approaches.
The Project employed an Inclusive Market Development-Based approach, emphasizing economic gender equality, women empowerment, youth engagement, and community-based nutrition, while also focusing on the value chain. This strategy involved multi-stakeholder engagement and synergizing with existing government and development partner initiatives like DADO, CRS, and SORUDA. By implementing this approach, the project provided smallholder farmers with opportunities to enhance their incomes through the cultivation of high-value crops, such as sesame, cotton, soybean, and iron-rich beans. Additionally, measures were taken to ensure sustainability, including integrating activities into the government's PDM approach, building capacity among extension staff, and linking VSLA/SILC/YSLA/PMGs groups to financial institutions and agro input service providers.
A crucial aspect of the project was empowering women and youth, often marginalized in agriculture and rural development. Women were trained in Climate-Smart Agriculture and offered access to markets and finance through VSLA/SILC groups. Furthermore, Role Model Men were involved in raising awareness on gender-responsive actions, family planning, and women empowerment within smallholder farmers' households, fostering attitudinal changes towards gender equality and encouraging women to play an active role in agricultural production.
To achieve success, the project effectively engaged both public and private extension workers, disseminating information on Climate-Smart Agriculture practices to smallholder farmers and boosting production and income. Additionally, collaboration with Tillage Service Providers promoted entrepreneurship among youth and reduced manual labor burdens for smallholder farmers.
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The Project employed an Inclusive Market Development-Based approach, emphasizing economic gender equality, women empowerment, youth engagement, and community-based nutrition, while also focusing on the value chain. This strategy involved multi-stakeholder engagement and synergizing with existing government and development partner initiatives like DADO, CRS, and SORUDA. By implementing this approach, the project provided smallholder farmers with opportunities to enhance their incomes through the cultivation of high-value crops, such as sesame, cotton, soybean, and iron-rich beans. Additionally, measures were taken to ensure sustainability, including integrating activities into the government's PDM approach, building capacity among extension staff, and linking VSLA/SILC/YSLA/PMGs groups to financial institutions and agro input service providers.
A crucial aspect of the project was empowering women and youth, often marginalized in agriculture and rural development. Women were trained in Climate-Smart Agriculture and offered access to markets and finance through VSLA/SILC groups. Furthermore, Role Model Men were involved in raising awareness on gender-responsive actions, family planning, and women empowerment within smallholder farmers' households, fostering attitudinal changes towards gender equality and encouraging women to play an active role in agricultural production.
To achieve success, the project effectively engaged both public and private extension workers, disseminating information on Climate-Smart Agriculture practices to smallholder farmers and boosting production and income. Additionally, collaboration with Tillage Service Providers promoted entrepreneurship among youth and reduced manual labor burdens for smallholder farmers.
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GAP ANALYSIS AND LINKAGE READINESS ASSESSMENT FOR YOUTH/VILLAGE SAVINGS AND LOANS ASSOCIATIONS (Y/VSLAs)
The Development Initiative for Northern Uganda (DINU), a Government of Uganda initiative with support from European Union, supervised by the Office of the Prime Minister is being implemented by a consortium led by CARE Denmark. The program is being implemented in the Karamoja sub region (covering 11 districts) as well as Kitgum and Katakwi districts. CARE Denmark commissioned gap analysis for Y/VSLA linkage to identify interventions aimed at contributing to improved access to credit through community saving and credit schemes.
The objectives of the study included gap analysis of Y/VSLAs, linkage readiness assessment for mature Y/VSLAs and evaluation “digital readiness” of group members. A representative sample of 773 Y/VSLAs from drawn from all the project districts were covered the study. The sample was classified in three categories: Mature groups totalling 350 (45.3%) Mature and ready for Linkage groups, 390 (50.5%) and Watch Category/Maturing groups and 33 (4.3%)
The analysis revealed that the gaps identified in Mature and Ready-for-linkage Y/VSLAs were closely similar to those in Watch Category (Maturing Groups) category and required more or less similar interventions.
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The objectives of the study included gap analysis of Y/VSLAs, linkage readiness assessment for mature Y/VSLAs and evaluation “digital readiness” of group members. A representative sample of 773 Y/VSLAs from drawn from all the project districts were covered the study. The sample was classified in three categories: Mature groups totalling 350 (45.3%) Mature and ready for Linkage groups, 390 (50.5%) and Watch Category/Maturing groups and 33 (4.3%)
The analysis revealed that the gaps identified in Mature and Ready-for-linkage Y/VSLAs were closely similar to those in Watch Category (Maturing Groups) category and required more or less similar interventions.
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HAMORIS Project (Hamenus Mortalidade no Risku ba Inan Sira)
This report is an end-stage evaluation of CARE International Timor-Leste’s HAMORIS project. The HAMORIS project aims at contributing to lasting reductions in maternal mortality and morbidity by increasing the number of women accessing quality Sexual Reproductive and Maternal Health Services (SRMHS).
There are four sets of conclusions drawn from the findings:
• There is increased access and utilization of improved quality SRMHS by women and men in the targeted communities of the HAMORIS project
• Normative changes towards acceptance of Gender Equality and less tolerance for GBV, have been produced as a consequence of the project
• There are unintended consequences for marginalised voices, including PWD
• Many of the recommendations of the MTR were followed but further time, resources needed to implement them all. Read More...
There are four sets of conclusions drawn from the findings:
• There is increased access and utilization of improved quality SRMHS by women and men in the targeted communities of the HAMORIS project
• Normative changes towards acceptance of Gender Equality and less tolerance for GBV, have been produced as a consequence of the project
• There are unintended consequences for marginalised voices, including PWD
• Many of the recommendations of the MTR were followed but further time, resources needed to implement them all. Read More...
SISTEMATIZACIÓN DE EXPERIENCIA “COMEDORES PARA LA PREVENCIÓN DE LA ANEMIA EN NIÑOS Y NIÑAS DE 6 A 36 MESES DE EDAD
El proyecto de ayuda humanitaria “Alimenta su Fuerza” en su segunda etapa, fue ejecutado por CARE Perú y financiado por el Banco de Crédito del Perú (BCP); su continuidad nació de la iniciativa para dar respuesta a la crisis alimentaria generada como consecuencia de la emergencia sanitaria por COVID-19 debido a medidas restrictivas que afectaron el ingreso económico de muchas familias y con ello la posibilidad de cubrir necesidades básicas. El proyecto tuvo como finalidad mejorar la seguridad alimentaria de la población en situación de vulnerabilidad, brindando apoyo alimentario con raciones nutritivas a través de espacios estratégicos como los comedores auto gestionados adscritos al Programa de Complementación Alimentaria de los gobiernos locales, a su vez de forma complementaria se incorporó un piloto para la prevención de la anemia en niños y niñas de 6 a 36 meses, que consistió en la entrega de preparaciones que incluyeron alimentos fuente de hierro, para ello se articuló acciones con establecimientos de salud y agentes comunitarios de la zona, así mismo se brindó acompañamiento a las madres o cuidadoras de los niños y niñas para que mejoren las prácticas de alimentación y accedan a los servicios de salud para la prevención y reducción de la anemia. Read More...
Urban Community Health Workers in Afghanistan
Building strong relationships and trust between community health workers and the communities they serve prior to public health emergencies can help ensure continuity of health seeking behaviors during times of crisis. When health services dropped during COVID-19 lockdowns, women community health workers increased services 25%.
Health-seeking significantly decreased during COVID-19 lockdown due to fear of contracting the virus, and
many of the health posts in CHWs homes were shut down at this time. In contrast, CARE-supported urban CHWs,
particularly in Kabul and Balkh, were able to continue service provision in their homes due to the strong trust
they had built with the communities they served and their recognized leadership among community members
and as part of the health system. The relationship between CHWs and local communities was complemented by
CARE’s efforts to quickly provide CHWs with personal protective equipment and build capacity on WHO
protocols for COVID-19 screening, detection, and referral of cases as well as risk communication and
community engagement. During COVID-19 lockdown, the CHWs also continued provision of SRH, GBV services,
and referrals to midwives at community-based health centers run by CARE. In addition to maintaining service
delivery, the CHWs also began offering counseling and support to local women using mobile phones. Read More...
Health-seeking significantly decreased during COVID-19 lockdown due to fear of contracting the virus, and
many of the health posts in CHWs homes were shut down at this time. In contrast, CARE-supported urban CHWs,
particularly in Kabul and Balkh, were able to continue service provision in their homes due to the strong trust
they had built with the communities they served and their recognized leadership among community members
and as part of the health system. The relationship between CHWs and local communities was complemented by
CARE’s efforts to quickly provide CHWs with personal protective equipment and build capacity on WHO
protocols for COVID-19 screening, detection, and referral of cases as well as risk communication and
community engagement. During COVID-19 lockdown, the CHWs also continued provision of SRH, GBV services,
and referrals to midwives at community-based health centers run by CARE. In addition to maintaining service
delivery, the CHWs also began offering counseling and support to local women using mobile phones. Read More...
End line assessment of GSK supported Community Health workers (CHW) initiative in Sunamganj district, Bangladesh
In spite of improvement in maternal and child health, the Sylhet division continues to have the poorest indicators in Bangladesh. Higher mortality for both mother and child and poor utilization of healthcare services still exist in the Sylhet division. Sunamganj is one of the remotest areas in Bangladesh and belongs to the Sylhet division having the poorest maternal and child health status. Since December 2012, CARE Bangladesh together with GSK and other key stakeholders has been implementing a Community Health Workers (CHWs) Initiative, which aims to address the lack of skilled human resources in remote and underserved unions of Sunamganj district. The overall goal of the CHW initiative is to improve maternal and child health outcomes in underserved/remote and poor communities of Bangladesh by increasing their access to quality health care services. Through a unique model of Public-Private Partnership (PPP), the project developed 319 Private CSBAs who are providing maternal and child health services including primary treatment of Non-Communicable Diseases (NCDs) like diabetes and hypertension in the entire Sunamganj district. To do a robust measurement in terms of assessing maternal, neonatal and child health (MNCH) related knowledge and practices as well as documentation of learning of these innovative initiatives, icddr,b conducted a baseline study in 2012 and end-line assessment in 2018. Read More...
Endline Report: An interim analysis of baseline and endline data for key indicators
TAMANI is a complex intervention for improving maternal and newborn health in Tabora, Tanzania. The overarching objective of this intervention is to address the challenges linked to (1) the decision to seek care, (2) the barriers to accessing care, and (3) the provision of the highest possible quality of care, collectively known as the “three delays”. Addressing these delays requires a complex set of changes in behaviors, attitudes, access to and use of resources, skills, and knowledge of clients and service providers. The intervention targeted the supply side by improving the quality of care at health facilities, and the demand side through programs to increase utilization of care through community engagement and addressing gender barriers to accessing care by women and their families. Read More...
End of the Project Evaluation | Strengthening Approaches for Improved Maternal, Neonatal and Reproductive Health in Myanmar: Lashio Township, Northern Shan State, Myanmar
GSK and CARE Myanmar have been working together in the country since 2012 to provide better health services. The project was expanded from 45 villages to 60 villages in northern Shan State, based on successes and lessons learned in 2012-2015. The project goal is to contribute to the reduction of maternal and neonatal mortality through increased access to, and quality of, sexual and reproductive health, and maternal and child health services. Read More...
TAMANI (Tabora Maternal and Newborn Health Initiative) Impact Evaluation
According to the 2015-2016 DHS survey, Tabora region has the highest percentage population (45.8%) in the lowest wealth quintile in the country, which reflects high levels of structural inequality that have a direct bearing on reproductive, maternal, newborn, child, and adolescent health outcomes.(2) Polygamy is most prevalent in the Western zone with approximately one-third of marriages polygamous, contributing to high fertility rates. Tabora has a low contraceptive prevalence rate of 21.9%, and the Western Zone has the highest levels of teenage childbearing in Tanzania (38%). The latest DHS survey (2015-2016) indicated that 44.3% of women in Tabora deliver at home.
Given this context, the international aid organization CARE began reproductive health programming in Tabora in 2012 with the aim of improving maternal and reproductive health. This paper presents an impact evaluation of CARE’s second stage of reproductive, maternal and newborn health programming in Tabora, the Tabora Maternal and Newborn Health Initiative (TAMANI), which builds on the experience of CARE in the region and spans from 2017-2021. Read More...
Given this context, the international aid organization CARE began reproductive health programming in Tabora in 2012 with the aim of improving maternal and reproductive health. This paper presents an impact evaluation of CARE’s second stage of reproductive, maternal and newborn health programming in Tabora, the Tabora Maternal and Newborn Health Initiative (TAMANI), which builds on the experience of CARE in the region and spans from 2017-2021. Read More...