Sexual|Reproductive Health
FAMILY PLANNING FOR RESILIENCE BUILDING – RESET PLUS PROJECT
The purpose of this baseline study is to determine baseline levels and document SRH-influencing behaviors, generate understanding of the attitudes related to Sexual and Reproductive Health, Family Planning, adolescents’ and youth' views and experiences of sexuality and sexuality information and education, the range and quality of SRH services available to them in project areas; traditional practices that impact on SRH, the role of religious and traditional leaders and levels of male involvement. Read More...
Meeting the demand of women affected by ongoing crisis: Increasing contraceptive prevalence in North and South Kivu, Democratic Republic of the Congo
Over 20 years of conflict in the DRC, North and South Kivu have experienced cycles of sta- bility and conflict, resulting in a compromised health system and poor sexual and reproduc- tive health outcomes. Modern contraceptive use is low (7.5%) and maternal mortality is high (846 deaths per 100,000 live births). Program partners have supported the Ministry of Health (MOH) in North and South Kivu to provide good quality contraceptive services in pub- lic health facilities since 2011.
This paper used cross-sectional population-based surveys in the program areas using a two- stage cluster sampling design to ensure representation in each of six rural health zones.
It found that modern contraceptive prevalence among women in union ranged from 8.4% to 26.7% in the six health zones; current use of long-acting or permanent method (LAPM) ranged from 2.5% to 19.8%. The majority of women (58.9% to 90.2%) reported receiving their current method for the first time at a health facility supported by the program partners. Over half of women in four health zones reported wanting to continue their method for five years or longer. Read More...
This paper used cross-sectional population-based surveys in the program areas using a two- stage cluster sampling design to ensure representation in each of six rural health zones.
It found that modern contraceptive prevalence among women in union ranged from 8.4% to 26.7% in the six health zones; current use of long-acting or permanent method (LAPM) ranged from 2.5% to 19.8%. The majority of women (58.9% to 90.2%) reported receiving their current method for the first time at a health facility supported by the program partners. Over half of women in four health zones reported wanting to continue their method for five years or longer. Read More...
Delivering High-Quality Family Planning Services in Crisis-Affected Settings II: Results
An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Read More...
Delivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program Implementation
In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). Read More...
Gender Equity and Women’s Empowerment: The Journey So far; The Experience of the ENSURE Program
The ENSURE Food Security Program is a USAID-funded, five-year intervention designed to profoundly and sustainably impact 215,000 vulnerable and food- insecure Zimbabweans in Manicaland and Masvingo Provinces. The program is a shared commitment by four partners and one service provider—World Vision, CARE, SNV, SAFIRE and ICRISAT—who work together to mainstream gender equity and natural resource management in the three key areas of maternal and child nutrition and health, agricultural production and marketing, and community resilience.
The success of ENSURE can be portrayed through the accounts of thousands of women and men whose lives have been changed through its various programme interventions. Tangible gender transformative changes can be noticed on several dimensions: joint household decision making; reduced violence against women; increased women’s leadership in community leadership; men assisting women with household chores and childcare; women’s ownership of high value productive assets; and increased access and control over income.
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The success of ENSURE can be portrayed through the accounts of thousands of women and men whose lives have been changed through its various programme interventions. Tangible gender transformative changes can be noticed on several dimensions: joint household decision making; reduced violence against women; increased women’s leadership in community leadership; men assisting women with household chores and childcare; women’s ownership of high value productive assets; and increased access and control over income.
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EVALUATION FINALE DU PROJET USAID/NUTRITION – WASH DANS LES REGIONS DE KOULIKORO, SEGOU ET MOPTI
La présente étude vise, en effet, à évaluer l'efficacité de la stratégie nutritionnelle intégrée de l'IRP combinant nutrition, agriculture, eau, assainissement et hygiène (WASH) pour améliorer l'état nutritionnel des femmes enceintes et allaitant et des enfants de moins de 2 ans.
Les principaux indicateurs du projet dans le domaine de la nutrition aussi bien chez les enfants de moins de 2 ans que les femmes en âge de procréer (réduction de la prévalence de l’émaciation, du retard de croissance, de l’émaciation, de l’anémie, amélioration du régime alimentaire minimum acceptable pour les enfants de moins de deux ans et du défit énergétique chronique, de l’anémie et amélioration du régime alimentaire minimum acceptable) ont tous favorablement évolués entre la situation de départ et la situation actuelle. Par contre, aucune valeur de l’indicateur initialement prévu n’a été atteinte par le projet. Il en est de même pour les indicateurs WASH. Cependant, la motivation des bénéficiaires pour soutenir le projet et ses acquis ont été observé. Les bénéficiaires se disent favorables à la poursuivre les activités réalisées après le retrait du projet. Il s’avère nécessaire de poursuivre les activités du projet pour lui permettre d’atteinte des objectifs fixés. Read More...
Les principaux indicateurs du projet dans le domaine de la nutrition aussi bien chez les enfants de moins de 2 ans que les femmes en âge de procréer (réduction de la prévalence de l’émaciation, du retard de croissance, de l’émaciation, de l’anémie, amélioration du régime alimentaire minimum acceptable pour les enfants de moins de deux ans et du défit énergétique chronique, de l’anémie et amélioration du régime alimentaire minimum acceptable) ont tous favorablement évolués entre la situation de départ et la situation actuelle. Par contre, aucune valeur de l’indicateur initialement prévu n’a été atteinte par le projet. Il en est de même pour les indicateurs WASH. Cependant, la motivation des bénéficiaires pour soutenir le projet et ses acquis ont été observé. Les bénéficiaires se disent favorables à la poursuivre les activités réalisées après le retrait du projet. Il s’avère nécessaire de poursuivre les activités du projet pour lui permettre d’atteinte des objectifs fixés. Read More...
Evaluation Finale “Dans les Zones de Feed the Future” du Projet USAID/Nutrition et Hygiène/ CARE dans la Région de Mopti – Mali
L’objectif de cette évaluation finale est d’apprécier le niveau d’évolution des indicateurs du Projet entre l’étude de base et étude finale. De façon spécifique il s’agit d'évaluer les niveaux actuels des indicateurs agricultures, les indicateurs Santé/Nutrition/WASH d’une part, et d’autre part, de mesurer l’impact des émissions radiophoniques sur les communautés bénéficiaires.
De façon globale des résultats forts encourageants sont notés, car la plupart des indicateurs ont
connu des améliorations par rapport à leur valeur de base en 2016. La synthèse de ces résultats
est présentée ci-après. Read More...
De façon globale des résultats forts encourageants sont notés, car la plupart des indicateurs ont
connu des améliorations par rapport à leur valeur de base en 2016. La synthèse de ces résultats
est présentée ci-après. Read More...
Myanmar Endline Report Gender Equality and Women’s Empowerment Programme II 2016-2019
Project name: Gender Equality and Women’s Empowerment Programme (GEWEP) II
Project period: 2016-2019
Number of people that have been directly reached: 4,429 Female and 2,305 Male
Myanmar endline / baseline report submission: 31st March 2019
Result highlights for GEWEP II in Myanmar
Sex Workers in Myanmar (SWiM) is growing. SWiM advocates for the rights of fellow sex workers by advocating for amendment of the 1949 Suppression of Prostitution Act, a law that punishes and fines prostitution, putting sex workers at increased risk. With the contribution from SWiM and other stakeholders, the Ministry of Social Welfare, Relief and Resettlement has been drafting a new law. The draft law is expected to be submitted to parliament by the end of 2019.
More than a hundred brothels have been lobbied to promote safer work environment for female sex workers using a minimal standard checklist. The minimal standard includes provision of condoms, and hygiene and sanitary materials for both clients and female sex workers. It also needs the brothel owners/managers to allow sex worker to go out for regular medical check-up.
58% of the endline survey respondents are members of one or more self-help groups. Participation in self-help groups develops sense of social inclusion among the sex workers. This is important, as sex workers are greatly discriminated in the general community and often excluded from the social activities in the general community.
During the survey, a subset of men – who were partner of, have work relationship with, or are somehow related to FSWs – showed aggressive attitudes towards their intimate partners. These attitudes may be linked to high incidence of violence against female sex workers. More exploration on this finding and more targeted engaging men activities are suggested for future programs. Read More...
Project period: 2016-2019
Number of people that have been directly reached: 4,429 Female and 2,305 Male
Myanmar endline / baseline report submission: 31st March 2019
Result highlights for GEWEP II in Myanmar
Sex Workers in Myanmar (SWiM) is growing. SWiM advocates for the rights of fellow sex workers by advocating for amendment of the 1949 Suppression of Prostitution Act, a law that punishes and fines prostitution, putting sex workers at increased risk. With the contribution from SWiM and other stakeholders, the Ministry of Social Welfare, Relief and Resettlement has been drafting a new law. The draft law is expected to be submitted to parliament by the end of 2019.
More than a hundred brothels have been lobbied to promote safer work environment for female sex workers using a minimal standard checklist. The minimal standard includes provision of condoms, and hygiene and sanitary materials for both clients and female sex workers. It also needs the brothel owners/managers to allow sex worker to go out for regular medical check-up.
58% of the endline survey respondents are members of one or more self-help groups. Participation in self-help groups develops sense of social inclusion among the sex workers. This is important, as sex workers are greatly discriminated in the general community and often excluded from the social activities in the general community.
During the survey, a subset of men – who were partner of, have work relationship with, or are somehow related to FSWs – showed aggressive attitudes towards their intimate partners. These attitudes may be linked to high incidence of violence against female sex workers. More exploration on this finding and more targeted engaging men activities are suggested for future programs. Read More...
Epidemic Control and Reinforcement of Health Services (ECRHS) Phase 1 Programme in Sierra Leone
This report presents findings from the end phase evaluation of the Epidemic Control and Reinforcement of Health Services (ECRHS) Phase 1 Programme in Sierra Leone, which was implemented from November 2015 to December 2018. The aim of the Programme is to ‘Improve the health status of the population of Sierra Leone’. The Programme was originally designed to provide response to the Ebola outbreak in Sierra Leone, but also considered a longer-term view and worked towards putting in place preparations putting in place preparations for the transition of an extended health system strengthening (HSS) effort.
The overall purpose of the evaluation was ‘to assess result and impact of the above-mentioned Epidemic Control and Reinforcement of Health Services Programme against the Programme goal and outcomes in targeted northern region of Sierra Leone. The evaluation was specifically commissioned to; 1) Assess the Programme result areas in relation to effectiveness, relevance and efficiency of the Programme, 2) assess changes made in general conditions and perspectives, 3) assess need for additional (Programme-) support in future, 4) assess sustainability of achieved results with respective to the DHMTs and Community-based Surveillance (CBS) system, 5) identify the Programme’s key challenges during implementation, and lessons learnt/best practices, and 6)generate concrete recommendations for decision making process regarding health and SRH Programming in the future.
The Evaluation integrated both quantitative and qualitative research methods. 1,608 respondents were randomly selected from across 80 communities for households/individual interviews. This sample included 1,196 female and 412 male respondents. Focus Group Discussions (FGDs) were held with community members in 60 communities and 30 key informant interviews (KIIs) were done with CARE, implementing partners, state actors and chiefdom authorities. Twenty-seven (27) Community Health Workers (CHWs) and 5 Water Management Committee members were also interviewed. Also, facility assessment was conducted for -77 PHUs using the Ministry of Health and Sanitation standard tool and case studies/insight stories were further documented from the field interviews.
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The overall purpose of the evaluation was ‘to assess result and impact of the above-mentioned Epidemic Control and Reinforcement of Health Services Programme against the Programme goal and outcomes in targeted northern region of Sierra Leone. The evaluation was specifically commissioned to; 1) Assess the Programme result areas in relation to effectiveness, relevance and efficiency of the Programme, 2) assess changes made in general conditions and perspectives, 3) assess need for additional (Programme-) support in future, 4) assess sustainability of achieved results with respective to the DHMTs and Community-based Surveillance (CBS) system, 5) identify the Programme’s key challenges during implementation, and lessons learnt/best practices, and 6)generate concrete recommendations for decision making process regarding health and SRH Programming in the future.
The Evaluation integrated both quantitative and qualitative research methods. 1,608 respondents were randomly selected from across 80 communities for households/individual interviews. This sample included 1,196 female and 412 male respondents. Focus Group Discussions (FGDs) were held with community members in 60 communities and 30 key informant interviews (KIIs) were done with CARE, implementing partners, state actors and chiefdom authorities. Twenty-seven (27) Community Health Workers (CHWs) and 5 Water Management Committee members were also interviewed. Also, facility assessment was conducted for -77 PHUs using the Ministry of Health and Sanitation standard tool and case studies/insight stories were further documented from the field interviews.
Read More...
Kore Lavi Safety Net Beneficiary Resilience Assessment
As part of its mandate, the Kore Lavi program has developed and established a food voucher-based social safety net model for the poorest households in conjunction with the Haitian Government – through the Ministry of Social Affairs and Labor (MAST). This Resilience Assessment contributes to a stronger understanding of the current food security and resilience situations of the most vulnerable program beneficiaries.
Based upon the data collected, the social safety net members – which is considered as the study sampling universe – are mainly affected by Illness, death and drought, respectively. The experiences shared by the respondents also revealed that they often face several types of shocks and stressors simultaneously.
The food voucher had a very positive impact and helped a lot during each key moment: before the shock or stressor affected the respondent, immediately after, sometime after and now. In the different stories that were shared, a certain number of respondents mentioned that they have no other means to ensure their food security - other than the Kore Lavi food vouchers. With regard to the food vouchers indirect contribution, it is important to highlight that 59% of
respondents used the money they saved to pay school fees and 28% to pay medical fees. 36% save it in their Village Saving and Loans Association (VSLA). Yet, there is also an emerging group that used the money to invest in agricultural endeavors and start-up income generating activities.
When comparing the three main types of assets (personal, social and physical-financial resources), it could be observed that especially vulnerable respondents tended to rely on social resources. Generally, the respondents used more negative coping mechanisms that compromise their food security like eating less or less preferred meals per day (58%), reducing expenditures related to household needs (32%), producing charcoal (33%), reducing agriculture production area (20%) and livestock (19%) or selling assets.
The study identified that 22% of VSLA members followed resilient pathways versus 16% of non VSLA respondents. In almost all the signifier questions, there were found small differences between both groups, but not as much as it was initially expected by the Kore Lavi team. Read More...
Based upon the data collected, the social safety net members – which is considered as the study sampling universe – are mainly affected by Illness, death and drought, respectively. The experiences shared by the respondents also revealed that they often face several types of shocks and stressors simultaneously.
The food voucher had a very positive impact and helped a lot during each key moment: before the shock or stressor affected the respondent, immediately after, sometime after and now. In the different stories that were shared, a certain number of respondents mentioned that they have no other means to ensure their food security - other than the Kore Lavi food vouchers. With regard to the food vouchers indirect contribution, it is important to highlight that 59% of
respondents used the money they saved to pay school fees and 28% to pay medical fees. 36% save it in their Village Saving and Loans Association (VSLA). Yet, there is also an emerging group that used the money to invest in agricultural endeavors and start-up income generating activities.
When comparing the three main types of assets (personal, social and physical-financial resources), it could be observed that especially vulnerable respondents tended to rely on social resources. Generally, the respondents used more negative coping mechanisms that compromise their food security like eating less or less preferred meals per day (58%), reducing expenditures related to household needs (32%), producing charcoal (33%), reducing agriculture production area (20%) and livestock (19%) or selling assets.
The study identified that 22% of VSLA members followed resilient pathways versus 16% of non VSLA respondents. In almost all the signifier questions, there were found small differences between both groups, but not as much as it was initially expected by the Kore Lavi team. Read More...