Sexual|Reproductive Health

Learning From Failure 2019

Driven by a wish to learn more from what goes wrong in our programming, and to examine where changes to the broader organization and system can improve our programming and impact globally, in 2019 CARE undertook its first evaluations-based failure meta-analysis. This analysis draws learning and evidence from 114 evaluations of CARE’s work from 2015-2018 to understand the patterns and trends in what goes wrong. This helps us take a data-driven approach to strategic investments and action plans to live out CARE’s commitment to high program quality and continuous improvement across the board.
The review draws from project specific data, but deliberately anonymizes the data and focuses on overarching trends to remove blame for any specific project team or set of individuals. This exercise is designed to help us learn more about how we can change our processes and patterns of support and engagement around weak areas to improve our work. CARE is using this data to build action plans and next steps to continuously improve our programming.
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EVALUATION OF LIFESAVING SHELTER, PROTECTION AND HEALTH SUPPORT FOR SOUTH SUDANESE REFUGEES IN UGANDA Rhino extension – Omugo, Arua District

CARE international in Uganda has been implementing a project on “Lifesaving Shelter, Protection and Health Support for South Sudanese Refugees in Uganda” between July 2017 and March 2018. The grant was awarded by the department of Foreign Affairs, Trade and Development (DFATD), International Humanitarian Assistance Division, through Global Affairs Canada (GAC). The GAC project was implemented in Rhino camp extension, Omugo, with a total project cost of 750,000 Canadian Dollars. The ultimate aim of the intervention was to save lives, reduce suffering, and maintain human dignity of refugees and the host communities in the Rhino settlement expansion site, with focus on the three thematic areas;
1) Increased access to appropriate, safe and dignified emergency temporary shelters for South Sudanese refugees, especially women, children and persons with special needs (PSNs) in Rhino Settlement Expansion Site;
2) Increased protection from GBV and sexual exploitation and abuse for refugees & host communities, particularly women and girls in Rhino Settlement Expansion Site; and
3) Increased access to critical SRMCH services for newly arrived refugee Pregnant and Lactating Women (PLW) to Rhino Settlement Expansion Site.
The project was designed to reach a total of 26,400 beneficiaries, 15,840 (60%) of whom are women and girls. Persons with Special Needs (PSNs) were a core target under this intervention, as well as women and girls, including Pregnant and Lactating Women (PLW). The majority of direct beneficiaries were South Sudanese refugees, with activities such as training and awareness raising also benefiting members of the host population. Read More...

Improving Effective Coverage of Maternal, New-born and Child Health Interventions for Reducing Preventable Child Deaths in Tangail and Khulna

Bangladesh has achieved success in reducing U5 & maternal mortality in last decade. UNICEF is partnering with GoB to contribute to reduce maternal and newborn deaths. To this end, MoH&FW with partnering with UNICEF and technical support from KOIKA implemented a MNCH project (IECMNCH) in Tangail and Khulna in line with UNICEF’s efforts to pay attention to low performing upazilas and HTR areas, started in 2015. CARE is one of the partners on this project.
designed to address main causes of newborn deaths (birth asphyxia, infection, prematurity)
to increase availability, utilization of quality MNCH-&-Nutrition services by
- increasing, sustaining of effective coverage of selected interventions;
- strengthening health system with increased availability & access to quality MNCH services;
-positive behaviour & social norm change through community participation & ownership for effective demand creation for increased utilization of MNCH services.

A baseline study in 2015 and an endline evaluation study in 2018 were implemented by UNICEF. Here are the endline study findings with corresponding baseline findings where necessary.
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Improving Sexual, Reproductive Health and Rights Including Maternal and Newborn Health in Bangladesh

UNICEF in collaboration with Bangladesh government launched a project “Improving Sexual, Reproductive Health and Rights including Maternal and Newborn Health in Bangladesh” to improve integrated sexual and reproductive health and rights including maternal, newborn, child and adolescent health in 5 districts. CARE was a key implementing partner in this project.

Before implementation of the project a baseline study in 5 project districts (Patuakhali, Rangamati, Sirajganj, Jamalpur and Moulvibazar) with 4 comparison districts (Barguna, Khagrachhari, Lalmonirhat and Sylhet), implemented by UNICEF and conducted by SURCH between 9th May and 18th August 2018
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Gaining Recovery: Improvement of Maternal and Child health in Return Areas of North Iraq

In 2016, Federal Ministry for Economic Cooperation and Development-Germany (BMZ) has provided funding to CARE-Iraq to implement the project titling "Gaining Recovery: Improvement of Maternal and Child health in Return Areas of North Iraq". The aim of this project was to enhance the opportunities of SRMH and child health care for the people of North Iraq specifically the returnees in Zummar, Bardiya, Rabiya and Qasir Serij areas of Ninewa Governorate of Iraq.
The overall goal of the project was "Contributing to Sustainable Development Goad (SDG) 3 – Ensure healthy lives and promote well-being for all at all ages, as well as Goal 3.1 – Reduction of maternal mortality ratio and goal 3.7 – ensure universal access to sexual and reproductive health-care services".
The project objective was "Improvement of maternal and child health in Northern Iraq". CARE-Iraq involved its partner, Harikar, for implementation of activities related to improving mother and child health through multi-dimensional approach. In CARE-Iraq’s multi-dimensional approach, mix methods of service delivery and community sensitization were adopted. Read More...

ACCESS Evaluation 2017

The ACCES Initiative is a project cofinanced by the European Union, CARE France, the Mairie of Paris, and ten communes in the Ouémé and Borgou departments of Benin. The primary promotor and implementer of the project was CARE International Benin/Togo and the targeted communes were Kalalé, N’Dali, Nikki, Pèrèrè, Tchaourou, Adjarra, Adjohoun, Akpro-Missérété, Bonou, Dangbo. The project lasted five years,with the goal of significantly improving access to infrastructure and services related to water, sanitation, and hygiene for 80 villages, 32 schools, and 10 health centers in ten rural communities of Benin. This was done through the construction and/or rehabilitation of water pumps and the extension of gravity schemes, the installation of incinerators in health centers, and the installation of latrines, trashcans, and urinals in primary schools. Additionally, trainings in management of the new installations were given to local actors and committees to foster self-reliance and local management, and Community Led Total Sanitation was used by facilitators to build demand for sanitation and to decrease or eliminate the practice of open defecation. Read More...

Women’s Empowerment Program (WEP) Midterm Report

In 2009, Norad-funded women empowerment programs (WEPs) started implementation in seven countries: Burundi, Mali, Myanmar, Niger, Rwanda, Tanzania, and Uganda. In 2009 and early 2010, an extensive quantitative baseline study was conducted in these countries around a common set of indicators. The present mid-term review (MTR), which was done using qualitative methodology, analysed in depth the process and nature of changes that the programs are contributing towards. In all the program countries, the country WEP team carried out the review internally with the technical assistance of an external consultant and CARE Norway (CN).

With slight variations, the overall objectives of the country WEPs focused on the economic, social, and political empowerment of women. The village savings and loan association (VSLA) methodology was common for all the programs; and these groups create the platform for working on other aspects of the program besides economic empowerment. The initial changes that the programs produce are seen in terms of increased access to savings and loans, employment opportunities, and asset ownership. The ability of the women to earn income, generate their own savings and make financial contributions in the household (HH) has greatly improved their self-esteem, thereby giving them better leverage to involve in and influence HH decision making processes. Men were highly appreciative of the income women were able to bring in to the family as a result of being involved in VSLAs. Through their improved position in the household, women reported being able to negotiate the use of sexual and reproductive health (SRH) services and the abandonment of different harmful practices. Through the use of couples-based approach and engaging men initiatives, HH relationships are beginning to improve; men in these households are reportedly starting to have a more positive attitude towards women’s empowerment and are themselves even taking part in domestic activities in some contexts. The VSLA approach is enabling women to create strong social networks that are becoming an influential force for social change. As a result of increased knowledge on their human rights and increasing leadership skills, women are beginning to understand how they have to position themselves to realize their strategic interests. The VSLA groups and networks also enable women to mobilise support when they are running for elections; this support has increased number of women being elected into different posts. The contribution of women in VSLAs and in community leadership positions is being increasingly recognised and appreciated by local authority figures, which can be seen when they actively seek the advice of women and VSL groups in relation to different community development initiatives.
Through working in partnership with others, the programs are being implemented in a high quality and timely manner. Engagement with strategic partners has occurred effectively in some countries, and been instrumental in enabling the programs to link grassroots evidence to national level advocacy activities which have achieved concrete results. [52 pages] Read More...

Women’s Empowerment Program (WEP) 2009-2013

CARE Norway, collaborating CARE country offices (COs), and partners have from 2009 through 2013 run the “Women Empowerment Programme” (WEP). With funding from NORAD, it has been implemented in Mali, Niger, Uganda, Tanzania, Rwanda, Burundi, Myanmar and DRC (from 2013).

The results presented in this report derive from CARE’s monitoring systems, thematic assessments and research done over the 5 years. This final report is intended to give NORAD an overview of key results within the program’s four thematic focus areas: 1)Women’s Economic Empowerment, 2)Women’s Participation in Decision Making, 3) Women’s Sexual and Reproductive Health and Rights, and 4) Prevention and Mitigation of Gender-based violence. In agreement with NORAD, the end-line evaluation of the WEP is due in May 2015. [55 pages] Read More...

PRIME: Endline Survey Report

PRIME, a five-year project, was launched in 2012 to help vulnerable pastoralist communities become more resilient to shocks of this nature. Led by Mercy Corps, PRIME is a consortium of 10 organizations whose main objective is to reduce poverty and hunger in the drought-prone Afar, Oromiya and Somali regions. To accomplish these objectives, PRIME implements market- driven approaches to livestock production and livelihood diversification that simultaneously support dryland communities to adapt to a changing climate. As part of its project activities, PRIME developed a monitoring and evaluation (M&E) plan to assess the project's overall impact and the performance of related indicators (impact, outcome and output), and custom indicators on animal health services and the dietary diversity of infants and pregnant and lactating women. [64 pages] Read More...

Sexual Reproductive Maternal Child Health Project

This report presents the findings of an end of project evaluation for “Sexual Reproductive Maternal Child Health” a project implemented by CARE International in Uganda through Gulu Women’s Economic Development and Globalization-GWED-G a local Non-Governmental Organisation based in Gulu Northern Uganda. The goal of the project was: “Improving Access to Reproductive, Child and Maternal Health in Northern Uganda” in the three districts of Gulu, Amuru and Nwoya, covering 9 Sub Counties (Ongako, Bungatira, Bobi, Koro, Patiko, Awach, Lamogi, Koch Goma and Alero). The three expected results were: 1)All members of the participating households have the required, age appropriate knowledge about key Sexual, Reproductive, Maternal and Child Health issues to support family members in accessing services; 2)Men and adolescent boys demonstrate supportive behaviours with regard to their family members accessing Sexual, Reproductive, Maternal and Child Health services; and 3) Health and Education service providers are more aware of demand based obstacles and actively engage to mitigate deterrents. [98 pages] Read More...

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