Sexual|Reproductive Health
USAID ADOLESCENT REPRODUCTIVE HEALTH A Baseline Study Report
USAID Adolescent Reproductive Health (ARH) is a youth coled initiative to empower girls and boys of 10-19 years,
including the most marginalized, to attain their reproductive health (RH) rights. The goal of the program is to support
Nepali adolescents to reach their full potential by choosing and practicing healthy reproductive behaviors together with the support of their community members.
The baseline study aims to assess the current situation of adolescents' sexual and reproductive health in USAID ARH
working areas (11 districts and 60 municipalities), with specific objectives:
* to identify family planning (FP) and reproductive health (RH) knowledge and practices among adolescents,
exploring mass media exposure and preference among adolescents,
* assess menstrual hygiene practices among adolescents,
* identify factors affecting the age at marriage, and
* identify gender and social norms related to adolescent
SRH issues in the community. Read More...
including the most marginalized, to attain their reproductive health (RH) rights. The goal of the program is to support
Nepali adolescents to reach their full potential by choosing and practicing healthy reproductive behaviors together with the support of their community members.
The baseline study aims to assess the current situation of adolescents' sexual and reproductive health in USAID ARH
working areas (11 districts and 60 municipalities), with specific objectives:
* to identify family planning (FP) and reproductive health (RH) knowledge and practices among adolescents,
exploring mass media exposure and preference among adolescents,
* assess menstrual hygiene practices among adolescents,
* identify factors affecting the age at marriage, and
* identify gender and social norms related to adolescent
SRH issues in the community. Read More...
Elevating Married Adolescents’ Voices for Responsive Reproductive Healthcare in Syria
Increases in early marriage and pregnancy resulting from Syria's humanitarian crisis highlight a critical gap in adolescents' access to life-saving sexual and reproductive health information and services, and a larger need for adolescent-specific interventions grounded in gender transformative approaches. Seeking to address this, CARE, UNFPA and Syria Relief and Development adapted global evidence-based approaches to humanitarian contexts to create the Adolescent Mothers Against all Odds (AMAL) Initiative for pregnant girls and first-time mothers aged 10 to 18 years. Designed to improve the lives of young girls through responsive health systems and enabling environments, AMAL includes three components: a Young Mothers Club for first-time mothers and pregnant girls, participatory dialogues with health providers, and reflective dialogues with girls' marital family and community members. The AMAL Initiative intends to ensure responsiveness to the unique vulnerabilities of adolescent sub-groups by co-implementing with them. Select girls undergo additional leadership training and serve as adolescent representatives on community advisory groups sharing feedback for program improvement. One hundred-four first-time mothers and pregnant girls, 219 community members, and 120 health providers participated in AMAL in northwest Syria. In a mixed methods evaluation, facilitators administered monitoring tools to identify program improvements, pre-post surveys to assess outcomes, and end-line discussions to gather perceptions of impact. Girls reported a 47% overall increase in self-esteem, confidence, health-seeking capacity, and communication ability. Community support for girls' use of family planning increased by 27% and girls' equal access to services by 35%. Findings across all participant groups demonstrate decreased expectations of early marriage and increased acceptance of family planning post-marriage. Areas that participants cited for potential improvement included programming for girls/women above the age of 18 years, and additional training for health providers on long-acting contraceptive methods. These results show that participatory adolescent-centered sexual and reproductive health programming is not only feasible in crisis settings but can improve the self-efficacy of vulnerable adolescents to overcome barriers to accessing healthcare and improving well-being. The AMAL Initiative is now being scaled up through local partners in Syria and piloted in northern Nigeria. Read More...
Uganda: Food insecurity a pressing concern
The Development Initiative for Northern Uganda (DINU) was a 38-month long project (January 2020 to February 2023) with an aim to improve food security, maternal and child nutrition, and household incomes for smallholder farmers in 11 districts of Uganda. The project has 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. As a result, here was a significant 16.3% increase in adoption and production of diverse food crops and animal products, as well as 23.8% increase in the adoption of climate-smart technologies among the project participants. Read More...
Development Initiative for Northern Uganda (DINU) Mid Term Evaluation
This Assignment was commissioned by CARE DENMARK – the Lead Partner of the Consortium of five (5) Partner Institutions (namely, CARE; Catholic Relief Services (CRS); Gulu Agricultural Development Company (GADC); Dynamic Agro-Pastoral Development Organization (DADO); and SORUDA) – to carry out the Mid-term Evaluation (MTE) of the “Inclusive Market-based Development for Smallholder Farmers in Karamoja, Teso and Acholi Sub-regions” Project – implemented by the Consortium. The Project is supported by the European Union (EU) – under the Supervision of the Office of the Prime Minister (OPM), through the 11 Project Area District Local Governments of: Abim, Kotido, Karenga, Kaabong, Moroto, Amudat, Nakapiripirit, Nabilatuk, Napak; as well as Katakwi and Kitgum – in partnership with other stakeholders – on behalf of the Government of Uganda.
The Overall Objective of the Mid-term Evaluation (MTE), was to: “review the implementation of the project, since its inception – with the aim of generating evidence towards promoting project performance improvement, accountability, learning and evidence-based decision-making and management”. In particular, the Evaluation was intended to: “assess results achieved to date in comparison with the outcome indicators outlined in the Project Monitoring, Evaluation, Accountability and Learning framework”. Accordingly, the MTE report documents: the background to the Assignment; the general approach to work and methodology employed; Project design (including relevance and coherence); as well as Project management systems, processes and operational environments. It also documents: Project performance and effectiveness during the period under review – up to its mid-term point; as well as the identified major achievements; challenges; constraints; risks; weaknesses and threats that characterized the Project. Lastly, it, further, documents resource management and efficiency in Project implementation; project “impact”; sustainability of Project Interventions and outcomes; the major conclusions; recommendations for the way forward; as well as lessons learnt – over the period under review. Read More...
The Overall Objective of the Mid-term Evaluation (MTE), was to: “review the implementation of the project, since its inception – with the aim of generating evidence towards promoting project performance improvement, accountability, learning and evidence-based decision-making and management”. In particular, the Evaluation was intended to: “assess results achieved to date in comparison with the outcome indicators outlined in the Project Monitoring, Evaluation, Accountability and Learning framework”. Accordingly, the MTE report documents: the background to the Assignment; the general approach to work and methodology employed; Project design (including relevance and coherence); as well as Project management systems, processes and operational environments. It also documents: Project performance and effectiveness during the period under review – up to its mid-term point; as well as the identified major achievements; challenges; constraints; risks; weaknesses and threats that characterized the Project. Lastly, it, further, documents resource management and efficiency in Project implementation; project “impact”; sustainability of Project Interventions and outcomes; the major conclusions; recommendations for the way forward; as well as lessons learnt – over the period under review. Read More...
N utrition Knowledge Attitude and Practice (KAP) Survey for DINU Program in North and North-Eastern Uganda
Background: The Development Initiative for Northern Uganda (DINU) is a Government of Uganda integrated programme. It is implemented in districts that include the 11 of Kitgum (Acholi), Nakapiripirit, Amudat, Nabilatuk, Napak, Moroto, Kotido, Kaabong, Karenga and Abim (Karamoja), and Katakwi (Teso) sub-regions for three years from 2020 – 2022. The overall supervision is with the Office of the Prime Minister through local governments in partnership with a wide range of stakeholders. DINU supports interventions in three specific interlinked programs: (1) Food Security, Nutrition and Livelihoods (2) Transport Infrastructures and (3) Good Governance. The CARE consortium focusses on the sector of food security, nutrition and livelihoods with specific emphasis on community-based interventions. A survey was launched by the CARE Consortium partners with the overall objective of generating comprehensive gender sensitive Nutrition Knowledge, Attitude and Practices (KAP) information in the targeted 11 CARE consortium districts. It is intended to help inform the implementation of the nutrition component of the DINU project.
Methodology: The KAP survey was conducted from 17th November to 8th December 2020 in the 11 districts. The study populations were mothers and/or caregivers in household with children aged 0-23 months, adolescent girls aged 10 to 19 years with or without children 0-23months. Key district, subcounty and community leaders who played crucial role in programming for MIYCAN related interventions were reached. A cross-sectional survey utilising both quantitative and qualitative data collection methods was used. Sample size estimation was based on WHO Vaccination Coverage Cluster Survey guidance, July 2015. Household questionnaire comprising of 5 modules was adapted from the FAO manual for assessing nutrition related KAP. Semi-structured interview guides were used to facilitate the Key Informants Interviews and Focus Group Discussions. Quantitative data collection was done using mobile phones through Computer Assisted Personal Interviewing (CAPI) working on the Open Data Kit (ODK) platform and hosted on the ONA platform. Quantitative Data analysis was done using SPSS 26. Qualitative data analysis was done based on the interpretative approach that involved eliciting meanings from the collected information. A total of 164 clusters were reached, 1,139 households, 1,158 children aged 0 to 23months, 1,112 women and 452 adolescents from all the 11 districts. Meanwhile, 22 FGDs and 44 key informant interviews were conducted. Read More...
Methodology: The KAP survey was conducted from 17th November to 8th December 2020 in the 11 districts. The study populations were mothers and/or caregivers in household with children aged 0-23 months, adolescent girls aged 10 to 19 years with or without children 0-23months. Key district, subcounty and community leaders who played crucial role in programming for MIYCAN related interventions were reached. A cross-sectional survey utilising both quantitative and qualitative data collection methods was used. Sample size estimation was based on WHO Vaccination Coverage Cluster Survey guidance, July 2015. Household questionnaire comprising of 5 modules was adapted from the FAO manual for assessing nutrition related KAP. Semi-structured interview guides were used to facilitate the Key Informants Interviews and Focus Group Discussions. Quantitative data collection was done using mobile phones through Computer Assisted Personal Interviewing (CAPI) working on the Open Data Kit (ODK) platform and hosted on the ONA platform. Quantitative Data analysis was done using SPSS 26. Qualitative data analysis was done based on the interpretative approach that involved eliciting meanings from the collected information. A total of 164 clusters were reached, 1,139 households, 1,158 children aged 0 to 23months, 1,112 women and 452 adolescents from all the 11 districts. Meanwhile, 22 FGDs and 44 key informant interviews were conducted. Read More...
Development Initiative for Northern Uganda (DINU) Value Chains and Market Assessment report
The CARE consortium comprising of partner organisations such as Catholic Relief Services (CRS), Gulu Agricultural Development Company (GADC), Dynamic Agro Pastoral Development Organization (DADO) and SORUDA are currently implementing a three-year project titled “Inclusive Market Based Development for Small Holder farmers in Northern Uganda. This project contributes to the Development Initiative for Northern Uganda (DINU) – A Government of Uganda program aimed at consolidating stability in Northern Uganda, eradicating poverty and under nutrition and strengthening the foundations for sustainable and inclusive socio-economic development. Specifically, the project under the CARE consortium contributes to DINU’s specific Objective one on: ‘Improving livelihoods through increased production of diversified food, enhanced market opportunities and better maternal and child nutrition.’ The CARE consortium currently targets 11 districts including: Abim, Kotido, Karenga, Kaabong, Moroto, Amudat, Nakapiripirit, Napak, Katakwi and Kitgum. Given this background, the study sought to:
• Map out existing and new Agricultural and non-Agricultural value chains and assess their potential to promote women and youth economic empowerment, and community-based nutrition and household incomes.
• Identify challenges, specific entry barriers for women and youth into the VC and opportunities along the Value chains of; 1) crops such as Soybean, groundnuts, nutritious potato, vegetable, etc.); 2) Honey; and 3) livestock (small ruminants, and other non-Agricultural value chain) and propose ways of addressing these challenges.
• Develop an individual VCs, including mapping of actors, actions, supporting functions, institutions, policy issues, along each chain and propose recommendations for specific gender sensitive value chain activities that promote women and Youth participation and economic empowerment (employment opportunities as well as increasing their incomes along the chain).
• Assess the market structure (players, channels, sourcing), demand and supply (product specifications, prices, volumes, preferences), trends, market opportunities and challenges for the different value enterprises above Read More...
• Map out existing and new Agricultural and non-Agricultural value chains and assess their potential to promote women and youth economic empowerment, and community-based nutrition and household incomes.
• Identify challenges, specific entry barriers for women and youth into the VC and opportunities along the Value chains of; 1) crops such as Soybean, groundnuts, nutritious potato, vegetable, etc.); 2) Honey; and 3) livestock (small ruminants, and other non-Agricultural value chain) and propose ways of addressing these challenges.
• Develop an individual VCs, including mapping of actors, actions, supporting functions, institutions, policy issues, along each chain and propose recommendations for specific gender sensitive value chain activities that promote women and Youth participation and economic empowerment (employment opportunities as well as increasing their incomes along the chain).
• Assess the market structure (players, channels, sourcing), demand and supply (product specifications, prices, volumes, preferences), trends, market opportunities and challenges for the different value enterprises above Read More...
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.
Read More...
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.
Read More...
Integrating Sexual and Reproductive Health and Gender Based Violence Programming
Learning brief on CARE's sexual and reproductive health (SRH) and gender-based violence (GBV) implementation programming in in Cox’s Bazar (CxB), Bangladesh, home to nearly a million refugees from Myanmar. Read More...