Sexual|Reproductive Health

Gender analysis on sexual and reproductive health Niger – Maradi

L’objectif de cette analyse est de donner des recommandations pour la conception des activités du projet afin de garantir que l’intervention s’inscrive dans le «Do no harm» (Ne pas causer des préjudices), et prenne en compte les raisons et les influences les plus profondes sur les comportements et les choix des personnes.
Le consortium en charge du projet représente un partenariat pionnier qui testera des approches innovantes, durables et évolutives pour atteindre certains des groupes les plus marginalisés du monde avec des services complets relatifs à la santé et aux droits sexuels et reproductifs (SDSR). Face aux chocs permanents auxquels sont confrontés les groupes vulnérables dans les milieux fragiles et affectés par le changement climatique, cette approche globale du projet ASPIRE est fondée sur un cadre de résilience. Alors que le monde en développement est de plus en plus touché par le changement climatique et les crises humanitaires, le renforcement de la résilience devient une priorité essentielle si l’on veut permettre aux groupes vulnérables de s'adapter et de mener une vie saine et épanouie, dont l'accès à des services de santé sexuelle et reproductive (SSR) de qualité est une composante essentielle. Read More...

Analyse genre sur la SSR et la résilience climatique Madagascar – régions ANOSY et DIANA (Gender and Climate Change Resilience Analysis)

Dans le contexte actuel du changement climatique global, les situations de crises induites par ce phénomène touchent beaucoup plus les femmes et les filles qui voient leur vulnérabilité accrue et leur capacité d’adaptation et de résilience réduite. Donner un choix aux filles et aux femmes en matière de santé sexuelle et reproductive permet de soutenir leur résistance à faire face aux chocs et facteurs de stress provoqués par le changement climatique. C’est pourquoi le programme ASPIRE souhaite «accroître la résilience des communautés touchées par le changement climatique grâce à des programmes intégrés de santé sexuelle et reproductive, de conservation et moyens de subsistance ».
Ce programme sera mis en oeuvre dans 3 pays dont Madagascar, avec le concours de plusieurs partenaires qui sont MSI Reproductive Choices, Care International UK, Blue Ventures, ThinkPlace et l’Itad. Le programme adopte une approche innovante en utilisant l’approche «Population, Santé et Environnement» (PSE), dont l’objectif est de «renforcer la résilience par des approches intégrées de la santé sexuelle et reproductive, du changement climatique et de la population, de la santé et de l’environnement». Comme cette association est peu fréquente dans le milieu du développement, l’idée est de disposer d’un large éventail de preuves sur la façon dont la prise de décision en matière de SSR participe à l’effort de renforcement de la résilience face au changement climatique. Read More...

How Bangladesh Is Getting COVID-19 Vaccines to the Last Mile

Bangladesh has been one of the fastest countries receiving COVAX support to scale up vaccines, delivering more than 221 million vaccines by March 14, 2022. 54% of Bangladesh’s population is fully vaccinated, and another 22% have received at least one dose. Bangladesh is on track to meet its goal of 70% of the population fully vaccinated by September 2022.

Close coordination across multiple actors—from the Government of Bangladesh to INGOs like CARE to local health entrepreneurs—have been one of the keys to success. Working closely with the government-led National Vaccination and Deployment Plan and innovating when there have been gaps and challenges have helped achieve this success. These strategies continue to make sure that vaccines reach the people who need them most.
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The Cost of Delivering COVID-19 Vaccines in Zambia

While Zambia aims to deliver COVID-19 vaccines to 70% of its people by June 30, 2022, the road to getting there is uncertain. The Zambian Ministry of Health reports that, as of February 21, 2022, 21.6% of people were fully
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...

A Lifesaving GBV, Women’s Leadership, and SRMH Support for Refugees, in Uganda, Arua District, West Nile ENDLINE EVALUATION – FINAL REPORT

CARE International in Uganda commissioned an endline evaluation to establish the performance of the GAC 3 project on outcome indicators and related information to determine reasonable targets and guide for assessing the outcomes of the project interventions. This report presents the results of the end term evaluation for the GAC 3. The results are from the two sampled refugee settlements of Rhino and Imvepi in Madi Okolo and Terego District formerly Arua District in West Nile Uganda. Overall the end term evaluation survey reached a total of 280 household respondents (186F, 94M) within both settlements.
Fieldwork was conducted for five days, using mixed quantitative and qualitative data collection and analysis methods. Quantitative data was obtained through a household survey using mobile data collection devices. A detailed questionnaire was developed, pre-tested for incorporation of relevant information. Primary qualitative data was obtained through six Focus Group Discussions (involving women, girls, boys and men) and twenty Key Informant Interviews that comprised of GAC 3 project staff, district local government officials, health workers, health partners, Office of the Prime Minister, among others. Qualitative data from mainly key informant interviews and FGDs were analyzed using thematic analysis techniques and the findings were used to strengthen the interpretation of the quantitative findings.
The end line evaluation findings indicate that there is improved feeling of safety and dignity. This was measured at household and community level. There was an improved feeling of safety and dignity as shown by the survey at 91% (92%F, M89%). Further interrogated, the respondents indicated that they felt safe at both household and community levels. At the community level people feel safe at 86% (86%F, 86%M) and at the household level they feel safe at 93% (94%M, 91%F). The study findings indicate men as change agents and as clients in relation to Gender Based Violence (GBV) seem to have been successful exhibited by the high values. Read More...

Evaluation finale du projet Education For Change – EFC Education Pour le Changement « Jannde Yiriwere » de CARE International au Mali

Le projet Education Pour le changement utilise une approche de résilience en vue de répondre aux défis environnementaux et humains auxquels le Mali est actuellement confronté et qui affectent sérieusement l'éducation, la sécurité des jeunes et leur accès aux opportunités. Le projet combine la Réduction des Risques et Désastres (DRR) et la résilience, le Droit à la Santé Sexuelle et reproductive (SSR), l'alphabétisation appliquée, et les opportunités d'accès à l'autonomisation financière en milieu scolaire et chez les jeunes non scolaires à travers l'utilisation de nouvelles technologies bien établies. L'Education Pour le Changement a conçu et est en train de tester un modèle intégré d'éducation, de la sante de la reproduction et d’autonomisation jeunes pour une mise à échelle au profit des jeunes vulnérables et marginalisés du Mali.
Le projet est exécuté par CARE International et ses partenaires dans la région de Mopti depuis 5 ans. Les bénéficiaires qui sont les élèves, enseignants et communautés ont bénéficié de différentes activités pour améliorer leur connaissance sur les différentes thématiques du projet et offrir l’opportunité de l’utilisation de NTIC dans l’éducation scolaire des adolescents.
Le contexte opérationnel de la région de Mopti pendant la période de mise en oeuvre a été l'un des nombreux défis majeurs. En plus des sécheresses et des inondations périodiques, des épisodes périodiques de conflit civil ont contribué à une forte migration. Deux grèves prolongées des enseignants pendant les périodes de mise en oeuvre du programme ont entraîné des fermetures d'écoles pendant les périodes de mise en oeuvre. Et puis COVID-19 a contribué à la livraison d'activités et aux défis moins que prévu pour les communautés bénéficiaires. Ajouté à cela, 3 écoles n'était pas joignables pendant une partie du projet.
Comme tout programme, le cadre des indicateurs a été évalué en 2016 avant l’exécution des activités, une évaluation s’en est suivi en 2018. Le présent document présente les résultats de l’évaluation finale du projet. Read More...

IMPACT ASSESSMENT: CARE’s Psychosocial Support Program

As part of the CARE’s response under the Syria Regional Response Plan (3RP), CARE International in Jordan is providing Psycho Social Support (PSS) to refugee and Jordanian women, girls, boys, and men in urban areas and Azraq camp, covering the second and the third layers of IASC’s intervention pyramid; community and family supports and focused, non-specialized supports. The main purpose of the PSS program is to protect them from psychosocial distress, improve their emotional and social well-being, and strengthen their coping mechanisms and resilience.
With more than twenty-one Jordanian staff as of August 2021, according to CARE, the program has benefitted over 44,627 women, 17,936 girls, 19,265 boys, and 33,049 men including 94,421 refugees and 20,456 Jordanians to date. There are eight safe spaces at CARE’s community centers in urban areas (Amman, Mafraq, Zarqa, and Irbid) and Azraq camp.
This document presents the findings of a qualitative impact assessment that aims to explore the impact of the PSS interventions, including both intended and unintended impact on targeted beneficiaries. The Programs Quality (PQ) Department used the Outcome Harvesting participatory approach, which collects evidence of what has changed “outcomes” and, then, working backwards, ascertaining whether, how, and to what extent the intervention has contributed to these changes.
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AMAL QUARTERLY SUMMARY REPORT

CARE International in Nigeria is implementing the AMAL initiative (Adolescent Mothers Against All Odds) to meet adolescents’ SRH needs through the creation of adolescent-responsive health systems and equitable community environments. The AMAL Initiative includes three components: a Young Mothers Club (YMC) for first-time mothers and pregnant adolescents, participatory exercises with health providers, and reflective dialogues with community members. The AMAL Initiative seeks to inform the global evidence base and dialogue around nexus approaches to adolescent-responsive SRH and gender-based violence (GBV) programming. After over a decade of conflict between non-state armed groups and the military, the humanitarian crisis in northeastern Nigeria is intensifying and the health needs of the population are growing. Deteriorating conditions such as ongoing displacement of peoples, lack of resources and shelter, and increased risk of sexual violence have contributed to increases in early and forced marriage for adolescent girls. These high rates of sexual violence and forced early marriage result in significant increases in adolescent pregnancy thereby further compounding the health risks experienced by girls and women in communities. Read More...

CARE Malawi COVID Vaccine Delivery Situation January 2022

“The vaccines are here but support for delivery is most needed, especially at the last mile.” – District Health Management Team member, Ntcheu
As of January 10, 2022, Malawi had delivered 1.84 million doses of vaccine out of the 3.12 million doses it has received so far.1 Many doses in country have rapidly approaching expiration dates, and if they do not get to people fast, they risk expiring on the shelves. To make sure the 1.26 million doses left go to the people who need them most, we must invest more in communication, engagement, and delivery. The $37M granted by the World Bank over the past year is sufficient for covering only 8% of Malawi’s total population. What is more, as the highly contagious Omicron variant spreads worldwide, it is even more critical that more people are vaccinated now. We cannot assume that the Government of Malawi and its current health system can do it alone.

The government and other health actors in Malawi are working tirelessly to vaccinate people, while facing multiple health crises. The health system is building on a base of committed (if overstretched) health workers, an openness to community feedback, and a long expertise of delivering The government is coordinating closely with many actors to reduce gender gaps, get vaccines to the last mile, and keep existing health services open. Nonetheless, the Ministry of Health is under-resourced, and operating in a global system where the vaccine supply that arrives may be close to expiring. For example, doses of the Astra-Zeneca vaccine had to be destroyed in the spring, after arriving in Malawi with only two and a half weeks left before their expiration date.

More investment is needed. To take just one example, the national government has been able to provide one van per district to support mobile vaccination sites, to get vaccines to the last mile. Mobile vaccinations are the most effective way to serve people who live far away from health centers and do not have access to easy forms of transportation. That means that in Ntcheu, one van is expected to serve a target population of 214,929 people living over 3,424 square kilometers. One van cannot serve those people fast enough to make sure vaccines get where they need to in time, especially when an inconsistent and unpredictable vaccine supply could have doses expiring at any time. Read More...

Nepal COVID-19 Vaccine Costing Study

By December 6, 2021, 19.2 million doses of COVID-19 vaccines have been administered in Nepal, enough for 36% of the population to have gotten at least one dose of vaccine. After a rough road with unpredictable vaccine supply, the government has been able to procure several million vaccine doses. Now delivery at the last mile is the biggest hurdle they face. Nepal’s Minister of Health says, “We are not going have shortages of vaccines anymore, but our main concern and focus now is on getting these vaccines to all corners of the country, including the remote mountain areas.”

Based on national data, and in-depth studies in 2 health districts, CARE estimates that delivery costs from “tarmac to arm” for vaccines in Nepal are $8.35 (1,019 NPR) per dose of vaccine administered, or $18.38 (2,241 NPR) per person fully vaccinated.

This is nearly 5 times more expensive than current global estimate for delivery costs. These costs range from $11 per fully vaccinated person in easier to reach areas, to $33 per dose in remote, difficult to reach areas. Gaps in vaccine coverage are particularly acute for mountainous areas, people with low mobility, and communities far from health centers. Even the lowest-cost estimates for the easiest to reach areas are nearly 3 times higher than global average estimates.

70% of these costs are personnel needs to ensure vaccines reach people at the last mile. This points to a major need to improve investments in vaccine delivery, especially the health care workers who administer vaccines and ensure everyone gets vaccinated.
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