Sexual|Reproductive Health

Bangladeshi Sailors Vulnerability to HIV and AIDs

Enhancing Mobile Populations’ Access to HIV and AIDS Services, Information, and Support (EMPHASIS) is a 5-year initiative funded by the UK’s Big Lottery Fund. The project has been implemented by CARE in three countries,
Bangladesh, India and Nepal. This study was initiated to generate evidence around the vulnerabilities faced by migrant populations traveling to India. Both qualitative and quantitative methods were used to explore the vulnerability of sailors and a standard BCC questionnaire was used to assess knowledge around HIV and AIDS. Qualitative methods were used to compliment quantitative findings to reveal other socio-economic dynamics that can contribute HIV and AIDS related vulnerabilities. Data collection was carried out in both Bangladesh and India. Both qualitative and quantitative data collection was done in Bangladesh,. As entry into the ports in India was restricted, only qualitative methods were used there. A total of 154 were interviewed with a quantitative questionnaire and 24 sailors participated in in-depth interviews. Focus group discussions (FGD) and Key Informant Interviews were conducted with selected community members such as doctors, Noujan Srameek Union members, and vendors. [46 Pages] Read More...

Journeys: Experiences of Nepalese and Bangladeshi cross border migrants living with HIV

Enhancing Mobile Population’s Access to HIV and AIDS Information (EMPHASIS), Services and Support is a 5-year project funded by Big Lottery Fund, UK. EMPHASIS is implemented in Nepal, India and Bangladesh to address AIDS related vulnerabilities of cross border populations who are moving between Bangladesh, India and Nepal EMPHASIS is an operations research project and one of the pioneer regional projects to address HIV and AIDS vulnerability among cross border populations. The project aims to address its goals through service provision,
capacity building of relevant partners/stakeholders, and advocacy through generating evidence. As part of generating evidence, EMPHASIS developed a research study to investigate the dynamics associated with accessing services for mobile groups who are already affected by HIV and AIDS. This study examines people and questions that were not covered by the EMPHASIS baseline survey that was previously conducted.

Three separate studies were conducted in Bangladesh, Nepal and India. Bangladesh and Nepal first initiated the study aiming to understand the dynamics of HIV infection among migrant populations and also to assess barriers to accessing services at source. In India the study was initiated later, to assess the barriers to accessing services at destination. The prime objective of the study was to present these barriers to services at the regional level among the regional stakeholders. Sharing the findings at South Asian Association for Regional Cooperation (SAARC) could be an important way to initiate dialogue between the governments of Nepal and India to formalize a cross border referral system. Country specific barriers to services will be provided as evidence to inform policy at the national level. [45 Pages] Read More...

Vulnerability to HIV & AIDS: A social Research on Cross Border Mobile Population from Bangladesh to India

There are a growing number of people migrating between Bangladesh, Nepal and India. Mobility has long been linked with heightened vulnerability to HIV & AIDS. While overall
HIV prevalence is low in Bangladesh and Nepal, there is a growing concern that vulnerable mobile populations are forming a bridge between high prevalence areas of India and low prevalence areas in Bangladesh and Nepal. Enhancing Mobile Populations’ Access to HIV & AIDS Services Information and Support (EMPHASIS) is a regional program being implemented by CARE Bangladesh, CARE India and CARE Nepal and led by CARE International UK (CIUK) to reduce AIDS related vulnerabilities among mobile populations crossing the borders of Bangladesh and Nepal into India. This 5-year (August 2009 – July 2014) program, is funded by the Big Lottery Fund (BIG) of United Kingdom.

Baseline Research on cross border migration was initiated to understand the drivers of mobility, access to services for migrants at source and destination, and to understand the risk and vulnerabilities associated with migration and HIV & AIDS. The study was conducted using quantitative methods and a separate qualitative study was conducted to enhance and complement the quantitative data. [57 Pages] Read More...

Somalia: Cash Transfers via Mobile Money for Maternal Child Health Services

This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.”
CARE Somalia has used Cash and Voucher Assistance (CVA) in its programs for over ten years. This includes CVA for food security and livelihoods, nutrition, WASH, and education, as well as multipurpose cash transfers. Since 2018, with support from Office of Foreign Disaster Assistance (OFDA) (now the Bureau for Humanitarian Assistance (BHA)), CARE Somalia has been implementing a food security and Livelihoods, health, nutrition, protection and WASH program. With BHA support, CARE currently supports 19 MCH facilities across Somaliland and Puntland that target children and pregnant and lactating women (PLW). Read More...

Ecuador: Vouchers for Sexual Reproductive Health and Rights

This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.” Ecuador is both a transit and destination country for refugees and migrants from Venezuela and elsewhere. As of July 2020, over 400,000 Venezuelans were living in Ecuador. Venezuelan refugees and migrants have considerable health, psychosocial, and economic needs. Within these groups, women, adolescents, and LGBTQI people face heightened risks of Gender-Based Violence (GBV), human trafficking, and sexual exploitation as well as challenges to earning an income while in Ecuador. Although the public health system in Ecuador is free to all regardless of migration status, not all health – and especially SRH services – are covered in the public system. Furthermore, safe access to available services without discrimination based on nationality, sexual orientation/gender identity, or age is a barrier to access and uptake of SRH services in Ecuador. Read More...

Colombia: Vouchers for Sexual Reproductive Health (SRH) Services

This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.” As a result of Venezuela’s socioeconomic and political crisis, there have been massive migratory flows of people from Venezuela into Colombia.1 According to the Interagency Coordination Platform for Refugees and Migrants, as of May 2020 over 1.76 million Venezuelans had fled to Colombia with many continuing to walk to and across the Southern Border with Ecuador as caminantes.

CARE Colombia began direct operations in the country in 2019, focusing primarily on the needs of Venezuelan
refugees and migrants in Pamplona, Norte de Santander and, later, Bucaramanga, Santander. Cash and Voucher
Assistance then (CVA) are primary modalities for CARE Colombia, particularly for its SRHR and protection portfolio.
Working with populations on the move as was was the case in this program, together with high levels of unmet SRHR needs resulted in a unique operating environment for a voucher intervention supporting SRHR programming.
This case study focuses on the design of the programming only. Due to the timing of the review, no substantive data on the user experience of the vouchers or outcomes could be captured. Read More...

Lebanon: Cash Transfers for Sexual Reproductive Health and Rights (SRHR) within Protection

This study is part of a larger multi-country study by CARE entitled “Cash and Voucher Assistance for Sexual Reproductive Health and Rights Outcomes: Learnings from Colombia, Ecuador, Lebanon and Somalia.”
On August 4, 2020, an explosion in the port of Beirut left hundreds killed and thousands injured, damaged numerous neighborhoods – including hospitals and residential buildings – and left 300,000 people homeless. The economic, social, and psychological tolls of the blast were added to an already strained population suffering from an economic crisis and the impacts of COVID-19. The Lebanese Red Cross reported in a post-blast study2 that, of those surveyed, approximately 5% of respondents reported having family members who were pregnant or lactating and, of those households, 40% reported needing Maternal Child Health (MCH) services. A UNFPA report identified a decrease in SRH service availability due to facilities destroyed or damaged in the blast.
Prior to the blast, the Interagency Sexual and Gender-based Violence (SGBV) Task Force conducted an assessment with 562 women and girls across the country on the SGBV impact since the beginning of COVID-19. This assessment found that 51% of respondents felt less safe in their communities and only 30% reported accessing health services.4 Sixty-seven percent of respondents reported that the main barrier to accessing services was lack of money.5 Read More...

CASH AND VOUCHER ASSISTANCE FOR SEXUAL REPRODUCTIVE HEALTH AND RIGHTS LEARNINGS FROM ECUADOR, COLOMBIA, LEBANON, AND SOMALIA

CARE is committed to ensuring that projects with cash and voucher assistance (CVA) are designed with and for women and girls, addressing recipients’ needs, challenges, and opportunities. CARE has invested in research on how to make CVA work for women and girls through gender-sensitive approaches to framing processes and outcomes of the modalities. As a widely accepted method of increasing access to services and improving autonomy, dignity, and resilience, programming with CVA has been integrated into numerous sectors to improve the lives of displaced communities, particularly the most underserved. To date, CARE’s CVA has primarily been used for food security and livelihood outcomes and multisectoral outcomes via multipurpose cash (MPC) transfers. Now, aligned with its strategic intent, CARE is investing in sectoral areas where CVA is less often used and that are of primary interest for women and girls, including gender-based violence (GBV) response and sexual and reproductive health and rights (SRHR).

Building on extensive experience with CVA and SRHR programming, CARE conducted a study to investigate how outcomes for the pilot initiatives using CVA for SRHR compare to global learnings, and to identify opportunities for strengthening and expanding pilots for long-term programming. The study reviewed programming in four contexts (Colombia, Ecuador, Lebanon, and Somalia). The initial study was undertaken by two consultants, one focused on Lebanon and Somalia and one focused on Colombia and Ecuador. Data collection included 25 remote key informant interviews (KIIs) with CARE staff at the global and country levels as well as staff from partner organizations, followed by After Action Reviews with each country team and a validation meeting. All activities were undertaken in either English or Spanish and transcripts were analyzed using data analysis software. Analysis was conducted both by country and across contexts to identify commonalities and thematic learning, mostly led by CARE technical advisors. Read More...

External ex-post evaluation of the “Multi-sectoral Protection Response for Vulnerable Populations in Ecuador affected by the Humanitarian Crisis” Project executed by CARE, Alas de Colibrí Foundation and Diálogo Diverso between 2019 and 2020

To respond to the migration crisis CARE Ecuador (CARE), Diálogo Diverso (DD) and Alas de Colibrí Fundation (ACF) associated to implement, with funding from the Bureau of Population, Refugees, and Migration (PRM) of the U.S. Department of State (that finances assistance actions for vulnerable refugee and migrant populations around the world), the “Multi-sectoral Protection Response for Vulnerable Populations in Ecuador affected by the Humanitarian Crisis” Project (PRM Project), from September 1, 2019 through August 31, 2020. The Project aimed at improving health and physical and psychological well-being of the forced-to-migrate Venezuelan population (and other nationalities), both migrants and refugees; as well as of the vulnerable local population, particularly LGBTIQ+ individuals and women survivors of gender-based violence, through a multi-sectoral intervention that includes: health care, legal and psychosocial advice, shelter, and comprehensive support interventions for the migrant humanitarian crisis. The project also generated advocacy actions to strengthen the capacities of public officials and institutions related to migratory processes, and to promote the restitution of migrants and refugees’ rights.
This report is 78 pages long. Read More...

Final Evaluation of the Regional Project: Men and Boys as Partners in Promoting Gender Equality and the Prevention of Youth Extremism and Violence in the Balkans – Young Men Initiative – YMI II

The Men and Boys as Partners in Promoting Gender Equality and prevention of Youth Extremism and Violence in the Balkans or Young Men Initiative II (YMI II) project was set to enable positive and peaceful societies for young people in Serbia, Kosovo , Albania and Bosnia and Herzegovina, that support gender equality and decrease interpersonal violence and its extremism. The project builds on the efforts dating from 2007 when YMI started to encourage gender-equitable attitudes and behaviors amongst young men, to decrease violence against (young) women and peer violence in Bosnia and Herzegovina, Croatia, and Serbia. YMI II project started on October 1, 2017 and ended on December 31, 2020.
The evaluation addressed the whole implementation period, all four target countries and main target and beneficiary groups – representatives of partner organizations, teachers, youth, movement leaders and governments. With the purpose to assess results achieved based on OECD-DAC evaluation criteria, the evaluation focused on relevance, impact, and sustainability of project activities – in relation to the expected results, outcome and outputs, as well as on key learning on approaches to inform future programming.
This report is 55 pages long. Read More...

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