Final

Impact, Influence, and Innovation: Reflecting on 10 Years of the CARE-GSK Frontline Health Worker Initiative

In recognition of their critical role in health linkages and systems strengthening, CARE and GSK established a decade long strategic investment in frontline health workers (FHW) and community health workers (CHW) in 2011 called the Frontline Health Worker Initiative. Following 10 years of partnership and programming, this report explores the resulting impacts, influence, and innovation. It synthesizes reach and impact data from 13 programmes across the 9 countries included in the Frontline Health Worker Initiative between 2011 and 2021. The countries included in this initiative are Afghanistan, Bangladesh, Cambodia, Cameroon, Chad, Laos, Myanmar, Nepal, and Togo.
The data presented here is specific to the communities in which CARE delivered sexual and reproductive health, maternal and child health, nutrition, and sanitation programming with GSK’s support. The analysis is designed to identify the changes in overall health outcomes that occurred at a population level. While these findings do not necessarily imply causation, CARE’s efforts have likely reasonably contributed towards these changes within the specific communities.
The Frontline Health Worker initiative has achieved these results across multiple development and humanitarian contexts – including slow-onset and sudden shocks, conflict, and most recently the COVID-19 pandemic. Many of these results were only made possible through the long-term investment from GSK and scalable actions that were implemented across all nine countries. Critically, the Frontline Health Worker Initiative established platforms, networks and health service capacity-building that served as a catalyst for CARE to pivot towards the response to the COVID-19 pandemic quickly in the communities where these projects exist.
Learnings from this programme will serve to strengthen CARE’s private sector partnership models for future programmes to build resilience and achieve health impact in communities. Read More...

ON THE FRONTLINE: Lessons on health worker empowerment through the COVID-19 pandemic response

Around the world,frontline and community health workers serve to connecthealth services, commodities, and informationwiththose who need them. Equippedwith the relevant skills and community trust, theycanstrengthen health systems by bridginggeographic and financial accessibility gaps for rural, hard-to-reach, and vulnerable populations through last-mile health delivery. When integrated into national and local healthcare systems, community health workers can additionally help patients navigate complex systems of care and ensure care continuity across services. Historically during times of health crises, global governments and organizations have often relied on community health workforces as frontline responders to deliver life-saving care to disproportionate l y affected populations. The 2020 COVID-19 pandemic was no exception, with many countries mobilizing their existing community health worker programs or initiating new ones to assist with pandemic response . Leveraging lessons learned through its decades long support and implementation of frontline and community health worker initiatives across 60 countries, CARE developed guidelines for community-level pandemic response and disease prevention during this time. In June 2020, CARE partnered with Abbott to launch a one-year in-depth primary care response to the COVID-19 pandemic Read More...

Improved WASH Services to the Myanmar Refugees Population in camps 15 (Jamtoli) and 16 (Potibonia), Ukhiya Upazila, Cox’s Bazar

Applying both quantitative and qualitative tools and approaches, the end-line assessment was conducted in February 2022. It covers 415 respondents' households from camps 15 and 16—data collection done with tablets in KoBo. The samples were drawn systematically. First, the sample size was determined following the most common statistical formula. The objectives of the study are as follows: 1) To know the present situation context on WASH; 2) To identify the targeted respondent's current Knowledge, Attitude and Practice (KAP).

The study findings reveal the following:
Water
- The most commonly reported primary sources for drinking water were Piped water tap/Tap Stand, reported by 66% of households.
- In terms of water collection, male engagement has been increased. Overall, 86% of households reported women, followed by adult males (55%) and Children (6%). However, the male also helps them when they cook and cloth wash.
- Overall, only 2% of households reported a combined travel and waiting time of more than 30 Water containers.
- Females preferred to get 'Kolsi' (a pitcher) instead of Bucket or Jerrycan for carrying water. On the other hand, male and adolescent children preferred Jerrycan for carrying the water.
- 76% of respondents feel safe collecting enough water to meet their households' needs, such as drinking, cooking, laundry, bathing etc. However, women also reported that they feel unsafe because men go to water points to collect water.
- A significant proportion of households (88%) do not treat drinking water. Because they believe the drinking water source is safe—12% of households use the aqua tab to treat their water.
Sanitation
- The most-reported defecation (sanitation options) for household members five and above was communal latrines 86%, followed by shared latrines 14%, and single-household latrines 7%. Others places (2 %), bucket and open defecation was seldom reported 1%.
- The accessible latrine is one of the beauties of this project. This latrine is included: The railing on the way, The handle inside, The tap, The commode, The single-use.
- The community also thinks that these latrines will be equally helpful for elderlies.
- A significant 79% responded to the affirmative of privacy of latrine use. A significant number of
- 18% of the households' female members use the designated bathing facilities. However, this figure is low because of privacy concerns.
Hygiene
- All (100%) respondents mentioned that they cleaned every time they filled with fresh/clean water. While at the time of hurriedness, that type of cleaning activity has disrupted.
- 100% of households owned soap at the time of the interview. The study further explored other hand washing options/solutions households use when they do not have soap; because of CoVID-19, all respondents, even children, are aware of handwashing. They can recall the critical time of handwashing.
- Regarding the best way to receive health and hygiene messages, 45% stated Home visits by volunteers, and 2nd choice is by the local leaders. However, the study findings also revealed that only 7% of households said they do not know how to prevent diarrhea.
- 69% of females used reusable clothes, 16% used disposable pads. The reusable cloth is the most preferred for use during the menses.
- Most female respondents said they wash and reuse the MHM materials and dispose of way is Household/Trash bin, Throw in the open waste area/communal bins, In the latrine, Bury in the soil, and, Burn them
RECOMMENDATION
- Consideration of men, women and girls carrying water and provide water container that these particular groups prefer;
- The child-to-chid session needs to discuss the importance of Gender Marker because children remove the gender markers frequently, which causes a problem for the women;
- Need to keep attention to the elderly person in terms of WASH facilities along with Persons with Disabilities;
- Video documentaries for hygiene promotion may be more effective together; in this connection, CARE can collaborate with "shongjog" which is the open platform of CwC in Rohingya Camp. Read More...

Climate Learning and Advocacy for Resilience (CLAR) Programme

Climate Learning and Advocacy for Resilience (CLAR) was a CARE Denmark global programme that during the years 2018-2021 provided technical support to CARE country programmes. The overall objective of CLAR was “Adaptive capacity and resilience of vulnerable communities to climate change impacts, risks and uncertainties has increased.” The programme had three interrelated specific objectives, focusing on (1) demonstrating good practice, innovation and impact in climate resilience, and generating new evidence and learning, (2) improving capacity and influence among CSOs and networks on global and national policies, plans and projects on climate change adaptation and finance, and (3) strengthening of climate knowledge brokering for multi-stakeholder, cross-discipline and South-South learning and coordination.
The intention with CLAR was to link practical approaches and outcomes in climate change adaptation work with influencing policy and planning processes, in particular national adaptation plans (NAPs) and finance. CLAR was to add value to CARE country programmes through the provision of technical support for integration of climate change adaptation implementation as well as cross-country learning and knowledge sharing. CLAR targeted both local, national, and global policy spaces to promote pro-poor, equitable and effective adaptation policies, and mechanisms. Through the Southern Voices on Adaptation (SVA) advocacy community of practice, CLAR supported the sharing of experiences and best practices in different contexts on how to influence adaptation policies and adaptation finance. Read More...

Information for Adaptation in Vietnam (InfoAct)

Enhanced livelihoods and increased resilience of poor ethnic minority women and men rural areas to the effects of climate change and variability.
The “Information for Adaptation in Vietnam” Project (InfoAct) is funded by the Federal Ministry of Economic Cooperation and Development, abbreviated BMZ, and jointly implemented by CARE Vietnam (CVN) and three local partners, named Center for Community Development (CCD), Lai Chau Department of Agriculture and Rural Development (DARD) and Lai Chau provincial Vietnam Women’s Union (VWU). The project sites include four communes of Dien Bien province and four communes of Lai Chau province, namely: Muong Phang and Pa Khoang communes (Dien Bien district); Ang Cang, Ang Nua communes (Muong Ang District); Than Thuoc, Trung Dong, Ho Mit and Nam So Communes of Tan Uyen district, Lai Chau province. The overall objective of the InfoAct Project is to enhance livelihoods and increase the resilience of poor ethnic minority women and men in rural areas to the effects of climate change and variability. This is to be accomplished through a specific objective (outcome) to ensure ethnic minority households in rural areas have improved access to and use of climate information, and resources to help increase their climate resilience. The InfoAct Project is focusing mainly on two target groups: (1) 5,000 ethnic minority households, especially women, in Dien Bien and Lai Chau provinces and (2) government authorities and service providers, namely Department of Hydro-Meteorology, Department of Agriculture and Rural Development (DARD) and the provincial VWU and CCD. As InfoAct was going to phase out after three years’ implementation and close all its activities by November 2021, an independent final evaluation was conducted to understand the project’s impacts/outcomes and key lessons learned.
The Final Evaluation applied a mixed-method approach by using qualitative and quantitative data from primary and secondary sources. The primary data was collected from the key informants and household survey. The household survey was implemented with 363 and 266 people in Dien Bien and Lai Chau provinces, respectively. A total of 49 In-deep Interview (IDI) was conducted with stakeholders. In addition, 34 women and 39 men in two provinces participated in Focus Group Discussion (FGD). Read More...

EVALUATION FINALE DU PROJET COOPERER II – APPROCHE INTERCOMMUNALE POUR UNE STABILISATION TERRITORIALE A L’EXTREME-NORD CAMEROUN : AXE KAELE – TOULOUM – YAGOUA RAPPORT FINALE

Malgré son potentiel économique et naturel indéniable, le Cameroun affiche un taux de pauvreté élevé qui décroit très faiblement (40,2% en 2001 ; 39,9% en 2007 et 37,5% en 2014). Dans le souci d’apporter sa contribution à la stabilité de la région de l’Extrême-Nord meurtrie par des crises multiformes, CARE International à travers son programme Résilience et inclusion des jeunes et des femmes, a développé l’initiative « Communes et Organisation de la société Civile Performantes pour des populations Engagées et Résilientes - COOPERER II », mise en œuvre dans les communes de Touloum, Yagoua et Kaélé de la région de l’Extrême-Nord. Le projet a couvert la période s’étendant d’avril 2019 à juin 2020, avec comme objectif global de contribuer à l’accès durable des femmes et des jeunes touchés par les effets de la crise sécuritaire à des opportunités agro-pastorales, sociales et économiques stables afin
de renforcer leur résilience face aux aléas environnementaux et climatiques Read More...

FINAL EVALUATION “Support to Development of Agricultural Cooperatives”

The Final Evaluation Report consists of a project background, methodology, main findings (including analysis of in-depth interviews and focus group results), conclusions, recommendations and lessons learnt. The methodology used triangulation, combining desk research (qualitative and quantitative secondary data) and primary data collected during the mission in North Macedonia via interviews and focus groups in Skopje and other locations.
Relevance: The project was clearly relevant to the context of North Macedonia and the Western Balkans region. The interventions were timely and focused on addressing the priority needs of farmers, important for enhancing sustainability of North Macedonian agriculture. Its design was based on the in-depth needs assessment, which was a collaborative effort carried out by the partners, stakeholders and project beneficiaries. In the course of its implementation, the identified needs farmers and stakeholders were also met by the project to a great extent.
Effectiveness: The effectiveness of the project was visible in several areas. However in some areas more time is needed – likely until the completion of the project - to unveil the project outcomes and impacts. The project greatly succeeded in creating a significant number of new ACs and increasing the involvement of farmers into this kind of business model. Yet, their membership size is often small. Despite the efforts to consolidate representation of the AC’s, there were mixed results regarding the umbrella organization. On the one hand, it visibly improved the planning, management, and provision of services while ensuring the continuation of the funding until the end of 2020. On the other hand, it split into two entities, which hampered the consolidation process. There is limited progress that is visible in terms improved business performance of the ACs. However, the project lifespan was too short to detect a major shift in economic terms.
Efficiency: The implementation of the project was smooth and largely in line with its budget and timeline. The project encountered minor delays and budget issues from the beginning. Yet, the project was complemented with in-kind resources of the partners and thus was cost-efficient. Due to the Covid-19 pandemic, the project duration had to be extended. The management of the project was very efficient and responsive against this force majeure. The project lifetime was extended and this allowed for an adequate adaptation to those unusual circumstances.
Sustainability: Despite the relatively successful establishment of the ACs, the sustainability of the project has been called into question due to the fact that related legal frameworks have not been adopted and the challenges ACs face in accessing the markets. The cooperatives benefitted from investments to upgrade farm facilities (machinery, post-harvest storage), yet they were not clearly embedded into functioning value chains. The pandemic proved to be challenging for enhancing the links between the farmers and other value chain actors. Participation in face-to-face meetings and business events was seriously constrained. Yet, the project succeeded in facilitating contacts between business partners, especially for the AC Prespansko Jabolche. Read More...

Evaluación final Proyecto Mujeres Emprendedoras

El presente estudio tiene como objetivo realizar un análisis comparativo entre la Línea de Base y La Evaluación final de la situación de las asociaciones de mujeres emprendedoras en el rubro gastronómico ubicadas en el Centro Histórico de Lima que forman parte del proyecto “Mujeres Emprendedoras”. El estudio mide los indicadores principales del proyecto, vinculados al fortalecimiento institucional, módulos de expendio de alimentos y desarrollo de capacidades.
Con dicho fin, el levantamiento de la información se realizó, en ambas oportunidades, mediante llamadas telefónicas a los beneficiarios(as) del proyecto Mujeres Emprendedoras. El instrumento de recolección de datos, la selección y muestra final de los participantes fue coordinado con CARE Perú según los avances previos al desarrollo estudio. La aplicación de las encuestas telefónicas se realizó sobre la base de beneficiarias(os) provista por la Municipalidad Metropolitana de Lima en coordinación con CARE PERÚ.
El estudio presenta seis secciones: La primera sección busca realizar la caracterización de la población de beneficiarios(as), donde se halla que se trata de una población con múltiples vulnerabilidades debido a la situación económica y la dependencia de los negocios familiares que han sido afectos durante la pandemia. La segunda sección busca conocer las características los negocios de las beneficiarias(os), evidenciando que se tratan principalmente de los negocios propios dedicados a la venta de alimentos en la vía pública. Estos negocios han sido golpeados duramente por la disminución de la demanda, no han tenido procesos de diversificación productiva ni han intentado expandirse fuera del ámbito local, pese a que, en la actualidad, se registran cambios ligeros en estas tendencias. En contraste, los negocios de los beneficiaros(as) han experimentado una reducción importante de trabajadores, principalmente, por los efectos de la reducción de la demanda y la reducción de los ingresos Read More...

Evaluación final Proyecto Alma Llanera I

La presente evaluación es elaborada con el objetivo de valorar la implementación del PROYECTO “ALMA LLANERA”, el cual ha sido ejecutado por CARE Perú.
Para el desarrollo del estudio se implementó una metodología mixta basada en la aplicación de técnicas e instrumentos de tipo cuantitativo y cualitativo. El ámbito geográfico del estudio de base comprende las zonas donde intervino el proyecto, las cuales comprende los departamentos de Tumbes, Piura, La Libertad, Lima y la provincia constitucional del Callao.
Las principales variables analizadas se corresponden con las características básicas del público objetivo (características personales de las beneficiarias, de sus hogares, acceso a servicios de protección y afectación por el COVID-19), la cobertura, la pertinencia del proyecto, la eficacia y el impacto del Proyecto en función a los cambios esperados de su estrategia de intervención (plasmados a través de sus indicadores de impacto y resultados).
Estas variables se analizaron en la población objetivo del proyecto. Los informantes que proporcionaron la información requerida para el estudio fueron principalmente la población migrante y refugiada atendida, trabajadores/as y promotores de salud, funcionarios/as públicos y privados de las entidades públicas locales y el equipo técnico del Proyecto.
En este grupo de informantes se aplicaron encuestas a población migrante y refugiada atendida por el Proyecto, encuestas a trabajadores/as y promotores de salud y se complementó con entrevistas a funcionarios públicos y privados de los Centros de Salud Mental (CSMC), ONG, Asociaciones de Migrantes/Refugiados y Promotores de la Integración. Para el recojo de información, se diseñó un total de 10 formatos de recojo de información primaria, los cuales fueron aplicados durante los meses de octubre y noviembre del 2021, con algunas limitaciones propias de una aplicación por teléfono (llamadas no contestadas, servicios suspendidos, números equivocados) y otras referentes a la disponibilidad del informante (rechazo directo, falta de tiempo).
Como resultado de lo anterior se presentan los siguientes hallazgos: Read More...

Línea de base Proyecto Aprendemos+, crecemos y emprendemos siempre III

El proyecto APRENDEMOS+ CRECEMOS Y EMPRENDEMOS SIEMPRE 2021 presenta una respuesta educativa semipresencial con el objetivo general de generar las condiciones pedagógicas y de bienestar para que los y las estudiantes de las IIEE de primaria rural multigrado/unidocente focalizadas logren aprendizajes satisfactorios en las competencias de las áreas curriculares de Comunicación, Matemática y Personal Social. Este proyecto cuenta con tres objetivos específicos o componentes: i. fortalecer las capacidades de los y las docentes/directores para mejorar los aprendizajes de los/las estudiantes de aulas multigrado/unidocente; ii. promover la participación de la comunidad educativa para fortalecer la gestión escolar; iii. fortalecer la práctica pedagógica, la gestión en docentes/directores y desarrollar aprendizajes autónomos a través de recursos educativos. En 2021, la propuesta se implementará en 115 instituciones educativas de nivel primaria multigrado/unidocente de las regiones de Amazonas, Cajamarca, Huánuco y Pasco; atendiendo a 2372 estudiantes y 187 docentes.
El presente informe del Estudio de Línea de Base del proyecto tiene como objetivo general medir los indicadores del proyecto a nivel cualitativo y cuantitativo; y, compararlos con un área de no intervención (grupo control). El estudio se enmarca en las consecuencias educativas de la pandemia de Covid-19, y las medidas de respuesta del sector para garantizar el acceso a una educación con calidad y equidad. El estudio cuenta con dos componentes. El componente cuantitativo contó con 294 entrevistas en IIEE tratamiento y control, dirigidas a directivos, docentes, estudiantes y padres/madres de familia. El componente cualitativo estaba compuesto por 32 entrevistas en 8 IIEE tratamiento y control, dirigidas a directivos, docentes, estudiantes, padres/madres de familia y agentes educativos comunitarios.
El informe presenta los resultados de los indicadores centrales del proyecto, así como la medición de indicadores referenciales, complementados por los resultados cualitativos a nivel descriptivo y analítico. Incluye además un conjunto de conclusiones y de recomendaciones para la implementación del proyecto. Read More...

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