Nutrition

Gender-sensitive WASH, Health/SRHR, and Nutrition support to vulnerable communities in East Darfur and South Darfur Project

This baseline study is carried out for the project ‘The Gender-sensitive WASH, Health/SRHR, and Nutrition support to vulnerable communities in East Darfur and South Darfur Project’. The project serves CARE reviews, and builds on CARE learning over many years in the region, respond to the global overviews and the donor GAC interest in saving the lives of conflict affected communities, by provision of urgent humanitarian assistances to 144,173 persons including females, males, girls and boys, from the host, IDPs and refugees’ communities, located in 7 localities in ED and 2 localities in SD. The key live saving activities delivery is designed with gender sensitive prospective focusing PLW and girls in reproductive age and U5 children health and nutrition needs. The project activities include; WASH, Health and nutrition interventions. Read More...

PROSPER II: Promoting a Sustainable and Food Secure World (September 2019 – August 2022)

CARE and Cargill’s partnership extends more than 60 years and is a testament to the values we share. Since 2008, CARE and Cargill have reached more than 4.6 million people, 600,000 people directly and 4 million indirectly, through 34 projects in 13 countries. Of those reached, more than 2.4 million are women.

Our work has tackled complex issues spanning smallholder agriculture, market access, women’s economic empowerment, nutrition, child labor, education, and water, sanitation and hygiene (WASH). Beyond the tremendous impact of our efforts on the ground, our partnership has contributed greatly to CARE’s global food and nutrition security approach, informing our signature initiative, She Feeds the World (SFtW). Read More...

Learning From Failure 2022

In 2019 and 2020, CARE published Learning from Failures reports to better understand common problems that projects faced during implementation. Deliberately looking for themes in failure has helped CARE as an organization and provides insight on what is improving and what still needs troubleshooting. This report builds on the previous work to show what we most need to address in our programming now.
As always, it is important to note that while each evaluation in this analysis cited specific failures and areas for improvement in the project it reviewed, that does not mean that the projects themselves were failures. Of the 72 evaluations in this analysis, only 2 showed projects that failed to deliver on more than 15% of the project goals. The rest were able to succeed for at least 85% of their commitments. Rather, failures are issues that are within CARE’s control to improve that will improve impact for the people we serve.
To fully improve impact, we must continue to include failures in the conversation. We face a complex future full of barriers and uncertainties. Allowing an open space to discuss challenges or issues across the organization strengthens CARE’s efforts to fight for change. Qualitative analysis provides critical insights that quantitative data does not provide insight into the stories behind these challenges to better understand how we can develop solutions.
CARE reviewed a total of 72 evaluations from 65 projects, with 44 final reports published between February 2020 and September 2021 and 28 midterm reports published between March 2018 and October 2020. Seven projects had both midterm and final evaluations at the time of this analysis. For ease of analysis, as in previous years, failures were grouped into 11 categories (see Annex A, the Failures Codebook for details).

Results
The most common failures in this year’s report are:
• Understanding context—both in the design phase of a project and refining the understanding of context and changing circumstances throughout the whole life of a project, rather than a concentrated analysis phase that is separate from project implementation. For example, an agriculture project that built it’s activities assuming that all farmers would have regular internet access, only to find that fewer than 10% of project participants had smartphones and that the network in the area is unreliable, has to significantly redesign both activities and budgets.
• Sustainability—projects often faced challenges with sustainability, particularly in planning exit strategies. Importantly, one of the core issues with sustainability is involving the right partners at the right time. 47% of projects that struggled with sustainability also had failures in partnership. For example, a project that assumed governments would take over training for project participants once the project closed, but that failed to include handover activities with the government at the local level, found that activities and impacts are not set up to be sustainable.
• Partnerships—strengthening partnerships at all levels, from government stakeholders to community members and building appropriate feedback and consultation mechanisms, is the third most common weakness across projects. For example, a project that did not include local private sector actors in its gender equality trainings and assumes that the private sector would automatically serve women farmers, found that women were not getting services or impact at the right level.
Another core finding is that failures at the design phase can be very hard to correct. While projects improve significantly between midterm and endline, this is not always possible. There are particular kinds of failure that are difficult to overcome over time. Major budget shortfalls, a MEAL plan that does not provide quality baseline data, and insufficient investments in understanding context over the entire life of a project are less likely to improve over time than partnerships and overall MEAL processes.
Some areas also showed marked improvements after significant investments. Monitoring, Evaluation, Accountability, and Learning (MEAL), Gender, Human Resources, and Budget Management are all categories that show improvements over the three rounds of learning from failures analysis. This reflects CARE’s core investments in those areas over the last 4 years, partly based on the findings and recommendations from previous Learning From Failure reports. Specifically, this round of data demonstrates that the organization is addressing gender-related issues. Not only are there fewer failures related to gender overall, the difference between midterm and final evaluations in gender displays how effective these methods are in decreasing the incidence of “failures” related to engaging women and girls and looking at structural factors that limit participation in activities.
Another key finding from this year’s analysis is that projects are improving over time. For the first time, this analysis reviewed mid-term reports in an effort to understand failures early enough in the process to adjust projects. Projects report much higher rates of failure at midterm than they do at final evaluation. In the projects where we compared midline to endline results within the same project, a significant number of failures that appeared in the mid-term evaluation were resolved by the end of the project. On average, mid-term evaluations reflect failures in 50% of possible categories, and final evaluations show failures in 38% of possible options. Partnerships (especially around engaging communities themselves), key inputs, scale planning and MEAL are all areas that show marked improvement over the life of the project.
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PROJET PASANGA

À la suite du passage de l’ouragan Matthew, CARE, étant donné sa mission humanitaire, a apporté un ensemble de supports dans les zones touchées à travers plusieurs interventions parmi lesquelles le projet d’Appui à la Sécurité Alimentaire, au Renforcement Agricole et à l’Amélioration Nutritionnelle dans la Grand’Anse (ASARANGA). Implémenté de concert avec ActionAid et Konbit Payizan Grand’Anse (KPGA), le projet ASARANGA avait pour but de contribuer à l’augmentation de la sécurité alimentaire et nutritionnelle des groupes vulnérables affectés par le passage de l’ouragan Matthew dans les communes de Beaumont, Jérémie et Roseaux à travers
quatre axes d’interventions :agriculture, relance économique, nutrition, et gouvernance. Read More...

SANI (Southern Africa Nutrition Initiative)

The Southern Africa Nutrition Initiative (SANI) is a $29,487,135 CAD project to address undernutrition in women of reproductive age (15-49) and children under 5 years in Malawi, Mozambique and Zambia. A partnership between CARE, Cuso International, Interagency Coalition on AIDS and Development (ICAD) and McGill University and the Governments and communities of implementing countries, SANI aimed to improve the nutritional status of women of reproductive age (15-49 years) and children under-5 years old. SANI was designed to align with national health and nutrition strategic priorities of Malawi, Mozambique and Zambia, and has been implemented in close collaboration with the Ministries responsible for Health, Agriculture, and Gender in each country, as well as national and district-level nutrition coordination committees (NCC and DNCC). Between June 2016 and March 2021, SANI contributed directly to the improved health of 234,000 women, children and men directly and over 498,000 individuals indirectly.
This final report covers the implementation period of the original SANI contribution agreement and project implementation plan finalized in February 2017.
Key project achievements:
Outcome 1100 aimed to improve nutrition practices and services for women of reproductive age, boys, and girls under 5 by strengthening the delivery of community-based nutrition services at the intersection between community health and the health system. Growth Monitoring and Promotion (GMP) and Community Management of Acute Malnutrition (CMAM) programs built this link, working on the continuum of prevention of malnutrition and early detection and treatment of moderate and severe acute malnutrition. Training and support on Maternal, Infant, and Young Child Nutrition (MIYCN), CMAM, and GMP was provided to health service workers and community health workers, and Care groups were established to support families to learn about and apply gender-sensitive MIYCN practices. Interactive teaching was also done at scale through participatory education theatre and cooking demonstrations using local nutritious foods. Social Analysis and Action (SAA) dialogues encouraged families involved in the program to identify, discuss, and challenge traditional social norms and practices that affect women’s health, nutrition, and empowerment.
Endline data revealed the following increases in nutrition-specific indicators from baseline:
- All three countries had considerable increases in rates of exclusive breastfeeding of children up to 5 months, increasing by 15-percentage points in Zambia (from 70% to 85%), 25- percentage points in Malawi (from 61% to 86%) and 17-percentage points in Mozambique (from 65% to 82%)
- Minimum Acceptable Diet (MAD) for children 6 to 23 months increased by 24-percentage points for boys and girls in Malawi (from 7% to 31%) and in Zambia by 7-percentage points for boys (from 24% to 31%) and by 13-percentage points for girls (from 17% to 30%)
- Knowledge of men and women on MIYCN practices improved by 6-percentage points for men (from 79% to 85%) and 4 percentage points for women in Malawi (from 90% to 94%), by 12- percentage points among women (from 59% to 71%) in Mozambique, and by 11-percentage points for women (from 81% to 92%) and 14-percentage points for men (from 72% to 86%) in Zambia. Read More...

Collective Impact for Nutrition (CI4N)

The objective of the Collective Impact for Nutrition (CI4N) initiative has been to improve the nutritional status of women aged 15 to 49 and children under 2, through a multisectoral approach and initiatives based on two strategic axes: (1) Alliances for learning and advocacy and (2) community nutrition. [34 pages] Read More...

Cocoa Sustainability Initiative III

The Cocoa Sustainability Initiative phase 3 (CSI III) is a three-year partnership between General Mills Foundation and CARE International that will be implemented over the period December 2020 to November 2023. The project seeks to improve the food and nutrition security of over 3,500 cocoa farmers and their families in 20 communities in the Asikuma-Odoben-Brakwa District in the Central Region of Ghana by promoting sustainable agriculture, climate resilience, inclusive agriculture systems, women’s empowerment and improved nutrition practices. Building on the success of CSI phase I and II, CSI III addresses a range of interconnected issues, from low agricultural productivity and income to gender equality and voice to inclusive governance, child protection, nutrition and climate change resilience. The aim of the study was to provide baseline values for project indicators to help track the progress and impact of the project during and after implementation. Drawing on face-to-face interviews, a mixed method approach with critical gender lens was employed in data collection and analysis. Specifically, data were collected through a household survey (N=225) and Focus Group Discussions with men and women (N=10). A summary of key findings and recommendations are presented below. [71 pages] Read More...

Integrated Humanitarian Assistance Program (IHAP) South and East Darfur

WASH, Health and Nutrition project is supporting the most vulnerable populations in South and East Darfur States. The project aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 443,190 individuals 332,764 individuals in South (including 253,191 IDPs and 79,573 host community members) and 110,426 individuals in East Darfur (including 10,000 IDPs and 100,426 host community members). CARE target IDPs and host communities in both South and East Darfur states by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for affected children under 5 and pregnant and lactating women (PLW). Integrating WASH, Health, and Nutrition activities the project will contribute to saving lives by reducing wasting and stunting levels caused by Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM).

In October 2020, CARE International Vibes Consultancy Services to conduct an end-line evaluation of the project implemented during the period 2019 to 2020 in two States (South and East Darfur) The evaluation is expected to contribute to strengthening accountability of CARE International for its donors and key stakeholders (including beneficiaries), and to learn from this experience to inform future WASH, Health and Nutrition projects. Key evaluation questions have been special focus on project relevancy, efficiency, effectiveness and impact of the project. This report therefore documents key findings of the evaluation as well as lessons learnt and recommendations useful in guiding the implementation of future projects. [44 Pages] Read More...

Final Evaluation Report: Gender-sensitive WASH, Nutrition and Health Support to vulnerable communities in South and East Darfur

CARE has been implementing the WASH ,Health and Nutrition project from which aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 174,504 individuals (87,077 males and 87,427 females) in East Darfur and South Darfur through the GAC-funded 2019-2021 project (“the GAC project”).The program aimed to benefit refugees in camp and out of camp settings, out of camp IDPs and host communities by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for children under five and pregnant and lactating women (PLWs). End line evaluation was conducted for the ended project.

Water: from the survey result it shows that 85.8% responded that their primary source of water is safe throughout the year, compared to the baseline survey which shows that 66% of the respondents still use unsafe drinking water sources.

Sanitary practices: 73.9% of survey participants indicated that they use family toilets for defecation, where in the base line survey show that 34% of the respondents having access to adequate sanitation.

Practice Of Hand Washing: 60.9 % of interviewees (Female: 61.0%, Male: 60.8%) know three critical moments, where in base line survey 65% of the respondents being able to mention at least 3 critical times to perform hand washing.

WASH satisfaction: The end line survey for HHs reported that with WASH regarding relevance, timely and accountability, (75.3%)- (70.6% f,77.9%m) reported that it was relevant

Nutrition: 72.9%% of respondents were satisfied with the nutrition assistance provided.
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McGovern-Dole Food Fore Education Program HATUTAN – Midline Evaluation

The HATUTAN program (Hahán ne’ebé Atu fó Tulun ho Nutrisaun no Edukasaun or Food to Support Nutrition and Education) is a five-year initiative to build a partnership between schools and communities in order to improve literacy, learning, healthy, and nutrition for children and adults in Timor-Leste. The program works in partnership with the Government of Timor-Leste and development stakeholders to address two strategic objectives: improved literacy of school-aged children and increased use of health, nutrition, and dietary practices. The HATUTAN program is funded by the U.S. government through the Foreign Agricultural Service of the United States Department of Agriculture under the McGovern-Dole International Food for Education and Child Nutrition Program. The program is implemented by a consortium led by CARE International with Mercy Corps and WaterAid. The lead Timorese government partner is the Ministry of Education, Youth, and Sports, in collaboration with the Ministry of Health, Ministry of State Administration, and Ministry of Agriculture and Fisheries.

To achieve these objectives, the program supports, among a variety of activities, the Government of Timor-Leste’s school feeding program (SFP) to fully operate in all basic education and preschools throughout the school year. Key project activities include strengthening and supplementing the government-sponsored SFP and building school capacity through trainings for teachers and administrators and provision of resource materials. Additionally, the HATUTAN program seeks to support farmers to boost the production of local produce to increase yields and help create sustainable sources of nutritious food for local schools. In addition to activities related to literacy and SFPs, HATUTAN seeks to conduct trainings related to nutrition, health, and other topics, and to promote gender equality and the reduction of gender-based violence.

This report presents the midline evaluation of the HATUTAN program, which began in early 2019. It is important to note that restrictions due to the COVID-19 pandemic have had a substantial impact on program activities and target outputs and outcomes. In March 2020, HATUTAN field activities were halted, field offices were temporarily closed, and staff began to work from home due to a State of Emergency issued by the Government of Timor-Leste. This State of Emergency remains in effect to date, with varying levels of restriction on school activities, movement, and group gatherings. As a result, the HATUTAN program is behind schedule in terms of some major deliverables due to COVID-19. Read More...

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