Sexual|Reproductive Health

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...

Our Best Shot: Frontline Health Workers and COVID-19 Vaccines

Fully realizing the social and economic benefits of halting COVID-19 requires investing in a fast and fair global rollout of COVID-19 vaccines. CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5.00 in delivering the vaccine.

Investments in frontline health workers are a critical component in this comprehensive vaccination cost. Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.

Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.

Current global debates are focused so narrowly on equitable access to for vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all—and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.

As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives—are the only way to end this threat. No one is safe until everyone is safe.
Read More...

Support for Service Delivery Integration- Services (SSDI-Services) Endline

SSDI-Services was the flagship project for USAID/Malawi’s health office. The project was implemented from November 8, 2011 to March 7, 2017 under a cooperative agreement, valued at USD 89 million. Active project implementation occurred over a 4.5-year period from April 2012 to December 2016, with the preceding and following months focused on startup and closeout activities respectively.

SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.

SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...

ENDLINE EVALUATION COVER PAGE Adolescent Empowerment Project (AEP) IN KAJIADO & MUKURU

CARE implemented the Adolescent Empowerment Project (AEP) in Kenya, funded through the Patsy Collins Trust Fund Initiative from 2015 to 2020. The project aimed to empower adolescent girls and boys from chronically insecure households to fully exploit their potential, take advantage of opportunities, and fulfil their aspirations. Over a 5-year implementation period, the project targeted adolescents (aged 10-19) in urban Mukuru (within Nairobi county) and rural Kajiado county with a suite of activities and services delivered through partners Hope Worldwide Kenya (HWWK) and Neighbors Initiative Alliance (NIA). Inputs were designed to expand life choices and empower participants to become engaged citizens and include activities on leadership skills development, adolescent sexual and reproductive health (ARSH), economic empowerment, ICT skills, and quality education.
This report is 70 pages long. Read More...

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