Water, Sanitation, and Hygiene

How Can Approaches that Achieve Gender Equality Help Advance all the SDGs: Impact Evaluations Evidence from CARE Programs

Approaches that achieve gender equality, that move beyond the individual level to address greater interpersonal, socio-cultural, and community factors that influence gender attitudes and behaviors, have been shown by rigorous impact evaluations to be impactful in promoting gender-equitable attitudes (e.g., SASA! Program in Uganda), reducing gender-based violence (e.g., Stepping Stones and Creating Futures program in South Africa), and decreasing social acceptance of intimate partner violence (e.g., RESPECT program in Tanzania).
Key Findings Summary:
What are the Impacts of Approaches that Achieve Gender Equality?
• Empowerment of women and girls: 8 out of 8 programs have positive impacts on increasing women’s and girls’ self-efficacy, mobility, sexual and reproductive agency, egalitarian gender attitudes, and economic situations; 5 out of 8 programs have positive impacts on reducing early marriage rates and intimate partner violence (IPV), and increasing women’s intrahousehold decision-making power; 6 out of 8 programs have positive impacts on changing community traditional gender norms and increasing women’s community leadership.
• Increased impact on other SDGs, such as poverty reduction (SDG 1), food security (SDG 2), health (SDG 2), education (SDG 4), access to clean water and sanitation (SDG 6), decent work (SDG 8), and reduced inequalities (SDG 10).
How Did These Changes Happen?
• Village Savings and Loan Associations (VSLAs).
• Active engagement of men and boys, community members and leaders.
• Couples’ curriculum and gender dialogues.
• Community-level social norms intervention: Social analysis and action (SAA)
• Life skills and financial management training. Read More...

Línea de Base: Proyecto “Higiene, Agua y Saneamiento en La Habana y Pinar del Rio”(Spanish)

This Baseline Report provides an overview of the "Hygiene, Water, and Sanitation in Havana and Pinar del Rio" project, implemented by CARE Cuba in collaboration with local partners. The project focuses on improving access to safe water for two isolated rural communities (El Vallecito and Valle San Juan) that rely on contaminated local wells and inadequate water storage systems. It addresses water-related health risks and promotes menstrual health by introducing menstrual cups to women and menstruating individuals. The baseline data will serve as a reference for measuring project outcomes aimed at reaching 256 people and 250 women.

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Final Report: Enhanced Humanitarian Response in Choma, Kalomo and Monze Districts in the Southern Province of Zambia

The water and sanitation activities benefited 7,859 people (2579 people, more than planned target) who use safe water in greater quantities and reduce the incidence of disease including awareness about better protection from gender-based violence. Of these people, 5654 people benefited from cash assistance to meet some basic needs. Some beneficiaries invested the money in purchasing agricultural inputs, small livestock and upgrading shelter to increase crop yields and improve food and nutrition security as well as decent shelter. In total, 14,574 people were reached and accessed information thereby contributing to disease prevention and improved hygiene practices. CARE assigned 3 staff and supported 4 DMMU enumerators who participated in conducting the vulnerability assessment and producing the 2023 national contingency plan. The plan informs the design of government and NGO interventions in response to disasters. Read More...

Integrated Health, WASH and FSL Assistance to Conflict-affected, Displaced, and Vulnerable Households in Amran governorate, Yemen

CARE Yemen has completed implementing CDCS-supported “Integrated Health, WASH and FSL Assistance to conflict-affected, displaced and vulnerable households in Amran governorate, Yemen”. The purpose of this program is to improve health, WASH, food security, livelihoods, and wellbeing for IDPs and vulnerable host communities in Amran Governorate in Yemen.

To set benchmark values for the outcome level indicators and to measure the success of the project in achieving its goals and objectives, a baseline and endline surveys was conducted in the project’s operational targeted areas. The endline survey was conducted with samples of targeted beneficiary households living in Raydah district of Amran Governorate in August 2023. The survey mainly used quantitative methodology (i.e., household survey) to collect pertinent data.

Here are the key survey outcomes:
1. Coping Strategy Index: The average CSI score for the surveyed HHs 9.96 (male: 10.03, female: 9.85), which is indicating that participants are relatively experiencing significant resilience and recovering from using negative food coping strategies.
Food Consumption Score: The average FCS for the targeted HHs is 54.65 (male: 54.81, female: 54.41). In addition, 89.93% are in acceptable food consumption.

2. Household Dietary Diversity Score: The average HDDS for the targeted household is 6.7 which indicated that surveyed HHs is somehow adequate dietary diversity. This denotes a good medium quality of diet whereby households consume an average of around 7 food groups out of the recommended twelve food groups.

3. HHS (Household Hunger Scale): The analysis of the endline data shows that only 2.16% of households faced moderate hunger; whereas 0.0% of households faced severe hunger during the survey time.

4. Access to safe water: about 74.3% of interviewees (male: 78.6%, female: 64.3%) mentioned to have access to safe water from protected water sources such as piped water system and protected wells.

5. Time taken to collect water: Majority of respondents 91.4% replied that the water is “Available inside the house” from the primary source which have been rehabilitated by CARE.

6. Practice of water treatment: 84.3% of respondents (male: 89.8%, female: 71.4%) mentioned treating water before drinking mainly using respectively the techniques of boiling, treated from pipeline, filters, Aqua-tabs, and Chlorine.

7. Availability of household latrines: The majority 98.6% of respondents (male: 98.0%, female: 100.0%) mentioned that they do have household latrines.

8. Practice of handwashing: approximately 87.9% of respondents (male: 86.7%, female: 90.5%) wash their hands at least three out of five critical times of hand washing.
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WASH lifesaving assistance and protection services to the conflict affected IDPs and host communities in selected districts of Taiz governorate of Yemen

CARE Yemen is currently implementing ‘WASH lifesaving assistance and protection services to the conflict affected IDPs and host communities in selected districts of Taiz governorate of Yemen.

The principal objective of the project is ‘Rural and urban communities affected by the ongoing conflict and disaster have received life-saving assistance (for immediate needs) and improved foundation to their sustainable livelihood and resilience whereas the specific objective of the project is ‘Targeted IDP and host community households have improved access to comprehensive WASH and Protection services strengthening their resilience.

The project’s key results are:
• Result (1) Conflict affected households have enhanced access to safe water and improved hygiene practices through comprehensive WASH assistance.
• Result (2) Improved access of the most at-risk women, men, girls and boys to critical information and specialized protection services for their protection.

In order to measure the success of the project in achieving its goals and objectives, a baseline survey was conducted 396 households’ visits in Al Mudhaffar, AlQahirah, Salh and Al Maafer Districts of Taiz Governorate, this endline report can provide a critical reference point for assessing changes and impact, as it establishes a basis for comparing the situation before and after an intervention.
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Hunga Tonga- Hunga Ha’apai Disaster Response Program End of Program Evaluation Evaluation Report

This Evaluation Report presents the end of program evaluation (the evaluation) of the Hunga Tonga-Hunga Ha’apai Disaster Response Program (the program), implemented in partnership by CARE Australia, MORDI TT and Talitha Project (the partnership). The evaluation was conducted between July- November 2023 by Iris Low and Leaine Robinson (Collaborate Consulting Pte. Ltd (CoLAB)); Katrina Fatiaki (Tapuaki Mei Langi Consultancy) and Dr. Rev. 'Ungatea Kata and Ofa Pakalani (Tupou Tertiary Institute). The evaluation focused on evaluating the merit and worth of the program implemented by the partners by identifying the achievements of the program, strengths of the partnership modality to build on, and lessons to inform and improve future humanitarian programming.

Based on what stakeholders define as high quality humanitarian response, the evaluation finds that majority of communities, staff, and stakeholders interviewed stated that the assistance provided by CARE, MORDI TT and Talitha Project represents a high-quality humanitarian response as it met affected communities immediate needs (water, agriculture, hygiene kits), reached those in the community who needed assistance the most, was led by local organisations who coordinated and worked with existing national processes and systems in Tonga and who will continue to remain engaged in communities post-disaster to support communities to recover.
Impact: What difference did the program make?
The program has made an impact and positive difference to affected communities in helping to address their immediate needs and quality of living and recovery in the aftermath of the volcano and tsunami disaster. The targeted assistance has contributed to communities improved access to clean drinking water and their knowledge and skills on how to maintain Water, Sanitation and Hygiene (WASH) infrastructure; enhanced food security in communities through more options for healthy eating from the community gardens, helping communities to recover quickly, and increased livelihoods for women who sell the surplus produce; motivated communities to work together so that they are better prepared for future disasters and supported different groups (women, young people, adolescent girls, elderly and persons with disabilities) in the community. The program reached 20,182 people (5,593 women; 4,524 girls; 5,149 men and 4,916 boys) across the affected areas of Tongatapu, ‘Eua and Ha’apai, with material and technical support to restore community rainwater collection systems, a significant impact in the aftermath of the disaster which left communities without access to clean drinking water. Read More...

SELAM 1 Early Recovery and Socio-Economic Stability in Tigray: FPI MONITORING REPORT

In June 2023, Altai Consulting, the Third-Party Monitor (TPM) for the EU FPI, was tasked by the Nairobi Regional Team (RT) to research and
communicate the progress and impact on the ground of the project NDICI CRISIS FPI/2021/427-921 – “SELAM 1 Early Recovery and Socio-Economic Stability in Tigray”, implemented by CARE and REST.

The project is implemented in Tigray as part of a cluster of projects alongside CST and MdM projects also montiroed by Altai during this visit. These interventions focus on responding to Tigray’s post-war challenges, mostly related to livelihoods support, access to health services, and trauma healing.

The monitoring team looked to capture progress towards the project’s intended objectives at the mid-stage of its implementation. During an earlier monitoring conducted in December 2022, the Altai team found that progress had stalled due to security challenges on the ground but that the projects were gaining momentum due to the peace agreement signed in November 2022. Read More...

Midline (monsoon flood) and baseline (flsh flood) study of SUFAL-!! project

The baseline study concerning the impact of flash floods and lightning on the SUFAL-II project aims to analyze the context of flash floods and lightning, assess the scopes of the Early Warning System, and examine current trends of hazard-specific responses taken by individual, community, and institutional levels. The objective of this project is to bolster the capabilities of vulnerable communities and institutions in Bangladesh to implement forecast-based early actions. The study employed a mixed-method approach, amalgamating both quantitative and qualitative data collection and analysis techniques. This was done to assess the context, accessibility, usage, and potential of early warning systems and early actions for mitigating the risks associated with flash floods and lightning hazards.
The study encompassed three districts prone to flash floods, namely Sylhet, Sunamganj, and Netrokona. For treatment group areas the selected Upazilas were Gowainghat, Dharmapasha, and Khaliajuri and for control group areas the selected areas were Sylhet Sadar, Sunamganj Sadar, Madan.
Data was collected from 502 households, 12 focus group discussions, and 19 key informant interviews. The study's findings indicate that flash floods and lightning are recurrent and severe hazards that pose significant threats to the communities' lives, assets, and livelihoods. These hazards disproportionately affect women, individuals with disabilities, and farmers. The study also identified several shortcomings in the existing early warning systems, including issues related to timeliness, quality, coverage, accessibility, comprehension, and trust.
The study further investigated the current and potential early actions that can be undertaken by communities and institutions to alleviate the impact of flash floods and lightning. These actions include seeking safe shelter, securing assets and livestock, and implementing strategies to cope with shocks and stress. Most significantly, there are no functional early warning systems in the targeted areas.
A total of 90.00% of the respondents from the treatment group and 50.80% of respondents from the control group areas said they were affected by flash floods within the previous three years. On the other hand, 69.30% of the respondents of treatment group and 50.80% of the respondents of control group areas admitted that their community members were affected by lightning in the past two years. Moreover, 74.40% of respondents of treatment group areas and 58.30% respondents of control group areas said that loss of human lives or major injury occurred due to lightning. Notably, Highest 81.90% of the respondents from both group areas said they did not get any early warning information regarding floods. FGD with respondents discovered that there is no functional early warning system in their areas for flash floods. Sometimes they got warnings through loudspeaker announcements when nearby areas got affected by the flood. In the case of lightning, 92.80% of the respondents from both group areas said they didn’t get any early warning information. Though there isn`t any early warning system for lightning, some respondents said in FGD that they occasionally identify symptoms by evaluating the cloud and notifying each other of the possibility of lightning which is considered as early warning for them. The respondents from both treatment and control group areas shared their opinions about different types of early warnings they received for different natural disasters. The highest 38.20% and 18.80% of the respondents received early warning (supposed to situation update) through television broadcasts from treatment and control group areas. The respondents from the treatment group and control group areas usually don’t get any functional early warnings. Hence, they consider flood situation updates and weather updates as early warnings. A total of 16.70% of the respondents admit that they won’t understand the early warning information due to language barriers, or technical jargon. From the treatment group areas, 61.50% of the respondents shared that due to a lack of clear instructions on severity and impact of the hazards, they won’t understand the warnings. Interestingly, a total of 17.90% of the respondents from both treatment and control group areas admitted some traditional beliefs and superstition might generate distrust against the early warnings. Read More...

START Network Alert 630 Tuvalu (Drought)-Learning Grant Water and Hygiene Assessment Findings Report

In July 2022, the Government of Tuvalu declared a State of Emergency due to worsening drought conditions across the country. The northern islands were severely impacted, particularly Niutao, where local actors had to turn to distributing bottled water in response to a critical undersupply of household water for drinking and general purposes.
This survey was completed as part of a grant under the START learning initiative, and the main purpose was to conduct a water and hygiene focused needs assessment for drought-affected populations on the three northern islands of Nanumea, Nanumanga and Niutao, with a particular focus on gender and inclusion. The northern islands can be difficult to reach and are often not included in research projects for this reason. Conducting a needs assessment provides data that national and local actors can use to inform ongoing drought response efforts, particularly around longer-term, equitable access to water, as well as assisting in better planning and delivery in future responses. The number of people surveyed was 258, representing 22% of the total population aged 13 and over (although a few 12 year olds were included). A survey conducted in October 2022 by the Tuvalu National Disaster Management Office provided a starting point for the START learning grant exercise.
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Australian NGO Cooperation Program (ANCP) Meta-Review of Evaluations

This report presents the findings of a review of the evaluations of seven programs funded by DFAT through the ANCP and implemented by CARE (Australia and respective country partners).
The purpose is to identify and summarise lessons learned, areas for development and examples of good practice that will inform CARE Australia’s implementation of its new theory of change. The review is intended for both internal and external audiences, including DFAT. Read More...

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