Circles of Change in Shondaland

Did you catch Cohort 2 Alum, Iman El-Mahdi, in Shondaland? ( the pioneering storytelling company behind many television series including “Grey’s Anatomy” and “Scandal”) Congrats to Circles of Change on the amazing attention you’re bringing to CARE’s work!  Read the story here:  https://www.shondaland.com/act/a21239255/timesup-metoo-and-the-global-movement-for-womens-rights/ 

 

Inspiring films tell the story of frontline health workers in Bihar

We’re excited to see new resources from the Bihar team!

A collaborative storytelling project from Bihar

Two  short and powerful films document the  Bihar Technical Support Program,   a  partnership between CARE the Bill & Melinda Gates Foundation, and the Government of Bihar to improve the quality of care and health system in Bihar, India. Through two films you will be inspired by the story of Manju Devi,  a frontline health worker in Bihar, working to save lives by delivering maternal and child health care in her village; and  in  the  second film you will be transported to  Bihar to  learn how CARE and the Government of Bihar are reducing rates of maternal, newborn, and child mortality and malnutrition, and improving reproductive health  services statewide. Watch the films here: bihar.care.org

Innovation  Briefs: Bihar Innovations

New briefs highlight five innovations being taken to scale in Bihar, India and beyond, Including Team-based Goals and Incentives. CARE has developed and implemented a package of evidence-based, quality innovations that seek to address the various issues which impede access to high-quality services in Bihar. The implementation of these innovations have resulted in successful outcomes and improvement in the health system – so significant that the Government of Bihar began to scale several of the innovations to all 38 districts in the state,  and some of the innovations are scaling nationally.  Find all five briefs at bihar.care.org.

Click here to read the Team-Based Goals and Incentives brief

New results for the Community Scorecard!

Congrats to the Community Scorecard team on their new journal article in BMC Health Services Research! Frontline Health Workers Coalition Blog published a quick review of the results:

“CARE’s theory of change  posits that the empowerment of community members and frontline health

A group of people in Malawi meet to discuss the state of health services in their community, using CARE’s Community Score Card© approach. © 2015 CARE

workers—where they feel comfortable advocating for their rights—plus the creation of space for power-holders, health workers, and community members to talk and interact in a safe, supportive, and equitable environment, leads to improved health outcomes. To test this, a research team conducted an evaluation in Malawi to analyze the effect of the CSC on a set of governance measures, including trust in health workers, power sharing, mutual responsibility, and collective efficacy.

The team found significant relationships between those who actively used the scorecard and perceptions of equity and quality of their discussions. They also found positive relationships with governance measures of actions resulting from the process, such as joint monitoring and transparency, collective action, and availability of community help.

“Active participation in the CSC ensures a safe, inclusive space to voice concerns and work together to improve health services and outcomes,” explained Sara Gullo, lead author of the article.

CARE Malawi’s Thumbiko Msiska agrees. “CSC enhances engagement of various stakeholders, especially rights-holders, and brings their perspectives into the conversations, clarifying expectations and promoting ownership.”

Read the full post by CARE staffer, April Houston here:

https://www.frontlinehealthworkers.org/blog/social-accountability-and-frontline-health-workers-can-help-us-realize-right-health

And the published paper here:  https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3651-3 

Chomoka launches this month!

The Chomoka team (Cohort 1) reached an important milestone this month with the onboarding of VSLA groups to start using the smartphone application for their weekly meetings. The team has been working diligently with the developers to test the application and fix bugs to create a stable version of the application that can be rolled out to a wider audience of groups. The team has 100 groups who have pre-registered for Chomoka in the Dar es Salaam area who will start using the application in the coming weeks and months. While the process has taken longer than the team hoped, they were determined to get the product right, using lean experimentation and human-centered design, so that customers have a positive first experience with Chomoka and word of mouth in communities drives demand. The team has 10 Chomoka Agents who have been trained and will be leading the on-boarding of the application with targeted VSLA groups from now into the new year. Check out how the app functions below! (The narration is in Swahili but the screen by screen navigation is in English!)

 

Young Mens Initiative: Engaging Men and Boys in the Fight for Gender Equality

Thanks to CARE Action Network for the shoutout to Cohort 1 team, Young Men’s Initiative!

How Young Men Can Change Gender Norms and Support Women and Girls

Engaging men and boys with the Young Men Initiative and CARE
6/15/18

Women’s economic empowerment sustainably lifts women, families and entire communities out of poverty — but only when men get with the program, too. Men and boys have a crucial role to play in achieving gender equality by reversing deeply entrenched norms, traditions and behaviors that for too long have limited women’s opportunities and trapped families in poverty.

Programs like the Young Men Initiative are working to do just that by changing rigid masculine norms, preventing violence against women and promoting gender equality during critical stages of adolescent development.

But how much do they really alter men’s attitudes and communities’ social norms? According to Besnik Leka, CARE’s project coordinator for the Young Men Initiative in the Balkans, “It’s still early days, but we’ve seen reductions in gender-based and interpersonal violence by 25 to 30 percent and big changes in divisions of household labor.”

“One mother called us to ask, ‘What are you teaching my sons? They came home and helped with cleaning. They’re setting the table.’ We tell parents, this is what they’re supposed to do. This is how we change family dynamics.” This is how we change social norms.

Engaging men and boys in gender-based violence

Gender Inequity in the Balkans

An estimated one in three women globally will experience gender-based violence in her lifetime, which includes rape, sexual harassment, assault, domestic violence and other forms of violence that devastates people’s physical, mental and emotional health and perpetuates broader structural inequalities and cycles of poverty.

Surveys conducted in Serbia and Croatia reveal how big the problem is in the region:

  • 60 percent of young men reported having made sexual comments or having touched girls without their consent
  • 18.8 percent of young men say there are situations in which women deserve to be beaten
  • More than two-thirds of adolescents aged 16-19 reported experiencing violent behavior from their partner; about halfsaid they’d been violent towards their partner
  • 65 percent of men reported having been slapped or spanked as children, while 16 percent of men reported witnessing violence by a man against their mothers

Surveys also revealed however, that some traditional attitudes are becoming more liberal:

Engaging Men and Boys

Besnik Leka of CARE's Young Men Initiative Leka is CARE’s project coordinator for the Young Men Initiative in the Balkans. “This is a very patriarchal society with a lot of violence, especially gender-based violence, but at Young Men Initiative, we also address the interpersonal violence young men experience so they understand that patriarchy harms everyone,” Leka said. “We say that, as much as feminism needs men, men need feminism, because feminism saves men from violence too.”

The Young Men Initiative and CARE sponsor gender equality training workshops as part of the curriculums at traditionally male-dominated vocational and technical schools.  “Young men face tremendous challenges but they’re also capable of tremendous growth,” Leka said. The trainings make men and boys aware of how patriarchy can harm them. Leka added that being the sole breadwinner puts a great deal of pressure on men, and that it’s better when everyone contributes to the family, including with household labor. “As more opportunities open up for women to engage in the economy we have to encourage more men to share care of the family,” he said.

While feminism has existed for decades, Leka explained that there hasn’t been much initiative for men to change. “Statistically, men cause most gender-based violence, yet women are asked to empower themselves while simultaneously being discriminated against by men and societies.”

Part of the problem, Leka says, is that men aren’t taught how to change. “It’s taboo for men to talk about certain things, like their problems and emotions. When we actually start talking with men though, about how blocking their emotions leads to stress and violence that harms them as well as women, they’re very receptive. It’s a real eye-opener to learn that young men have high suicide rates here.”  Leka will ask boys and men to rate their emotions from ones they express more freely to ones the express with more difficulty. Most admit they express anger freely, but they’re afraid to show fear.

“As they work through our program, they learn that beauty comes with sharing emotions, even if they’re afraid of unmasking themselves.”

Financial and social inclusion in the Balkans

Social and Economic Inclusion

The Young Men Initiative and Leka also address women’s social and economic inclusion by working to change inheritance attitudes and laws. “Not many women inherit what their parents build. Usually it is given to the son. Even when a woman does inherit something, culturally, she’s expected to give it to her brother. She’s told that a ‘good sister’ doesn’t take stuff from her brother,” Leka explained. The problem, however, is it’s not just about the tangible inheritance. It’s about women’s economic potential.

“In Kosovo,” he explains, “all business and growth is based on banks and loans, but to get a loan, you need collateral. Men can own or inherit cars, houses and land so it’s easy for them to get loans. Without collateral though, women can’t get loans so they’re eliminated from opportunities to start or grow businesses.” Young Men Initiative is helping young men and their families understand the impact of economic progress that takes place when daughters can share inheritances. Simultaneously, CARE is working to change inheritance laws to include children of both genders.

CARE has worked in the Balkan region (Kosovo, Serbia, Albania, Croatia and Bosnia Herzegovina) since 1992, helping war-affected people develop sustainable livelihoods. Currently, CARE’s programing in the region focuses on two key areas – gender equality and social and economic inclusion.   

Innovation, Partnership, and Self-Reliance: Health Policy Lessons from India’s Bihar State

We’re excited that our team from Bihar (Cohort 1) will be at the CSIS Global Health Policy Center for a half-day conference examining the lessons learned from the Bihar Technical Support Program and its implications for U.S. foreign policy and assistance programs.

Wednesday, December 19, 2018 9:00 am – 1:30 pm
CSIS Headquarters

Click here to register for the online webcast 

Bihar State is the third largest in India with a population of 110 million, which would make it the 12th largest in the world if it was its own country.  Bihar has some of the highest rates of maternal, neonatal, and infant mortality in India, as well as malnutrition, stunting, and high fertility.  These issues are exacerbated by extreme poverty, early marriage, gender and social inequality, and low literacy rates.  The Bihar Technical Support Program, funded by the Bill & Melinda Gates Foundation and implemented by CARE, was founded to address these challenges with the goal of boosting capacity and self-reliance.  The program covers all 534 blocks in 38 districts of Bihar and involves at least 400 public sector hospitals and 200,000 frontline workers.

The Bihar Technical Support Program offers many lessons learned about innovative program design to meet a variety of critical health challenges in a large population, as well as for purposefully building capacity with the intent to transition support at a designated end date.  With self-reliance and country ownership on the Washington foreign policy community’s minds with USAID Administrator Mark Green’s strategic transitions agenda and proposals for significant reductions in U.S. foreign assistance spending, the Bihar program offers important lessons for broader health and development programs.

The conference runs from 9am – 1:30pm.  Conference Agenda:

Welcome Remarks
Sara M. Allinder
Executive Director and Senior Fellow
CSIS Global Health Policy Center

Introductory Remarks
Sushil Kumar Modi
Deputy Chief Minister, Government of Bihar

Panel I: Overview of the Bihar Technical Support Program and Achievements from the Partnership

Panelists:
Usha Kiran
India Country Lead, State Health and Community Systems
Bill & Melinda Gates Foundation

Mangal Pandey
Health Minister, Government of Bihar

Hemant Shah
Chief of Party
Bihar Technical Support Program

Moderator:
Heather Higginbottom
Chief Operating Officer
CARE

Panel II: The Role of Data and Innovation

Panelists:
Sanjay Kumar
Principal Health Secretary, Government of Bihar

Kenney Ng
Manager, Health Analytics Research Group
IBM

Macon Phillips
Chief Digital Officer
CARE

Moderator:
Sara M. Allinder
Executive Director and Senior Fellow
CSIS Global Health Policy Center

Panel III: Policy Implications of BTSP

Panelists:
Gary Darmstadt
Associate Dean for Maternal and Child Health
Stanford University School of Medicine

Kerry Pelzman
Deputy Assistant Administrator, Bureau for Global Health
USAID

Moderator:
J. Stephen Morrison
Senior Vice President and Director
CSIS Global Health Policy Center

This event is made possible through generous support from CARE.