About CARE International

CARE International is a global confederation of 14 National Members, 6 Candidates and 1 Affiliate with a common mission and vision to save lives, defeat poverty and achieve social justice. CARE works to tackle the underlying causes of poverty by responding to humanitarian crises and strengthening gender equality, building on their 75 years of experience in humanitarian action. In 2020, CARE and partners helped more than 33.8 million people to support women’s rights to sexual, reproductive and maternal health. CARE also works with communities to help them to prepare and plan for emergencies, bringing together development and humanitarian programmes to support resilient communities to be ready, anticipate and adapt to shocks, manage growing risks and address underlying causes of vulnerability. Gender is at the heart of CARE’s work. CARE’s programs aim to meet the different needs of women, men, girls and boys and contribute to the longer-term goal of achieving gender equality through the use of gender transformative approaches that seek to empower women and girls and engage men and boys.

CARE International in action

The protracted crisis in South Sudan has left more than two-thirds of the host population and approximately 300 000 refugees and asylum seekers in South Sudan in need of some form of humanitarian assistance due to years of conflict, deteriorating economic conditions and unprecedented flooding (2021 South Sudan Humanitarian Response Plan). These crises have been compounded by the COVID-19 pandemic and has required significant support from partners to support key areas of the health response. CARE international is supporting the COVID-19 response in four counties of South Sudan with very different needs.

Coverage for refugees

In the north, CARE is working in Pariang county, where the estimated 140 000 refugees and 80 000 host community members are at high risk for COVID-19. The Pariang hospital has, to date, recorded one of the highest case positivity rates, regularly registering above 10% while the rest of the country averages around 1%. CARE international supports seven health facilities in Pariang and works closely with UNCHR to ensure that refugees at nearby camps and settlements can access CARE health services. CARE also supports with Risk Communication and Community Engagement (RCCE) activities, point-of-entry screening around the Nuba mountains, surveillance, and contributes to governmental laboratory capacity.

CARE’s experience over the last year in Pariang has positioned them well to contribute to the COVID-19 vaccination microplan. One of the points that they have advocated for heavily in the Pariang context is to ensure that there is sufficient time and funding available to prepare the community in advance of receiving the vaccine delivery. Based on experiences in Juba in March of this year, CARE is advocating for more RCCE activities to address rumours with the community to reduce hesitancy and fear of vaccination. Additionally, CARE has noted the lack of personnel to continue with routine vaccination, so they are advocating that in Pariang, COVID-19 vaccination should not be integrated with other vaccination efforts, instead arguing it should be funded separately to ensure success of both routine and COVID-19 vaccination campaigns. CARE is currently supporting RCCE activities in areas where vaccine distribution has begun and has seen initial, positive uptake by community members.    

Last mile delivery

In Boma State, CARE contributed to the microplan, by building off their experience on acute watery diarrhea (AWD) outbreaks in the area. Last year, an AWD outbreak among a population living close to the border with Ethiopia spread quickly due to the area becoming in-accessible during the rainy season. Of the 50 000 people in the plan, only about one-fifth are close enough to the main town hospital, while most of the population lives over 10 kilometres from the nearest hospital. In addition to the flooding creating difficulty to physically reach the populations, growing insecurity due to inter-communal conflicts create further challenges to delivering COVID-19 vaccines to these last mile locations. Across South Sudan, only about 30% of the population lives within five kilometres of a health facility, so in areas such as Boma State, CARE has advocated that microplans prioritize also primary health facilities including mobile health units, in addition to larger hospitals. 

Barriers to gender equity

In Wau county of Western Bahr Ghazel State, CARE conducted a rapid gender analysis to understand how COVID-19 has impacted women and how the vaccination strategy can be improved to promote gender equity. The study found that COVID-19 lockdowns led to many women and girls losing their ability to gain an independent income from male family members, increases in cases of GBV at household level and increases in teenage pregnancies linked to school closures. They also are more likely to be responsible for care of children and sick community members, including providing COVID-19 home-based care. The lack of spending money to pay for travel to health care facilities and the increased care responsibilities preventing women from having the time available to walk to very distant hospitals may be behind the worrying trend that over 70% of those vaccinated to date are men. CARE advocates that microplans prioritize distribution of the vaccine in rural areas as a measure to increase equitable access to vaccines among women. 

At the global level, CARE is calling for investments in training, equipping and supporting frontline health workers – particularly women - so that they can continue to administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. WHO estimates that while women make up 70% of the global health workforce, they only occupy 25% of leadership roles, as such CARE is advocating that women frontline health workers have meaningful roles in shaping vaccine roll-out. CARE also recognizes need to protect the 3.5 million semi-formal and informal health workers who serve patients at the last mile of delivery, and encourages the donor community to invest in health systems’ readiness to distribute vaccines equitably, including hard-to-reach populations.

Operating across South Sudan

CARE has been operating in the now independent South Sudan since the 1970s, working in health, nutrition, food security, livelihoods, women’s economic empowerment,  protection (including gender-based violence prevention and response), gender and peace building. “CARE is an active partner making important contributions to meet humanitarian health needs in South Sudan” shared Dr Mukesh Prajapati, South Sudan Health Cluster Coordinator, adding “which is why the health cluster supported them for inclusion in the country funding mechanism for the humanitarian health response.” CARE’s approach in building resilience in fragile settings is to put women and girls at the centre, by promoting gender equality. The signing of the Comprehensive Peace Agreement in 2005 allowed CARE to expand into Jonglei and Upper Nile States to support returnees from the refugee camps.

Related Links

Global Health Cluster