Care Uganda: ROCO KWO – Transforming Lives of Women Affected by Conflict Rose Amulen, Tilman...
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DIME – FRAGILE STATES DUBAI, MAY 31 – JUNE 4 Care Uganda: ROCO KWO – Transforming Lives of Women Affected by Conflict Rose Amulen, Tilman Brück, Veronica Eragu, Pia Peeters and Aki Stavrou
Care Uganda: ROCO KWO – Transforming Lives of Women Affected by Conflict Rose Amulen, Tilman Brück, Veronica Eragu, Pia Peeters and Aki Stavrou
Care Uganda: ROCO KWO Transforming Lives of Women Affected by
Conflict Rose Amulen, Tilman Brck, Veronica Eragu, Pia Peeters and
Aki Stavrou
Slide 3
Opportunity (WHY?) Conceptually: Lack of evidence of which
approaches to address psychological distress/trauma are effective
for survivors of Sexual and Gender Based Violence (SGBV) and other
conflict-affected populations. Operationally: Care Uganda is
starting a 15-year program of activities to help most vulnerable
war affected women, including victims of SGBV in Northern Uganda.
This evaluation offers an opportunity to improve programming in
Northern Uganda at the start of a long-term program and also to
inform other programs in similar settings in other countries.
Slide 4
Project description Care Uganda is starting a 15-year program
Aims to further development of vulnerable women in post-conflict
Northern Uganda Intervention will offer economic and psychosocial
support through a variety of measures at the individual, household,
group and community levels.
Slide 5
Strategies : Promoting womens empowerment Womens vulnerability
to rights denial and abuse- closely linked to the level of economic
and social power (H/h, community level) Promote a shift in the
power relations that cause women to suffer low social status/
systematic injustice Addressing the psychosocial needs of the
community over 20 years of conflict. Associated abuses, trauma,
frustrations and vulnerability to- severe psychiatric symptoms,
substance abuse, gynecological complaints, HIV/AIDS infection, low
self-esteem, suicidal tendencies, stigmatization, dehumanizing
consequences of war. Psychosocial support will be provided through
community structures, referrals to other key service providers
including health, justice and security Support envisaged to create
social change, build self esteem, reduce PSS burden, strengthen
coping mechanism.
Slide 6
Research questions Objectives of the impact evaluation To
generate evidence-based learning on impact of psychosocial
assistance / counseling on functionality and well being (aspects
include mental, social, physical and economic) for women survivors
of war- related GBV / vulnerable women and their family members
impacted by conflict. What are the questions? 1. What type of
psycho-social/counseling support works best? (individual, family
counseling, group counseling, women support groups, combination) 2.
How does psycho-social/counseling help vulnerable women? 3. Does
psycho-social/counseling work better when combined with livelihood
support?
Slide 7
Indicators Indicators of well-being subjective well-being (life
satisfaction etc) objective measures of well-being (assets, food
security, mental health indicators etc) Indicators of functionality
(behavior patterns) measures of economic and social activities Both
at the individual and family/ household levels for example the
well-being of children
Slide 8
Identification strategy Eligibility and selection rules 4
districts in Acholi sub-region in Northern Uganda in there choose
16 vulnerable sub-counties in there choose 80 vulnerable villages
in there choose 4800 vulnerable women add another 4800 women in
years 2 and 3 each i.e. no random selection, no
representativeness
Slide 9
Ethical considerations Ethical considerations: 1. Evaluation
will exclude the most traumatized women (in acute need of medical
care &/or referral to specialized services). 2. No village or
woman will be deferred treatment in the interests of the
evaluation. 3. Program delivery mechanisms and content will not be
altered in the interests of the evaluation. 4. Selection not
randomised treatment & control subjects chosen specifically
because of traumatic experience.
Slide 10
Sampling considerations Client (Treatment )Group: No of
villages &respondents within villages to be decided after
timing, capacity & budgets resolved. Selection of clients to be
staggered over villages selected for Program Intervention in Years
1 & 2. Control group 5 options: Additional Villages Future
Villages Extra Participants Alternative Mechanisms Combination
Approach
Slide 11
Rapid Vulnerability Survey (RVS) A RVS will be administered to
both treatment and control groups. In control groups where program
intervention is phased into future delivery or not available, low-
risk trauma identification criteria will be used. Identification
criteria will be used to rank and match clients and control group
women into possible generic sub-categories. If severely or
high-risk traumatised survivors identifies in RVS in control
groups, they will be immediately offered counselling and
support.
Slide 12
Control Group Option A Additional Villages (to Program
Intervention Villages): Chosen that are completely distinct &
independent from those participating in the program. Ideally not
having any other like or otherwise development program being
delivered during IE timeline. Will be identified in a similar
process as defined under eligibility program villages. Should have
similar characteristics on average to the program villages (i.e. be
similarly vulnerable) RVS to fine-tune. Conceptually, this is the
most powerful approach. Ethical considerations re: not providing
services to vulnerable women. Cost considerations.
Slide 13
Control Group Option B Future Program Intervention Villages:
Use phasing-in feature of the project to identify control groups.
Draw from villages scheduled for late 2 nd & 3 rd year wave of
the program. Will administer RVS for baseline - ask potentially
high-risk traumatizing questions later on (just before the
intervention) as these will be long-term recall issues.
Slide 14
Control Group Option C Extra Participants within Program
Intervention Villages: Increase sample of vulnerable women for the
same villages. Permits the marginal impact of expanding the project
in each village to be determined. 2 variant approaches: 1.Ask group
selection committee to extend the vulnerability group beyond the 60
most vulnerable women selected for treatment by a further 60 and
who will comprise the control group. 2.Through RVS to be conducted
to a random sample of non-client women (post client selection),
calculate a vulnerability score to determine a sample of women who
are similar to the client women selected by the participatory
approach, to whom the RSV also administered.
Slide 15
Control Group Option C (cont) Ethical considerations of not
providing full-treatment to control group. Basic treatment would be
extended. Cost implications of extending basic treatment in each
sample village. Disadvantage is that this approach will not capture
the spillover effects of the program within a village (i.e. the
evaluation will underestimate the effect of the intervention).
Slide 16
Control Group Option D Alternative Mechanisms (Differentiated
Program Delivery to Program Intervention Villages): The program
could pre-determine which types of trauma counseling &
livelihoods support (if any) will be made available to each of the
villages. Multiple combinations of different treatments,
implementation processes and mechanisms could be tested. Advantage
is - this requires less surveying than any other approach.
Disadvantage is - will not be able to identify the basic effects of
the program. (if different measures have positive but similar
effects, then in a comparison of these measures one would hardly
detect a significant difference.) Does involve altering project
design
Slide 17
Control Group Option E Combination Approach Strong case for
adopting some or all of these measures in combination. Advantage:
each approach permits a different type of analysis. Allow for
differentiated learning on the program Complementarity will enable
a more complete picture overall.
Slide 18
Timeline Finalize draft impact evaluation concept note (July
2010) Workshop with CARE to finalize Impact Evaluation design
(September 2010) Initiate baseline survey (November 2010,
tentatively) Take it from there
Slide 19
Impact evaluation team CARE staff (Care Uganda and Care
Austria, Rose, program director, CARE director, M&E officer,
program staff at the field level) World Bank (DC based staff and
Kampala based staff, Pia, Aki, Veronica) DIME: Tilman and his team,
field based coordinator