WE-Care Malawi Programme Report: Linking unpaid care work and mobile value-added services in Malawi | Randomized Controlled Trial

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Malawi was one of the six countries in which Oxfam's Women's Economic Empowerment and Care (WE-Care) programme was implemented. In its first phase (2014–2016), WE-Care aimed to build evidence to influence policy and practice change around the issue of unpaid care work. In Malawi, three research methodologies were used, including qualitative participatory research and quantitative methods to generate a strong evidence base for awareness raising and policy advocacy at the national and global levels. The programme was designed to be closely linked with the GSM Association’s mNutrition programme, which is a three-year multi-country programme, of which Oxfam is part. This report describes the use of information and communications technologies for data gathering, analysis and implementation of a randomized control trial. This aimed to understand the impact that access to mNutrition (mAgri and mHealth) services had on the allocation of time to unpaid care work.
  12   WE-CARE MALAWI PROGRAMME REPORT Linking unpaid care work and mobile value-added services in Malawi Alvaro Valverde – Private Sector Adviser (ICTs) we-carewomen’seconomicempowermentand care    LINKING UNPAID CARE WORK AND MOBILE VALUE-ADDED SERVICES IN MALAWI  3 Table of contents Executive summary 51. Introduction and background 7 1.1 Introduction 71.2 Oxfam’s WE-Care Programme 71.2.1 Defining unpaid care work and simultaneous activities 71.2.2 Introduction to the programme 71.2.3 Care change strategies 71.2.4 Components of the WE-Care programme 81.2.5 Key cross-country findings of the programme 81.2.6 The WE-Care programme in Malawi 91.2.7 Linking WE-Care and mNutrition 10 2. Rapid Care Analysis 12 2.1 RCA methodology 122.2 RCA findings 122.3 Who does what work? 142.4 Gender and age distribution for care work 162.5 Age implications of who does more care work 162.6 Negative and positive norms and perceptions in care work 162.7 Seasonal changes in care work 172.8 Most problematic care work 172.9 Developing options and solutions 182.10 RCA conclusions 19 3. Household Care Survey 20 3.1 HCS – RCT baseline 203.2 HCS findings 203.3 Implications of the unequal distribution of care work between genders 24 4. Randomized Control Trial – design, implementation and results 25 4.1 RCT design 254.1.1 Research questions 254.1.2 Hypotheses 254.1.3 Objectives 264.1.4 Study site and populations 264.1.5 Study design 264.1.6 Subject selection 264.1.7 Subject recruitment 264.1.8 Trial interventions 274.2 RCT implementation 284.2.1 RCT steering committee 284.2.2 RCT monitoring, quality control and assurance 284.2.3 Issues encountered during implementation of the RCT 294.3 RCT findings 294.3.1 Care work, income-generating activities and sleep hours 304.3.2 Time constraints, care work and personal care 304.3.3 Relevance and uniqueness of the treatment messages 324.3.4 Behavioural change 324.3.5 Gender-based violence 344.3.6 Implications for mNutrition 34 5. Conclusions 366. Recommendations 37  4   Executive summary LINKING UNPAID CARE WORK AND MOBILE VALUE-ADDED SERVICES IN MALAWI Acronyms and abbreviations BMJ  British Medical Journal CABI  Centre for Agriculture and Bioscience International CADECOM  Catholic Development Commission in Malawi CI  Confidence interval CSO  Civil society organization FGD  Focus group discussion GAIN  Global Alliance for Improved Nutrition GBV  Gender-based violence GCP  Global content partner GSM Global System for Mobile Communications (a trademark) GSMA  GSM Association H0  Null hypothesis HA  Alternative hypothesis HCS  Household Care Survey HNI  Human Network International ICT  Information and communications technology IFPRI  International Food Policy Research Institute ILRI  International Livestock Research Institute IVR  Interactive voice response LCP  Local content partner mAgri  Mobile Agriculture mHealth  Mobile Health MNO  Mobile network operator mNutrition  Mobile Nutrition Programme RCA  Rapid Care Analysis RCT  Randomized Control Trial SMS  Short Message Service TA  Traditional authority WE-Care  Women’s Economic Empowerment and Care
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