Madagascar

Basic Support for Institutionalizing Child Survival (BASICS)

1999–2009

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As a technical assistance partner for newborn and child health to the USAID Bureau for Global Health, the Basic Support for Institutionalizing Child Survival (BASICS) Project develops and implements strategies to reduce preventable infant and childhood deaths in the developing world. MSH works as a partner in BASICS, which began its third phase in October 2004. Under this indefinite quantity contract (IQC), BASICS assists USAID/Washington Bureaus, USAID field missions, host-country governments, donor agencies, NGOs, PVOs, research institutions, and the private sector to scale up and increase the use of newborn and child health and nutrition interventions by families, communities, and health systems.

Since 1993, BASICS has worked to achieve substantial improvements in coverage and to expand effective newborn and child health interventions. BASICS focus areas include newborn health, essential nutrition actions like vitamin A supplementation, immunization, integrated management of childhood illness, treatment of diarrhea and pneumonia, and malaria control. In addition to strengthening the delivery of basic newborn and child health services, BASICS has expanded its technical scope to include pediatric HIV & AIDS, birth spacing, and child survival and nutrition in complex humanitarian crises. BASICS areas of expertise include assistance to countries on comprehensive strategies or selected interventions for newborn and child health, building partnerships, delivery of quality newborn and child health services, community-based treatment and private sector approaches to expand access to services, and capacity building and training.

Rational Pharmaceutical Management Plus Program

2000–2008

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RPM Plus works in more than 40 developing countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program works to improve the availability and use of quality medicines, supplies, and basic medical equipment in the public and private sectors and to promote practical, sustainable changes in pharmaceuticals management by developing capacity within cooperating countries and fostering collaboration between countries.

Malaria is a major cause of morbidity and mortality in Madagascar. In efforts to reduce the public health impact of malaria and with RPM Plus technical assistance, Madagascar has recently adopted intermittent preventive treatment for the prevention of malaria during pregnancy as a key component of its national malaria strategy, and changed the first-line malaria treatment to be consistent with current WHO recommendations (artemisinin-based combination therapy).

In partnership with the USAID Malaria Action Coalition (MAC), RPM Plus provided technical assistance to the Madagascar Ministry of Health to quantify the antimalarial drug requirements for use in case management and in prevention of malaria during pregnancy. RPM Plus and the MAC are also supporting Madagascar’s Ministry of Health to develop and roll out an integrated pharmacovigilance system to monitor adverse drug reactions.

Advance Africa

2002–2004

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Advance Africa was a family planning/reproductive health service delivery project designed to increase access to and improve the quality of clinical and nonclinical programs in sub-Saharan Africa. The project worked to increase capacity for informed decision-making by clients and communities, and for the public sector to sustain quality family planning/reproductive health service delivery programs. Advance Africa also worked with USAID missions to scale up existing efforts by closing gaps in service delivery, and building partnerships among public and private health and nonhealth organizations. The project implemented innovative approaches to revitalize family planning programs within the broad context of Africa’s HIV/AIDS pandemic. MSH was the prime of a consortium of six international organizations that managed implementation of the Advance Africa project.

Advance Africa was commissioned to develop a comprehensive report of Madagascar's Family Health Program and its successful mobilization of communities. To identify successes a documentation team led by BASICS II and Advance Africa, conducted strategic mapping activities to cover reproductive health issues. Various implementing agencies played key roles in planning the activity and educating the documentation team about the evolution of Madagascar's program. The documentation team found that significant progress had been made in immunization coverage, breastfeeding, contraceptive prevalence, vitamin A supplementation, and care seeking for childhood illnesses. The final report was designed to facilitate the transfer of lessons learned to other programs and countries.

Madagascar Population Support Project (APPROPOP)

1993–1998

As part of the USAID/Madagascar health and nutrition support program, APPROPOP developed family planning services, increased contraceptive prevalence and brought population growth to a level consistent with Madagascar's socioeconomic objectives and resources with the goal of achieving "smaller, healthier families." Interventions included establishing national norms and standards for family planning services; implementing a grants program; enhancing the national family planning information system; developing an information, education, and communication strategy; and providing training in clinical family planning, financial management, supervision, management, and training of trainers for hundreds of senior health managers and service providers. Through these efforts APPROPOP helped to increase the contraceptive prevalence rate (CPR) from 3.5 percent to 9.7% nationally – an overall increase of 177% over the 5 year project life. Increases in mostly rural Fianarantsoa Province were even more dramatic (from 1.3% to 5.1% over the same period - a nearly three-fold increase). Several of the most innovative features of the project were the establishment of family planning services in the workplace, the introduction of non-scalpel vasectomies, and expanded access to long-term methods, development of a popular radio series on health issues, and integration of family planning services with environmental action programs.

Strengthening Pharmaceutical Systems (SPS) Program

2007–2012

Strengthening Pharmaceutical Systems is a follow-on to the Rational Pharmaceutical Management (RPM) Plus Program. MSH is pleased to announce that the US Agency for International Development has awarded us the Strengthening Pharmaceutical Systems (SPS) Leader with Associates Cooperative Agreement. SPS will focus on four key results:

• Improve governance in the pharmaceutical sector
• Strengthen pharmaceutical management systems to support public health services
• Contain the emergence and spread of antimicrobial resistance
• Expand access to and improved use of essential medicines

The five-year, $147.5 million cooperative agreement is led by Dr. Douglas Keene as Program Director and Dr. Maria Miralles as Deputy Director.

To help meet goals relating to the key result areas, the SPS Program is building on the successes of RPM Plus while expanding the range of technical areas to include financing, pharmacovigilance, pharmaceutical care, integration of new health technologies, and increased use of the private sector, among others. MSH will accomplish this enhanced program of activities by collaborating with a number of new partner organizations.

The SPS core partner team includes:

• BroadReach Healthcare
• Ecumenical Pharmaceutical Network
• The Lewin Group
• LMI Government Consulting
• University of Washington Department of Global Health
• WHO Collaborating Center in Pharmaceutical Policy: Harvard University/Boston University

In addition to the core team, MSH is joined by a select group of organizations that will serve as specialized resources for SPS. These organizations include:

• African Medical and Research Foundation
• American Society of Health-System Pharmacists
• Euro Health Group
• Infectious Disease Institute at Makerere University
• Joint Commission International
• London School of Hygiene and Tropical Medicine

As we work toward the overall goal of SPS, the SPS team is striving to advance the science and "art" of strengthening pharmaceutical management systems. The SPS Program provides a great opportunity for MSH and USAID to continue supporting developing countries in their quest to increase access to essential medicines and facilitate the scale up of vital treatment programs.