USAID Mikolo: Our Impact

{Photo Credit: Samy Rakotoniaina}Lynda Razafiharilalao, a Malagasy community health volunteer, shows various modules of the mHealth app to a fellow volunteer.Photo Credit: Samy Rakotoniaina

In rural areas of Madagascar, community health volunteers (CHVs) are instrumental in improving maternal and child health services. Their activities include raising awareness on healthy behaviors, child growth monitoring, family planning counseling and services, and treatment of simple illnesses, such as pneumonia, diarrhea, and malaria. As CHVs are part of Madagascar’s health system, their activity reports feed into the national health information system.

{Photo Credit: MSH}Community members discuss plague response.Photo Credit: MSH

Bubonic plague is endemic in Madagascar. Typically, the country experiences 400 to 600 cases of the disease each year. However, in 2017 the plague also took the pneumonic form. Between August 1 and November 26 there were 2,417 confirmed, probable, and suspected cases of plague, according to the World Health Organization (WHO). More than three-quarters of the cases were clinically classified as pneumonic.

 {Photo courtesy of Sherri Haas}MSH staff at the Global Digital Health Forum 2017.Photo courtesy of Sherri Haas

Management Sciences for Health’s work across the digital health spectrum was shared at the Global Digital Health Forum 2017 (GDHF 2017) in Washington, D.C. December 4-6, 2017. The GDHF is the premier global conference on the use of digital technology for health in low- and middle-income countries. MSH is an Advisory Board Member of the Global Digital Health Network and contributed substantially to development of the conference. The theme this year was The Evolving Digital Health Landscape: Progress, Achievements, and Remaining Frontier.

{Photo Credit: Samy Rakotoniaina}Photo Credit: Samy Rakotoniaina

The entire population of Madagascar is at risk for malaria, and severe malaria is among the top five causes of death in the country, especially among young children, for whom the disease is a major killer of Malagasy children under five years of age. In this age group the national mortality rate is 7 percent, though this rate varies throughout Madagascar’s 22 regions; ranging from less than 1 percent in the central highlands to almost 11 percent in the coastal regions.

Fanamamy Retsilaky receives a prize from the Ministry of Public Health for his contribution to the fight against malaria.Photo Credit: Samy Rakotoniaina.

Madagascar has seen a strong upsurge in malaria cases over the past two years, particularly in the southwest, despite the Ministry of Public Health (MOPH)’s eradication efforts. Malaria-carrying mosquitoes seem almost invincible despite the use of insecticide-treated bed nets and indoor spraying. As a result, communities have become more engaged in prevention activities in order to protect themselves from the deadly disease.

 {Photo Credit: Leonard Razafimandimby/AIM}Herilalaina with his healthy 4-month old childPhoto Credit: Leonard Razafimandimby/AIM

In remote communities of Madagascar, the distribution of chlorhexidine, an antiseptic and disinfectant, by community health volunteers (CHVs) is a major innovation that greatly contributes to the reduction of child mortality. This umbilical ointment prevents deadly infections and eases the healing process.

 {Photo credit: MSH staff}Harivelo, a community health volunteer, counsels a young woman on family planning options after her pregnancy test turned out negative.Photo credit: MSH staff

Vololona Razafimanantsaranirina Harivelo has been a community health volunteer (CHV) in the northeastern Malagasy village of Vohitsoa for more than five years. She has impacted the lives of more than 500 people in her community, providing maternal and child health services, including family planning.

{The daughter of a community health volunteer with her newborn.} Photo Credit: Sara Holtz/MSHThe daughter of a community health volunteer with her newborn.

   John Yanulis is program director of the USAID Mikolo project, which is reducing maternal, infant and child morbidity and mortality across nine regions in Madagascar. Funded in 2013, the project provides increased access to and improved quality of community-based primary health care services. Through community health volunteers trained in reproductive health and family planning, the project has reached more than 108,000 women who were not previously using family planning methods, and provided over 83,000 couple years protection.

{Photo credit: Fanja Saholiarisoa/MSH}Photo credit: Fanja Saholiarisoa/MSH

The US Agency for International Development (USAID) Mikolo Project is a five-year project led by Management Sciences for Health (MSH) focused on reducing maternal, infant, and child mortality in some of Madagascar’s hardest to reach communities by increasing access to community-based primary health care services and encouraging women of reproductive age to adopt healthy behaviors for themselves and their children. One of Mikolo’s key efforts is to offer Malagasy women the option to use modern contraceptive methods. 

{Photo credit: Sara Holtz}Photo credit: Sara Holtz

A recent outbreak has prompted the USAID Mikolo Project, led by MSH, to actively engage in the global fight to eradicate polio in Madagascar. Eight new cases of acute flaccid paralysis, the most common sign of acute polio, were reported between April and May of this year.

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