USAID Mikolo: Our Impact

{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.

{Photo credit: MSH}USAID Mikolo recently recognized 10 community health volunteers for completing their training in the use of pregnancy test kits.Photo credit: MSH

4,000 Madagascar Community Health Volunteers Learning to Use Pregnancy Test Kits Although more married women in Madagascar are using modern contraceptives than ever before, their use among this group has stabilized at about 30 percent. In response, the USAID Mikolo Project is training 4,000 community health volunteers (CHVs) how to use pregnancy test kits—a pioneering strategy to help expand family planning in remote areas.

 {Photo credit: Fanja Saholiarisoa/MSH}Community health worker, Celestine Razanabao, receiving a couple for family planning counselling in Manandriana village, Madagascar.Photo credit: Fanja Saholiarisoa/MSH

Although the remote village of Manandriana in southern Madagascar is six kilometers from the nearest health center, the local population’s health has improved in recent years because of community volunteers like 50-year-old Celestine Razanabao.  

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

Malnutrition is an underlying cause of 45 percent of deaths in children under the age of five worldwide and leaves 165 million children stunted, compromising cognitive development and physical capabilities. Chronically malnourished children are, on average, nearly 20 percent less literate than those who have a nutritious diet. Thus, malnutrition can shape a society's long-term health, stability, and prosperity.

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