Assuring the Quality of Community-Based Health Services in Madagascar—a New Approach

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The USAID Mikolo Project created a new approach to assure, improve, and sustain the quality of community-based health services.This technical brief describes the Mikolo approach and assesses its impact on community health volunteer performance between 2014 and 2016.

The USAID Mikolo Project quality assurance / quality improvement approach included ve key activities:

  1. Formal training or refresher training every year
  2. On-the-job coaching and mentorship once every two months
  3. Monthly performance monitoring and group supervision at the health facility 
  4. Standards-based competency evaluation every quarter 
  5. Annual certication or re-certication every eight months
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