Improving umbilical cord care by setting an example in Madagascar

 {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.

Child mortality remains an important challenge for community health in Madagascar, with a rate of 50 mortalities per 1,000 live births. Remote populations lack access to basic health care; they may only rely on services provided by CHVs. In this context, many families still use traditional methods, such as covering the baby’s navel with a piece of cloth soaked in alcohol.

Herilalaina Livarison lives in the commune of Andakatanikely and is one of the nearly 6,700 CHVs supported by the USAID-funded Mikolo project, implemented by MSH. Since the project trained him on preventing child infections, Livarison regularly educates women of childbearing age on his community activities package. He provides chlorhexidine on request at a price of Ariary 1,000 (about US $0.31). This antiseptic is used right after childbirth at the health center.

“Future mothers do not always realize the dangers associated with babies’ navels exposed to bacteria. During door-to-door sensitizations, I also recommend that they regularly go to the nearest health center for antenatal care consultations, and I teach them how to spot danger signs,” said Livarison.

More than 4,500 newborn babies have received this innovative umbilical care in the USAID Mikolo project’s intervention areas since October 2015. Livarison’s child is one of those healthy babies, as this committed CHV wanted to set an example and raise awareness among his community.

“The remaining stump of Princia’s umbilical cord completely healed in only 20 days. I think it was much faster compared to other cases, thanks to this antiseptic ointment,” he said.

The relatively high price of this product constrains low-income families’ access to it. However, the close collaboration with heads of health centers to recommend chlorhexidine has noticeably increased the use of the antiseptic ointment right after delivery.