Objectives

Sustainable reduction of infant and child mortality by focusing on two approaches: family sensitization through mass awareness activities and support to a Community Health Volunteer network, able to prescribe essential medicines to young children at the village level.

Combining these 2 approaches has proven effective in reducing under 5 mortality rates by 50%, from around 150 deaths for 1.000 children to 70 per 1.000 in just a few years.

Intervention areas

• Manakara District (since 2002)
• Farafangana District (since 2008)
• Vohipeno District (since 2018)

The project is implemented in the South East of Madagascar and targets a total population of around 800.000 people, mostly farer families. In these often isolated areas, sanitary conditions are deplorable and enable the spread of infectious diseases responsible for high infant and child mortality rates: malaria, diarrhoea and acute respiratory infections. Healthcare access is hindered by the long distances that families have to cover on foot to reach a health centre (up to 25 kilometres) and by chronic deficiencies of the underused healthcare system (staff absenteeism, drug stock outs, etc.).

Activities

• Conduct mass awareness sessions and practical workshops for the general population, including caretakers of young children, on the topic of malaria, diarrhoea and healthcare seeking practices when a child is showing symptoms. These sensitization activities aim at improving prevention practices (bed net usage, hand washing, prompt consultation for sick children at the health centre or community health volunteer, etc.)
• Train and monitor 1 400 Community Health Volunteers in order for them to diagnose and manage the most common and dangerous disease in children, as per the national health policy (malaria, diarrhea and pneumonia)
• Conduct large scale mortality and behaviour surveys to confirm the impact of the project
• Transfer the management and supply of the Community Health Volunteers to local health authorities in order to sustain the program

Partners

• Health institutions: rural health centres, and District Health Services
• Local authorities
• Community Health Volunteers