Overview

Through a total market approach, the USAID-funded Improving Market Partnerships and Access to Commodities Together (IMPACT) program helped build Madagascar’s capacity to deliver quality health products to the Malagasy people. We worked with the government to strengthen its supply chain and increase cost efficiency while enabling the health system to harness private-sector contributions, including those from retail pharmaceutical outlets. 

Led by Population Services International (PSI) with MSH, PATH, Banyan Global, and the Telma Foundation as partners, IMPACT worked with the USAID-funded, MSH-led ACCESS program to strengthen the health system and achieve sustainable health impacts. This six-year (2018–2024) cooperative agreement helped increase access to and use of effective health products by enhancing coordination among the public, nonprofit, and commercial sectors for reliable supply and distribution of quality health products; strengthening the capacity of the government of Madagascar to sustainably provide quality health products; expanding the engagement of the commercial health sector to serve new health markets according to health needs and consumer demand; improving the sustainability of social marketing to deliver affordable, accessible health products; and increasing demand for and use of health products among the Malagasy people, including piloting an accredited drug sellers initiative.

Throughout its six years of implementation, the IMPACT program:

• Improved pharmaceutical management practices: The program adapted and implemented the MSH Supervision, Performance Assessment, and Recognition Strategy (SPARS) approach across 78 district wholesale pharmacies, which uses a combination of staff training and performance reviews to improve the skillset of the health workforce and strengthen supply chain management.
• Prevented stock-outs of essential medications: By prioritizing quantification activities, the program ensured no stock-outs of malaria-related medicines and commodities between 2021 and 2023 despite supply chain challenges caused by the pandemic.
• Promoted regulatory systems strengthening: Between 2019 and 2023, the program facilitated efforts to clear a backlog of over 1,700 applications for medicine marketing authorization and helped reduce the processing time of marketing authorization applications from 2 years to 6 months, ensuring the safety and effectiveness of medicines and allowing them to be more readily available to patients.
• Enhanced data-driven decision-making: The program helped logistics and procurement management staff better utilize data from End-Use Verification surveys that monitor the availability of health care commodities, preventing stock-outs of rapid diagnostic test kits.