Five Years of Health Impact, 10 Stories of Success

We are pleased to share this booklet that summarizes 10 of the best stories we’ve collected from the field. These narratives are a legacy to Madagascar’s health system and for future public health interventions in the country. They show how USAID transforms lives by working hand in hand with the Ministry of Public Health to strengthen community resilience and to enhance the quality of primary health care services in rural communities. These are the stories of individuals, of unsung heroes, that have gone above and beyond what is called for in their normal day-to-day lives to have an even greater impact on the health of their communities. These are the faces that have catalyzed community health into a foundational platform upon which the entire health system can be built to achieve the Ministry of Health’s goals of reducing maternal and child morbidity and mortality nationwide.

These individuals were instrumental in the USAID Mikolo Project’s success in increasing access to and availability of community-based primary health care, especially for women of reproductive age, children under age five, and infants living in remote areas in Madagascar. Implemented by Management Sciences for Health (MSH), with partners Action Socio-sanitaire Organisation Secours, Catholic Relief Services, Institut Technologique de l’Education et du Management, Dimagi, and Overseas Strategic Consulting, Ltd., the project was aligned with Madagascar’s national community health policy and specifically focused on reproductive health; family planning; maternal, newborn, and child health; and malaria prevention and care. The five-year project directly served an estimated 4.6 million people who live more than five kilometers from a health facility among 506 communes in 42 districts within 8 regions of Madagascar.

The USAID Mikolo Project supported the Ministry of Public Health by training and supporting 7,591 community health volunteers (CHVs) and mobilizing communities to strengthen the continuum of care. The community-based delivery of the service package offered by CHVs is endorsed by the World Health Organization and has been shown to be an effective way to address shortages of human resources without compromising the quality of care.

This booklet will tell you the stories of community-based savings and loans groups that brought accessible financial solutions to thousands of households; the tales of frontline community health volunteers who saved many lives in remote villages; and the chronicles of mothers and babies who benefited from our innovative approaches. We all want a stronger health system in Madagascar, and we truly hope that this booklet will inspire you to make this goal a reality.