Madagascar Community-Based Integrated Health Program (CBIHP -also called MAHEFA)

Dates: 2011-2016

Country: Madagascar

Client(s): USAID

Services: Technical Assistance, Assessment, Monitoring, Evaluation, and Research, Program Development, Training, Quality Assurance and Improvement

Technical Expertise: Health Supply Chain Management, Maternal Health, Research, Monitoring, and Evaluation, Nutrition, Newborn and Child Health , Environmental Health, Family Planning & Reproductive Health, Social and Behavior Change Communication, Health Care Waste Management, Health Service Delivery, Health Systems Strengthening, Immunization, Infectious Diseases

Madagascar, the fourth largest island in the world, is also one of the world's poorest countries. 80% of the population lives in rural areas with difficult access to most services. In Madagascar, as in many other countries, the remote communities living in poverty are the most vulnerable segment of society. The availability of health services is extremely limited, leading to high rates of infant, child, and maternal mortality. In addition, 65% of the population does not have access to safe drinking water and sanitation.

The USAID-funded Madagascar Community-Based Integrated Health Project (CBIHP), known locally as MAHEFA, is a five-year health program that is providing basic, quality health care to isolated populations in six north and northwestern regions of Madagascar (DIANA, SAVA, Sofia, Menabe, Boeny and Melaky). The program’s overarching goal is to increase the use of proven, community-based interventions and essential products among underserved populations of Madagascar. Activities focus on improving access to and use of an integrated package of maternal, newborn, and child health services, family planning, and improving safe water, hygiene, and sanitation. The program is known for innovative solutions to reaching remote communities, documented improvements in community health, and collaborative work with local NGOs, the Malagasy Ministry of Health, civil society organizations, and community leaders.

With the support of MAHEFA, community health workers provide a package of services, including counseling, referrals, treatment, and demand generation in the following areas:

Maternal, newborn, and child health;
Family planning/reproductive health, including prevention of sexually-transmitted infections;
Water, hygiene, and sanitation;
Prevention and treatment of malaria; and

Through MAHEFA, over 5,000 community health workers (CHWs) in the target areas are trained, equipped and supported to provide services in all of MAHEFA’s intervention areas. The increase in quality services at the community level will result in reduction of neonatal and child health morbidity and mortality.

It is MAHEFA’s vision that by May 2016 when the project ends, all communities in MAHEFA’s regions will effectively participate in improving health. Community support institutions will support community workers in building healthy behaviors and improving access to water, sanitation, and hygiene at home. Progress in maternal, newborn and child health will be measurable and sustainable, and communities will have access to quailty health care provided by the community health workers (CHWs) who have been trained, equipped, and supported by MAHEFA. Most villages will have increased access to safe drinking water and improved sanitation access.

JSI is the lead implementing organization and has two main implementing partners: The Manoff Group and Transaid. In addition, JSI works with and through a network of talented partners including small and large NGOs, private sector groups, social marketing organizations, and community partners.

In 2013 and 2014, new work in support of GAVI objectives was launched. One project, providing technical assistance to support the introduction of new vaccines including HPV and rotavirus, expands JSI's earlier work in strengthening routine immunization systems throughout the island. In addition, JSI brings it's quantitative research experience and immunization/epidemiological perspective to the GAVI Health Systems Strengthening evaluation, working closely with local research partners.

Watch USAID/Madagascar's 30th anniversary video which features MAHEFA's work


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