Changing the definition of accessible: ensuring health supplies are available during the rainy aeason in Madagascar

Victorine is the supply point coordinator in the remote village of Namakia in Madagascar’s Boeny Region. She is responsible for ensuring that community health workers (CHWs) in her designated area (commune) have the medical supplies that they need to serve their clients. However, Victorine normally becomes concerned as the rainy season approaches. Roads may become impassable, and she questions whether she will be able to provide the CHWs in her commune with the medical supplies they would need in the coming months. One of the greatest challenges faced by CHWs is the potential breakdown in the supply chain, which they rely on for their essential medicines. Though they may receive adequate training and supervision, without these supplies, CHWs are not able to function at full capacity.

However, with the support of the USAID-funded MAHEFA Program, implemented in Madagascar by John Snow, Inc., Victorine will be able to ensure that the CHWs she works with are properly supplied during the rainy season.

In addition to distributing these provisions by road before the heavy annual rains and flooding, the MAHEFA program and its partner HoverAid launched an innovative new strategy to ensure continued delivery when the roads become impassable. MAHEFA will ensure year-round availability of essential health commodities by using a hovercraft to access supply points in even the most isolated communities. HoverAid is aims to contract with private sector businesses that will use the craft for commercial product distribution, subsidizing the routes for health product distribution. The goal is for the private sector to cover all the fixed costs of basing a hovercraft in the region and for health care deliveries to be provided at fuel price only, which will help to ensure the sustainability of the approach.

“The hovercraft was a great idea for transporting health commodities because road transport, during the rainy season, can be very difficult in this area”, said Felana Andriamirina, a representative of AJPP, an NGO partner of MAHEFA working in Mitsinjo District. “Normally there is a shortage of health commodities during the rainy season. The hovercraft will change this.”

Previously, the accepted norm was that supply point coordinators like Victorine would not have been able to receive commodities during the 4-5 month rainy season when the paths and roads are flooded. Thanks to MAHEFA’s new partnership with HoverAid, and supplies from PSI, the supply point coordinators will receive commodities year round. Victorine is now confident that she will be able to provide the community health workers with the essential medical supplies they need to diagnose and treat childhood malaria, diarrhea and pneumonia, plus products for family planning and water purification. As Andriamirina states, “There are many NGOs in Madagascar that make big promises but do not follow through. This is especially true in hard to reach areas or during the rainy season. Not MAHEFA. They have found a way to overcome this using a hovercraft.”