JSI is currently the implementing partner in Madagascar for the DMPA-SC Access Collaborative Project, working to ensure the successful scale-up of the self-injectable contraceptive, DMPA-SC. JSI is also implementing the USAID-funded bilateral project, Mahefa Miraka in Madagascar, working in seven remote regions to strengthen the local public health system’s capacity to manage community health activities and support community health volunteers.
In Madagascar, community health volunteers can provide injectables, including DMPA-SC, along with a number of other short-term methods. In support of national scale-up, Mahefa Miaraka has facilitated the largest portion of trainings of DMPA-SC. In 2018, Mahefa Miaraka worked in 34 (of the 114) districts to train 4,753 community health volunteers (CHVs) as well as 554 public sector facility-based providers who train and supervise these CHVs.
Under the CHAI Madagascar Catalytic Opportunity Fund (COF) project, JSI supports the Ministry of Health (MOH) to complete the training of trainers outlined in the MOH’s training plan. Specifically, JSI is training all 56 previously-trained master trainers in DMPA-SC self-injection (22 from the regional level and 34 from Mahefa Miaraka-supported districts). These trainers have been previously trained in provider-administered DMPA-SC, DMPA-IM and NXT. JSI will also train the remaining 80 district master trainers on provider-administered DMPA-SC, self-injected DMPA-SC, DMPA-IM, and NXT. This will complete all master training nationally.
JSI is also evaluating the feasibility of using a low-cost training mechanism to facilitate DMPA-SC scale-up among injection-experienced providers. This methodology includes a brief orientation guided by the DMPA-SC job aid and a post-orientation supervision visit. JSI will explore and document how this approach was used in 2018 in Madagascar. JSI will then utilize the findings of this assessment to design and evaluate a small-scale pilot on the use of job aids as a training mechanism for injection-experienced providers. The pilot will take place in four districts, targeting 25 providers in each district.