Diarrheal diseases are the third leading cause of death for children under 5 years of age in Madagascar. To address this public health threat, the country applied to Gavi, the Vaccine Alliance, and received approval to introduce rotavirus vaccine, which was launched in May 2014. This vaccine, in addition to the PCV-10 vaccine (introduced in Madagascar in 2012), presents a significant step forward for the country in addressing child morbidity and mortality since the political crisis that began in 2009.
While diarrhea prevention and control activities were not directly integrated with the rotavirus vaccine introduction, Madagascar does have a strategy for diarrhea and pneumonia prevention and for community engagement that includes the “Champion Community” approach, within which the rotavirus and PCV introductions are now linked. This approach includes components such as:
- An EPI training module for health workers that includes a chapter on the different methods for preventing diarrhea, including the rotavirus vaccine, hand washing and use of latrines;
- During the national and regional launches for the rotavirus vaccine, sensitizations were conducted on hand washing;
- During community dialogue sessions before introducing the rotavirus vaccine, discussion included the causes of infant and child mortality due to diarrhea and methods for prevention such as the vaccine, hand washing, and using latrines.
In addition, integration of the rotavirus and PCV vaccines with the broader prevention and control of diarrhea and respiratory illnesses was discussed during a Civil Service Organization (CSO) workshop held in September 2014, with recommendations developed during that workshop for CSOs and the MOH to further link these interventions, including with HSS support for strengthening routine immunization. JSI, 2016.