JSI RESOURCES: Publications

Madagascar Technical Brief – Community-Based Programs Effectively Address Child Health and Nutrition Priorities in Madagascar


A child under five (CU5) can progress from uncomplicated to severe illness within a few hours. In Madagascar, malaria, diarrhea, pneumonia, and underlying malnutrition are among the leading causes of illness and death. The country has seen reductions in child deaths, from 93 to 51 deaths per 1,000 live births during the period 2003 to 2019. Infant deaths have decreased from 60 to 37 deaths per 1,000 live births during the same period. The delivery of quality child health services faces several challenges in Madagascar, including geographic access to health care, weak supply chains, poverty, and the low number of qualified medical and health personnel available to a growing population. Moreover, approximately 40 percent of Madagascar’s population live five or more kilometers from a health center.

To overcome these challenges and address the gaps in health service provision for vulnerable CU5, Madagascar’s MOPH has prioritized community-based health service delivery for CU5 close to their homes through the use of community health volunteers (CHV) selected by community members, and trained and supervised by the local health center. Madagascar’s community-based Integrated Management of Childhood Illness (c-IMCI) provides health prevention and treatment services for CU5 close to the homes of remote and economically vulnerable populations. The extension of health service delivery to the community level through CHVs has increased population access to quality services, notably for vulnerable groups.

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