For many people in Madagascar, the USAID-funded Community-Based Integrated Health Program, locally known as MAHEFA, means increased access to improved health services. MAHEFA is also helping people make positive changes in their communities. Outlined below are some of the many people who benefit from and work with the MAHEFA program.
I have at least 20 grandchildren and so many great-grandchildren that I’ve stopped counting,” says 80-year-old Augustine Kalisy. “I am happy to know that they no longer have to travel more than 15 kilometers to get water from the river, like my generation had to, now that we have a well built by MAHEFA. ”
“My children and grandchildren have had cleaner water and fewer problems with diarrhea. When they do have diarrhea, they can now be treated by our community health volunteer (CHV).”
I am happy to know that they no longer have to travel more than 15 kilometers to get water from the river, like my generation had to, now that we have a well built by MAHEFA.”
The Listening Group Moderator
Helene Nako is a moderator for the listening group in her fokontany. Equipped with her radio, Helene leads weekly collective listening groups for members of her community. Developed by the MAHEFA program, these broadcasts cover health topics including maternal and child health, family planning, nutrition, WASH, and gender, and discuss how people can change health-related behavior for the better.
An elementary school teacher and a mother of six, Helene loves helping people. “I think I must have it in my blood — I really enjoy sharing what I know and helping other people grow.”
I think I must have it in my blood — I really enjoy sharing what I know and helping other people grow.”
Helene, listening group modertor
The Mother and Daughter
A smiling duo, Josephine, 31, and Rosina, 16, are mother and daughter. They are also both regular family planning users. It was Josephine who first took her daughter to their local MAHEFA-trained CHV to discuss family planning options.
“I didn’t want her to become pregnant at a young age like I did,” she says. “I want a better future for my daughter.”
As for Rosina, a high school student, she aspires to become a teacher. She feels grateful for the services provided by her CHV. “She is a woman that we both feel very comfortable with, she puts us at ease,” says Rosina.
I want a better future for my daughter.”
The Military Veteran
Sixty-five year old Robin Erinesy, a former military member, works as an emergency transport volunteer. He was trained and equipped by MAHEFA. “Since my days in the military, my vocation has always been to serve people. I’ve transported more than 70 people with my bicycle ambulance — children, pregnant women, and the elderly.”
“I like knowing that even at my age, I can still make a difference in my community. This work allows me to save lives and also keeps me physically fit.”
I’ve transported more than 70 people with my bicycle ambulance — children, pregnant women, and the elderly.”
Robin, emergency transport volunteer
The New Mother
Toky is a very cheerful 18-year-old woman who recently gave birth to her first child, Fleurette. When she found out that she was pregnant, she enrolled in her town’s mutual health insurance program and began paying the monthly fee of 300 Ariary (10 cents).
She is grateful that she did. “Following complications during my pregnancy, I had to be rushed to hospital. I was transported by a bicycle ambulance provided by MAHEFA. I paid nothing out of pocket, and I ended up saving 50,000 Ariary ($16) just on transportation alone.”
“Fleurette and I are both very healthy thanks to the MAHEFA program.”
Fleurette and I are both very healthy thanks to the MAHEFA program.”
Toky, new mother
The Youth Peer Educator
Lova Ravaoarimanana, 22, is advocating for change in her community. As a MAHEFA-trained youth peer educator (YPE), Lova works closely with her fokontany’s CHVs to empower youth to make responsible reproductive health decisions and sensible family planning choices. Her peers come to her for accurate information about family planning, sex, sexually transmitted infections, and HIV and AIDS.
“To get people to talk about sex, I must be armed with a smile and an open mind every session,” she says. “Through my work as a YPE, I have learned a great deal myself. I enjoy sharing my knowledge with people my age and helping them make positive health choices when it comes to sex.”
I enjoy sharing my knowledge with people my age and helping them make positive health choices when it comes to sex.”
Lova, youth peer educator
The Community Health Volunteers
Rahajamanana Andriamihaja, 51, and Rakotoniaina Andrisoa, 30, each from the fokontany of Miandrivazo, are among the 6,080 CHVs providing health services in their communities.
Our greatest accomplishment has been convincing our communities to no longer refer to the ‘dadarabe’ (traditional healer) for illnesses. Instead, they visit our health hut and we treat them or refer them to the nearest basic health center.”
Rahajamanana and Rakotoniaina, community health volunteers
The Medical Inspector
Miandrivazo’s Deputy Medical Inspector Jean Victor Rejany maintains a close relationship with CHVs like Andriamihaja and Andrisoa, whom he supports through frequent supervisory visits and by mentoring basic health center staff in his district. During supervisory visits, Jean Victor notices the evolution of the health status of his communities.
Laurencia, the daughter of Soripatso, was treated with chlorhexidine when she was born. Part of MAHEFA’s CHV training program since 2013, chlorhexidine is a simple antiseptic that is applied to the freshly cut umbilical cord stump to prevent newborn infections.
“Instead of applying alcohol as with my first child,” Laurencia’s mother Soripatso explains, “we used chlorhexidine, which was simple and easy. At the same time, I felt very confident that my baby will not have any infections. Today, my child is healthy.”
ASPIRE offers after-school clubs for adolescent girls and young women ages 10-24 who have left school before completing their education, or who are in school but are at high risk of dropping out. The clubs use modern educational tools, host peer-led discussions on HIV prevention and social issues, present motivational talks, and provide practical training for getting a job after finishing school. Girls in need also receive help to pay for school fees, exam and practical fees, uniforms, books, and bags. After learning about the program, Rachel decided to enroll with her sister and cousins.