After five years of operation, the Mahefa Miaraka program has built a stronger community health system in rural regions

ANTANANARIVO – Today, USAID Mission Director John Dunlop and the Minister of Public Health Professeur Rakotovao Hanitrala Jean Louis marked the close of USAID’s five-year Community Capacity for Health Program during an online ceremony. Since 2016, the program, locally known as Mahefa Miaraka or 'Together we are capable' in the Malagasy language, has provided technical support to the Ministry of Public Health to implement the National Community Health Policy (PNSC) in seven regions – Analanjirofo, Boeny, DIANA, Melaky, Menabe, SAVA, and Sofia. While Mahefa Miaraka is closing, the legacy of its work and many of its initiatives will continue.

The U.S. Government, through the United States Agency for International Development (USAID), funded Mahefa Miaraka with $31 million over five years to strengthen the planning, delivery, and management of community health services for the Malagasy people. The program put special emphasis on improving family planning, reducing the practice of open defecation, preventing child marriage, and delivering health and nutrition services for pregnant women, new mothers, and young children.

Major Achievements Under USAID’s Mahefa Miaraka Program:

1. Helped the government update the National Community Health Policy and adopt new health policy guidelines, which included universal health coverage and a National Strategic Plan for Strengthening Community Health 2019 – 2030.
2. Established 5,205 Community Health Coordination and Development Committees.
3. Equipped and trained approximately 10,000 community health volunteers. The volunteers will continue to support 4,125 health huts and 734 basic health centers.
4. Trained more than 9,500 community health volunteers how to treat common childhood diseases and provide reproductive health and family planning services to mothers and youth.
5. Treated more than 377,000 cases of malaria in children under five years old, conducted nutritional screenings for more than 1,112,000 children under five years old, and referred 13,435 cases of severe malnutrition to health centers for treatment.
6. Helped more than 468,000 women access modern family planning methods and increased the use of modern family planning methods among young people by 8% compared to 2017.
7. Developed emergency medical evacuation plans in 97% of program-supported fokontany. 71,000 patients used emergency community transport services set up by the program.
8. Trained community health volunteers to lead discussions, educate, and provide access to family planning options in their communities. Community health volunteers now provide 2.5 million community members with health information and education services every three months.

The Mahefa Miaraka program was a collaborative effort between USAID and the Ministry of Public Health, the Ministry of Water, Sanitation, and Hygiene and the Ministry of Population, Social Protection, and Women’s Promotion. JSI Research & Training Institute implemented Mahefa Miaraka in collaboration with Action Socio-sanitaire Organisation Secours (ASOS), Family Health International 360 (FHI 360), and Transaid.

This partnership is an excellent example of how the United States and Madagascar are working together like “mpirahalahy mianala” to improve and expand access to community health services. The U.S. government is the largest single-country donor to Madagascar's health sector, providing $72 million in 2020 alone to fund USAID’s health projects. These projects reduce Madagascar's maternal and child mortality, provide access to potable water and sanitation, protect communities from malaria, improve access to family planning, ensure a reliable supply chain of vital health care supplies and medication, and reinforce the national community health policy.

Sources: Press release by U.S. Embassy Antananarivo - USAID Madagascar