Community health workers (CHWs) improve access to quality health services at the community level. Despite the critical role that CHWs play, governments often have limited insight into their activities, the quality of their services, the conditions of the communities that they serve, and how best to link these CHWs and their beneficiaries to the larger health system.
In Madagascar 83% of the country’s 22.9 million people live in rural areas that can be difficult to access. CHWs play a crucial role in providing access to healthcare in those parts of the country that are underserved. Over 34,000 CHWs work to extend basic health services such as maternal and child health, family planning and reproductive health, nutrition, TB, and sanitation services. This study seeks to examine the influence both financial and non-financial incentives have on CHW program performance and retention in Madagascar.
Community Health Volunteers (CHVs) have played a critical role in the success of USAID in Madagascar’s health sector. As CHVs, they can provide basic health care services and health education at the community level, thus improving health care access in remote regions. This report highlights the successes and challenges of USAID/Madagascar’s investment in CHVs.
This paper explores the effectiveness of child health interventions and how to improve health care access for children, mothers, and caregivers. Multi-sectoral approaches, including utilization of community-based programming and community health workers, can help extend the reach of health care to these populations.
USAID's 2016 Acting on the Call Report provides updates from the program that aims to end preventable maternal and child deaths in 25 priority countries, which together accounted for more than two-thirds of child and maternal deaths worldwide.
Globally, 2.5 billion people are “unbanked,” lacking access to formal financial services. As a result, roughly one third of the world’s population is forced to rely on cash transactions or informal financial systems, which can often be unsafe, inconvenient, and expensive. Among the unbanked, however, a billion have access to a mobile phone, and mobile-based financial services are quickly closing the financial access gap.
Most countries in sub-Saharan Africa have now adopted integrated community case management (iCCM) of common childhood illnesses as a strategy to improve child health. In March 2014, the iCCM Task Force published an Indicator Guide for Monitoring and Evaluating iCCM: a ‘menu’ of recommended indicators with globally agreed definitions and methodology, to guide countries in developing robust iCCM monitoring systems. The Indicator Guide was conceived as an evolving document that would incorporate collective experience and learning as iCCM programmes them- selves evolve.
To improve access to contraceptives in remote and rural areas, sub-Saharan African countries are allowing community health workers (CHWs) to distribute hormonal contraceptives. Before offering hormonal contraceptives, CHWs must determine pregnancy status but often lack a reliable way to do so. This study design implemented a randomized experiment in Eastern Madagascar among CHWs who sell injectable and oral hormonal contraceptives. Results show that providing CHWs with free pregnancy test kits increases the number of new hormonal contraceptive clients.
The Integrated Community Case Management (iCCM) Task Force (TF) has proposed a list of 48 indicators to guide governments and partners in monitoring and evaluating national iCCM programs. These indicators are compiled in the document entitled Indicator Guide for Monitoring and Evaluating Integrated Community Case Management. Recently, the iCCM TF began a review process to determine the number of indicators being reported by country programs, and opportunities and challenges related to measuring indicators not being reported.
For more than a decade, the US Agency for International Development (USAID) Mission in Madagascar and other partners have invested in the development of a national community health volunteer (CHV) system to improve access to life-saving primary health care services for rural and remote populations. This project aims to increase access to and availability of community-based interventions in 800 communes concentrated in 16 regions of eastern and southern Madagascar.