Since the coup in 2009 and the withholding of international funding, the government of Madagascar has been forced to cut spending on state services such as education and health. In the last few years, many medical clinics have therefore closed, after running out of supplies or money to pay staff.
To address the chronic lack of health services, the US Agency for International Development (USAID) has initiated a project to train and support health workers who offer health support to communities as volunteers. Funding for the programme bypasses international sanctions because the 6 million dollars of aid is spent directly through civil organisations. This money is being used to train health volunteers in around 800 rural communities, mostly in eastern and southern areas.
Volunteers are trained in primary health care issues, such as the detection and treatment of malaria, pneumonia and diarrhoea. They are also shown how to screen children for malnutrition and trained in giving advice on breastfeeding and diet. In addition, health workers provide family planning services and are taught to screen for pregnancy and detect early warning signs of obstetric and neonatal complications.
Speaking to the news agency IRIN, one of the new health volunteers said “I am proud to be selected [for the training] and to contribute to the lives of women in the village.” Villagers in one community west of the capital Antananarivo expressed their relief at being able to access basic medical help such as family planning services without having to travel a significant distance to the nearest hospital or clinic.
The health system in Madagascar remains extremely fragile, particularly in rural areas, where even if clinics remain open, they may only have one qualified member of staff. The UN’s child agency, UNICEF, also runs a programme in Madagascar to train up health workers. The head of child survival for UNICEF in Madagascar told IRIN that maintaining operational medical centres was vital for “severe cases” of illness or malnutrition, where patients needed to be referred for treatment.
Malnutrition among children remains a huge problem. For more information about the health situation in the country, see the recent blog post for SOS Children by visiting NHS doctor Martin Brooke.