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USAID Community Capacity for Health Program (Mahefa Miaraka)

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How Can Population, Health, and Environment Projects Learn from Family Planning High Impact Practices?
JSI’s Yvette Ribaira shares best practices from Madagascar in a new webinar.

On February 6th, JSI population, health, and environment (PHE) expert Dr. Yvette Ribaira shared insights from her experience in Madagascar during a webinar examining the link between PHE programs and high-impact practices (HIPs) drawn from family planning activities.

Watch the webinar here: https://bit.ly/2SKbuvG

Dr. Ribaira, a medical doctor, has spent her career in public health strengthening the Madagascar’s health system, with a specific focus on community health in the last decade. She currently leads the JSI’s USAID Community Capacity for Health Program in Madagascar, locally known as Mahefa Miaraka, which implements the Population Health and Environment (PHE) Activity, funded by Advancing Partners and Communities.

The webinar was hosted by the PACE (https://thepaceproject.org/) (Policy, Advocacy, and Communication Enhanced for Population and Reproductive Health) project and included presenters from the Population Reference Bureau and USAID.

Read more about JSI’s work on population, health, and environment, as well as family planning, in Madagascar and around the world at www.jsi.com

Published in: Government & Nonprofit
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USAID Community Capacity for Health Program (Mahefa Miaraka)

  1. 1. USAID Community Capacity for Health Program (Mahefa Miaraka) Successfully Integrating High-Impact Family Planning Practices into Population, Health, and Environment Projects Presented by Yvette Ribaira, MD, MPH binar, February 6, 2019
  2. 2. Outline • Background • Program Approach • Key Findings • Recommendations.
  3. 3. Background • 80% endemic species • 80% of the population is rural • 76% of the population is poor • 2.7% population growth • Lack of access to FP services Sources: DHS, 2008/09 – WB, 2017
  4. 4. Program Approach 4,885 villages and 6.1 million people
  5. 5. Program Approach (cont’d) Community health forms the foundation of the health system Community health to improve geographical access to primary care Community health to reach UHC and achieve SDG Institutional framework to standardize health interventions
  6. 6. Program Approach (cont’d) Community members select CHVs. Local coordination committee (health hut building, planning) support CHVs. FPTraining, skills certification, supervision by health facility. Provision of FP counseling and service job aids, management and IEC tools. 1. 2. 3. 4.
  7. 7. Program Approach (cont’d) Community-level health promotion and sensitization Capacity of community stakeholders to assess community needs, develop key messages and advocate for improved services Innovations to promote adolescent and youth health
  8. 8. Key Findings In Policy Development HIP • NPCH updated (2017) • FP law available (2018) • Norms guideline reviewed • CHVs curricula standardized
  9. 9. Key Findings CHV Service Delivery (n = 6,093) • 92% CHVs in environmental areas trained in FP service delivery. • 54% CHVs male. • 72% coverage. Source: Mahefa Miaraka, database, oct 2013 - sept 2018
  10. 10. Key Findings (cont’d): Evolution of Coverage in Local Services by CHVs Sources: CCHP, Activity Reports 2012 – 2018 New Family Planning Users <1% 34% 62% 67% 17% 25% 34% 40% 38% 36%299 48,704 152,821 194,954 34,722 55,355 68,992 111,700 111,700 111,700 94,097 142,502 246,619 289,923 202,632 221,866 204,467 281,818 294,124 306,430 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 % of CHV's contribution New users at CHV New users at Health Facility
  11. 11. Key Results (cont’d): Trend in Contraceptive Prevalence and FP Unmet Need Sources: Penser, 2012 – USAID , OMS, 2014 – USAID, Baseline 2016 30.6% 17.3% 9% 26.9% 41.3% 46.4% 62.0% 0% 10% 20% 30% 40% 50% 60% 70% 2012 2014 2016 2020 % with unmet need in Family Planning Contraceptive Prevalence Rate
  12. 12. Key Results (cont’d): Unintended Pregnancy Averted and Cost Saving in Vaccination Source: Darroch J. and Singh S., Estimating Unintended Pregnancies Averted from CYP, 2011. Year 2013 2014 2015 2016 2017 2018 2019 2020 2021 Unintended pregnancy averted 11,520 19,932 34,847 10,714 20,419 48,816 51,552 57,888 57,888 Cost saving in vaccination of children (USD) 171,300 296,385 518,175 159,315 303,630 725,895 766,575 860,790 860,790
  13. 13. Key Findings: People Reached by SBCC Channels (n = 4,987,099) HighVisibility Events 12% Radio broadcast 59% Reached by CHVs activities 29% Source: Mahefa Miaraka, annual report, sept 2018
  14. 14. • Enabling environment: integrating the application of FP law in the health and environment policy. • Service delivery: universal health coverage in part through task shifting to CHVs. • Behavior Change Communication: targeting youth and men. Recommendations for HIPs
  15. 15. Thank you forYour Attention! This presentation was made possible thanks to the financial support of the American people through the United States Agency for International Development (USAID). JSI Research & Training Institute, Inc. is fully responsible for the content of this presentation, which does not necessarily reflect the views of USAID or the US Government.

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