This presentation was given by Yvette Ribaira at the International Conference on Family Planning (ICFP) in Kigali, Rwanda in November 2018. (This is the English version of the presentation). In Madagascar, there are 80% endemic species, 80% of the country is rural, 72% of the population is poor, with only 2.7% population growth. There are over exploitation and destruction of natural resources and lack of access to family planning in rural areas. Program implications: 1. Partnership for integration health, population, environment 2. Coverage in universal health by delegation of tasks to CAs 3. Increased productivity by women and men

1. Se réengager dans la santé population environnement à
Madagascar: quelles contributions de la planification familiale
Présentée parYvette Ribaira, MD, MPH
Kigali, 13 Novembre 2018
USAID Community Capacity for
Health Program (Mahefa Miaraka)
Re-engaging Population, Health, and
Environment in Madagascar: Family
Planning Contributions
Presented by
Yvette Ribaira, MD, MPH
Kigali, November 13, 2018

2. Presentation Plan
• Context
• Principle Interventions
• Key Results
• Lessons Learned

3. Context (1/3)
• 80% endemic species
• 80% of the country is rural
• 72% of the population is poor
• 2.7% population growth

4. Context (2/3)
• Overexploitation and destruction of natural resources.
• Lack of access to family planning in rural areas.

5. Contexte
(3/3)
• Restoration
• PF
• Alternatives

6. Program Interventions
10,000 AC in all the
villages

7. Methodology
• 7/22 regions from 2012 to 2018.
• Analysis of 294,255 AC reports on GESIS.
• Survey evaluations
• Adding It Up method.

8. Key Results:
Geographical distribution of environmental zones and
CAs, 7 regions
Sources: MAHEFA / Mahefa Miaraka, database, 2012-2018
Repartition
districts
(n=34)
Number
of ACs
(n=9,893)
Number of
former AC
in PF
(n=9,207)
Number of
former AC
in PCIMEc
(n=9,145)
Coastal Areas 22
(65%)
6.093
(62%)
5.588
(61%)
5.604
(61%)
Environmental
zones
20
(59%)
5,103
(52%)
4.738
(52%)
4.724
(52%)

9. Key Results:
Evolution of coverage in local services by CAs
Sources: CCHP, Activity Report 2012 – 2018
0
20000
40000
60000
80000
100000
120000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
RDT + AC Traités ACT AC
n1 = 721.178 ; n2 = 675.320
0
10000
20000
30000
40000
50000
60000
70000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
RDT + CSB Traités ACT CSB
n1 = 391.888 ; n2 = 370.897
Simple cases of malaria in children under 5 years

10. Key Results:
Evolution of coverage in local services by CAs
Sources: CCHP, Activity Reports 2012 – 2018
-
50,000
100,000
150,000
200,000
250,000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Nouvelles Utilisatrices AC Nouvelles Utilisatrices CSB
New Family Planning Users

11. Key Results:
Trend in Contraceptive Prevalence and Unmet FP 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
% qui ont un besoin non satisfait en planification familiale Prévalence contraceptive

12. Résultats clés:
Grossesses inattendues évitées
par Couple-Année-Protection
Source: Darroch J. and Singh S., Estimating Unintended Pregnancies Averted from CYP, 2011.
-
50,000
100,000
150,000
200,000
250,000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
CYP Nombre de grossesses inattendues évitées

13. Résultats clés:
Economie estimée (USD) relative à la vaccination
selon Couple-Année-Protection
Source: Darroch J. and Singh S., Estimating Unintended Pregnancies Averted from CYP, 2011.
1,088,881
4,663,185
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
4,500,000
5,000,000
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
4,500,000
5,000,000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
CYP Economie réalisée relative à la vaccination

14. Program Implications /
Lessons Learned
• Partnership for integration health,
population, environment.
• Coverage in universal health by
delegation of tasks to CAs.
• Increased productivity by women
and men.

15. Thank you for
your 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.