Madagascar household child health and nutrition survey

Major findings include the following. (1) Despite reasonably high levels of coverage for prenatal services, the Ministry of Health and Population (MOHP) must improve the delivery of services to women attending prenatal consultations in the target districts. Although participation levels in prenatal services are high, a lack of resources is preventing local health facilities from delivering all of the services considered to be part of the national package of health services. Rates of vaccination coverage with tetanus toxoid, and distribution of nivaquine or iron-folate tablets are all well below the reported levels of attendance. (2) Levels of child malnutrition, particularly chronic malnutrition, are very high in both study districts, largely due to infant feeding and breastfeeding practices. (3) Vaccination coverage levels in the two districts for both mothers and children do not meet MOHP targets and are not sufficiently high to eliminate morbidity and mortality caused by the target diseases (maternal and neonatal tetanus, measles, pertussis, polio, tuberculosis, and diphtheria). (4) Maternal knowledge of the symptoms, prevention measures, and home-based treatments for common childhood diseases such as diarrhea, acute respiratory infection, or measles is low, which potentially contributes to the morbidity and mortality associated with these diseases. (5) The survey revealed a large unmet demand for modern contraceptives and family planning services among mothers of infants and young children in the two districts.