USAID/MCHIP 3rd QUARTER REPORT MCHIP FY5 Quarter 3 Country Program Report MADAGASCAR

The program's goal is to assist in scaling up evidence-based, high-impact maternal, newborn, and child health (MNCH) interventions. Madagascar's maternal mortality ratio remains high at 498 per 100,000 live births, and the infant mortality rate has remained at about 50 deaths per 1,000 live births since 2010. MCHIP's program objectives in Madagascar include providing support and technical leadership in MNCH, contributing nationally relevant program learning on integrated health approaches to MNCH, increasing uterotonic coverage for postpartum hemorrhage (PPH) prevention, and introducing the best practice of chlorhexidine coverage to prevent neonatal infection. Technical assistance at the national level includes participation in the Safe Motherhood Working Group, training and curriculum development for private sector pre-service training institutes, and national-level information-sharing on targeted evidence-based globally approved best practices. MCHIP has reoriented certain project activities to better align with current USG restrictions on public sector interaction. The project will no longer train and work with professional associations that include members involved in the public sector. Instead, MCHIP will work with Faith-Based Organizations (FBOs), private franchised network members, and the organization Sante Sud. Reoriented funds will allow for an additional intervention site for PPH prevention to be added in Ambatondrazaka and pre-service training support to be increased. During the third quarter of FY 2012-2013, MCHIP made significant progress in achieving its objectives. The program trained 116 healthcare providers working with FBOs on MNCH, increased the capacity of 310 Community Health Workers (CHW) to provide essential maternal and newborn care, and improved health outcomes in Fenerive Est and Ambatondrazaka. MCHIP also conducted supervision of 193 Community Agents (CAs) for the postpartum hemorrhage study, distributed 2,710 packets of misoprostol to pregnant women, and conducted 75 postpartum interviews for quality control. MCHIP's major accomplishments in the third quarter include training and supervision in targeted MNH skills and knowledge, pre-service training assessment and technical teaching improvement, and collaboration with technical advisors to train professional trainers working in private midwife institutes. The program has also signed MOUs with 5 additional private midwifery training institutes and conducted follow-up visits to assess the effectiveness of training programs.