Physical Health Madagascar Project #57300

Improving Maternal and Child Health in Madagascar

by SEED Madagascar

Project Report | May 9, 2024
Iterative and Holistic Community Based Health

By Sally Deitchman | Programmes and Office Assistant

Child Vaccination Campaign

Every day, ten women die from complications related to pregnancy and childbirth, and over 100 children under five years old die from preventable childhood diseases such as acute respiratory infections, diarrhoea, and malnutrition. These statistics are propelled by incredibly high national poverty levels and low access to healthcare centres, leaving Malagasy communities typically uneducated on maternal and child health. This issue is particularly apparent in the Anosy region, which has especially low levels of maternal and child health education. Understaffed and poorly equipped local health services worsen this lack of knowledge.

To combat this, project Votsira aims to increase maternal and child health education by improving maternal and child health attitudes, building the capacity of local healthcare providers and implementing approachable maternal and child health classes. The target audiences of these education sessions was initially just mothers and grandmothers, but has since expanded to include fathers, and mothers-to-be. The basics of this project, such as the curriculum development and training of local community healthcare workers, were established in the earlier phases. Each phase has since learned from the previous to create more effective and efficient iterations of the curriculums and classes.

In its fourth phase, project Votsira has adapted the previous class curriculum to emphasise areas of lowest competency. The identified topics include acute respiratory infections, antenatal care, nutrition, and malaria. With the adapted curriculum (since January 2024), 132 community-based education sessions have occurred. Community health workers have also conducted 1,980 follow-up household visits. Using local partnerships, 18 education sessions were completed at community health centres.

As this project evolves and grows, we appreciate the overwhelming support SEED has received and are grateful for each and every one of you.

SEED is now looking to fund Votsira’s next phase and would love for you to continue to be a part of it.

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Jan 19, 2024
Community Information Sessions

By Lauren Hodgson | Project Leader

Fathers attending a session on HIV and syphilis

Phase IV of Project Votsira works with community health workers to deliver a Maternal and Child Health Information Course to community members across Fort Dauphin. Designed together with the local Ministry of Health, the course covers: antenatal visits, acute respiratory infections, vaccinations, colostrum, breastfeeding, nutrition, family planning, diarrhoea, syphilis, and HIV.

During the programme, weekly information sessions are held in 11 villages, covering a new topic each month. Participant groups are split into four; mothers, fathers, grandmothers, and pregnant women, to allow freedom of discussion. From September 2022 to February 2023, 1,320 community members completed the first round of the maternal and child health course.

Following the delivery of the course, over 90% of participants had a good knowledge of the symptoms, preventative measures, and treatment of malaria, the treatment of respiratory illnesses, and the symptoms and treatment of diarrhoea. In contrast, only 28.3% of participants had a good knowledge of the causes of malaria, and 31.3% of participants demonstrated good knowledge of the symptoms of acute respiratory infections. Year two of phase IV will focus more on building knowledge around these areas

The information course also saw 93% of participants acknowledge the importance of exclusively breastfeeding their children until at least six months of age, and 52% of people report that they would follow recommendations on antenatal visits and skilled attendant delivery. Overall, fathers were the group least likely to follow recommendations, with 69.4% of men reporting that they would not follow recommendations on attending four antenatal sessions due to the expense and lack of money. As family members, particularly fathers and grandmothers, often have significant household influence, their support is crucial to enable access to life-saving maternal and child healthcare services when needed. As a result, year 3 of the course will involve more fathers than originally planned.

SEED wishes to thank all donors and well-wishers supporting project Votsira.

Mothers in a Maternal and Child Health session

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Sep 22, 2023
PROJECT VOTSIRA PHASE IV: IMPROVING MATERNAL AND C

By Betty Gisore | Programmes and Office Assistant, SEED Madagascar

Training of community health workers

In southeast of Anosy region in Madagascar, preventable childhood diseases such as diarrhoea and acute respiratory infections contribute to the region’s high levels of neonatal, infant and under 5 mortality. In addition, misinformation and low levels of education among mothers further contribute to poor maternal and child health outcomes. Through project votsira (which means wellbeing of a new mother and her child) SEED has and continues to deliver health education sessions to caregivers and building capacity of healthcare workers in order to improve maternal and child health knowledge, attitudes and practices. Project votsira has been implemented through 3 phases, and SEED is currently implementing the 4^th phase (June 2022 to May 2024).

Year 1 of votsira phase 4, was a great success with a total of 528 education sessions delivered to 1320 caregivers, and 2631 household visits to give opportunity to mothers to ask more specific and personal questions. Focus groups and roundtable discussions at the end of year 1 of phase 4, provided valuable insights into areas requiring more focus in year 2. Year 2 curriculum includes sessions on; antenatal visits and hospital delivery, acute respiratory infections and vaccinations, breastfeeding, colostrum, nutrition, malaria, diarrhoeal diseases, family planning, syphilis and HIV.

By June 2023 a total of 940 caregivers were recruited to participate in the 2^nd round of mother and child health course in votsira phase 4. As of July 2023, a total of 88 sessions on antenatal care and nutrition were already covered. The remaining sessions will be rolled out in the course of year 2 of implementation of the project.

One beneficiary caregiver, testifies that she now knows more through the education sessions and her life and that of her grandchildren is changed. SEED’s work through project VOTSIRA is testimony to the great support received through generous donors abroad and from local Malagasy people.

Maternal and child health education session

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