Madagascar is a country with steep mountains, dense rainforests, and 80% of the population living in rural, difficult-to-reach areas. Access to healthcare is, not surprisingly, a challenge, impacting not just the health but the overall quality of life for people in remote communities across the country.
Malagasy Heniky Ny Fahasalamana (MAHEFA), which in Malagasy translates to “Healthy Malagasy Families,” was a USAID-funded initiative whose goal was to reduce neonatal, infant, and maternal mortality, fertility, and malnutrition in areas of Madagascar where some of the greatest challenges to accessing the formal health care system exist in rural and difficult-to-reach communities.
The Manoff Group contributed significantly to the formative research, strategy design, and implementation of MAHEFA’s programs for SBC, gender, partnership building, and WASH for this JSI Research and Training Institute-led project.
The Manoff Group developed a Behavior Change Empowerment strategy for community health volunteers. Eighteen recommended activities were detailed in a job aid known as the Torolalana sy Vahaolana (Guide and Solutions), which included a thematic calendar showing the optimal time to address specific behaviors (e.g., promoting malaria prevention near the beginning of the rainy season) and the frequency with which some behaviors should be re-promoted. Additionally, activities promoting gradual but long-lasting transformation focused on reducing gender inequities at community level are included in each weekly calendar cycle.