Accelerated Child Survival

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Accelerated Child Survival Development
The Madagascar Case study

• Wash. DC, Feb. 9, 2005

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Histoire politique de Madagascar depuis
lIndépendance
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Major decisions in 1999 for children and womens
health

• Revitalization of the cost sharing system within
  all the health public facilities and provision of
  essential drugs to those facilities
• Redeployment of staff at all levels more than
  1600 health personnel during the last 2 years
• More participation of women in key decision
  posts 10 in 1997, 27 in 1999, 50 among the
  heads of hospitals
• Reopening of nurse training schools which where
  closed 6 years ago
• Regular increase of budget allotment in favor of
  essential social services 13,6 in 1997, 17,5
  in 1999.

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Key UNICEFs contributions since 1999

• 1999 High coverage during the two sessions of
  the National Immunization Days (over 100
  children under 5 were reached receiving the Polio
  vaccine and the vitamin A)
• Strong political commitment about the vaccine
  independence initiative (GAVI) and the
  generalization of safe motherhood and IMCI
  services
• Effective generalization by the Ministry of
  health of the cost sharing system with a positive
  impact on availability of essential drugs in most
  of health centers
• 2001 A national massive distribution campaign
  for Vitamin A capsules has been organized The
  coverage rate has been estimated to over than 80
  of children aged 6- 59 months.

In partnership
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The success of the efforts in partnership must be
supported and extended to other programs!
Way forward
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Key Challenges

• Implementing Child survival initiatives EPI,
  IMCI, ANC
• Partnership reinforcement around ACSD/MBB
  (effective scaling up)
• Improve health system performance
• Implement MTEF exercises