Five years of MAHEFA

The Community-Based Integrated Health Program (CBIHP), locally known as MAHEFA, is a five-year, USAID-funded, JSI-led, integrated community health programme. The program operates in six regions (Menabe, SAVA, DIANA, Sofia, Melaky and Boeny) in north and northwestern Madagascar.

Over the life of the program, 6,052 community health volunteers (CHV) were trained, equipped and supervised in providing basic health services at the community level. The CHVs were selected by their own communities, supervised by heads of basic health centres, and provided services based on their scope of work, as outlined in the National Community Health Policy (NCHP). Their work, and the work of other community actors involved with the MAHEFA programme, was entirely on a voluntary basis.

Over the five-year implementation period, MAHEFA supported 279 communes in establishing or advancing their local health governance structures, most notably the Communal Health Development Committees (CCDS, Commission Communal de Développement de la Santé) and Health Committees (COSAN, Comité de santé) at the commune and fokontany levels, respectively. By the end of the programme, all 279 communes had established a CCDS and all 3,023 fokontany had established a COSAN. Members of the CCDS and COSAN were trained on the content of the NCHP and their necessary contributions.

Sharing lessons learned in contributing to the advancement of community health

The workshop was attended by Dr Damoela Randriatsimaniry, General Secretary of the Ministry of Public Health and Mrs Susan Riley, USAID Mission Director for Madagascar. Representatives from various ministries and development partners were also present. During this workshop, participants discussed lessons learned and explored materials produced throughout the life of the programme. Additional activities included a presentation of 15 technical briefs, outlining community health themes and associated MAHEFA contributions, and a poster exposition on seven thematic areas of community health.

The MAHEFA programme has been implemented by JSI Research & Training Institute, Inc. (JSI), in partnership with Transaid and The Manoff Group, and in collaboration with the Ministry of Health, the Ministry of Water, Sanitation and Hygiene, and the Ministry of Youth and Sport.