A New Approach for provider performance improvement with Clinical and Quality Assurance Components in Moramanga, Madagascar

Norohaingo Andrianaivo, Eliane Razafimandimby, Jean Pierre Rakotovao, Marc Eric Rajaonarison Razakariasy, and Lalanirina Ravony share their presentation on ensuring standardized malaria in pregnancy service delivery in Madagascar. The poster was viewed at the 66th Annual Meeting of the American Society of Tropical

Malaria is endemic in 90% of Madagascar. However, the entire population is considered to be at risk for the disease, with pregnant women particularly vulnerable. Madagascar adopted the IPT in pregnancy policy in 2004.

The Malaria Indicator Survey in 2016 in Madagascar showed only 10% of Malagasy pregnant women receiving three doses of SP (IPT3). MCSP previously conducted health provider training in antenatal care in workshop style, with usually one provider per facility attending each training.

To increase the number of providers offering standardized service according to the new WHO recommendations for IPTp, in 2016 MCSP Madagascar began implementing a new low dose/high frequency training approach, with routine supportive supervision. On-site training and supportive supervision provide the opportunity for the trainer and providers to discuss the barriers to delivery of IPTp-SP.

Additionally, with the addition of a new IPTp indicator in the facility dashboard, the trainer/supervisor can monitor the indicator, and discuss plan of action with providers as needed. To date, in Moramanga District, 16 providers in six facilities have benefited from this performance improvement approach.

The qualitative and quantitative study of provider performance and results from January 2017 to May 2017 shows that Providers do follow the WHO’s new recommendations on IPT.  Adequate action plans were implemented to prevent SP stock out and to commit community health workers.

The increase of antenatal care utilization rate in these facilities. The IPT uptake increased This intervention is expected to show that IPT uptake and other maternal and newborn outcomes are improving in Madagascar.

This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the Maternal and Child Survival Program and do not necessarily reflect the views of USAID or the United States Government.

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