Focusing on intersectionality in a global health crisis has enabled us to rapidly reorganize and respond to the most pressing needs to help people, especially the most vulnerable, and to strengthen their resilience to the shocks caused by the COVID-19 pandemic. This has confirmed the flexibility of our integrated approach that allows us to adapt to needs and priorities according to the context. The PHE Network and its members have readjusted their actions, in line with the government's priorities in the fight against the COVID-19 pandemic: to strengthen Madagascar’s health care system while supporting communities in the management of their natural resources. Fighting COVID-19 is a challenge, but it is also an opportunity to strengthen the adoption of the integrated Population Health Environment (PHE) approach as a holistic approach to development in Madagascar.
Amplify our voice
In early December 2020, the SAVA region hosted the first round of the Workshop on Resilience and Health Surveillance initiated by the Directorate of Health Surveillance and Regional
Epidemiological Monitoring of the Ministry of Public Health, in collaboration with the PHE Network and the USAID Hay-tao Programme. Our common objective: to share the practical guidelines in force for each type of community activity concerned with COVID-19 prevention and response.
The regional coordination meetings will be resumed, with three meetings per region, in order to harmonize activities and best support members in integrated PHE activities. Two webinars on stakeholder engagement in PHE implementation will be organised this year. We want to take our voices to a higher level, based on the specific roles of policy makers, NGOs and partner associations in the implementation of the PHE approach.
Amplify our movement
For the first time since the creation of the PHE Network, pilot sites for the implementation of the PHE approach will be established in four regions in Madagascar. If the health situation allows it, the North-West will have a new PHE antenna in Boina. Following the recommendations expressed by PHE members, PHE days will be organised in the regions from the beginning of 2021. These days will highlight the positive aspects of the PHE approach at the regional level: improving community health and supporting sustainable natural resource management and livelihood resilience. They will start in the North East with the initiators of these showcase events.
Updates from PHE network members
World Conservation Society (WCS), in collaboration with the District Health Services, conducted two mobile clinic and community health workers (CHW) training missions, reaching six villages bordering the Makira Natural Park: 556 people were treated free of charge, 13 CHWs
were trained and 4 CHW kiosks were equipped. Last November, WCS and the Maroantsetra School District conducted four sessions of Environmental Education (covering the importance of environmental conservation as well as hygiene and healthy nutrition) and a Breakfast Programme in four fishing villages of Antongile Bay. This January, WCS and Madagascar National Park(MNP) supported a community school in a village bordering Masoala National Park and organised mobile clinic missions.
Ny Tanintsika promotes the complementarity of actions in its areas of intervention. The school canteen programme, funded by Mary's Meal, supports 25,368 children in 178 public primary schools across three highland
regions. These schools also benefit from the installation of 16 hand-pumped boreholes, financed by Feedback Madagascar, and the reforestation of 1,830 trees planted by the school community. These integrated programmes contribute to the achievement of several local development objectives including the promotion of children's schooling, access to drinking water, hygiene and sanitation, reforestation, healthy nutrition and good governance.
The Lemur Conservation Foundation (LCF) achieved its main goal in 2020: to rebuild Camp Mantella in Marojejy National Park. At the same time, more than 500 women received implants and IUDs in 27 villages. LCF also supported an
environmental education programme in Marojejy with two groups of students from the Club Vintsy WWF Andapa and the Alliance Française of Sambava. In collaboration with Madagascar National Park, seven forest patrols were carried out. The PHE programme was recently relaunched with Marie Stopes nurses.
In order to facilitate the empowerment of the mothers' groups and their transfer to the community management associations (CLBs) in six villages, Blue Ventures, in collaboration with the Ambanja district health
authorities and the CLBs management committees, organised a three-day training session for 12 elected leaders of the mothers' groups and three CLB chairpersons at the end of November. The training focused on maternal and child health, associative management, conducting meetings, awareness-raising and communication. The objective is to give women access to sustainable management of community health and natural resources
The Reef Doctor team has developed community vegetable gardens with women from the village of Ranobe, South West Madagascar. These small-scale, sustainable and empowering agricultural enterprises contribute to ensuring much needed food security for rural communities
vulnerable to the effects of climate change and the socio-economic impacts of the current pandemic. The project has now expanded to six sites and involves more than 100 women.
The main mission of the DREDD is to encourage all citizens to participate in reforestation. The "one pupil, one tree" programme, in close collaboration with the regional directorate of National Education, participates in this. The nine districts designate a pilot school to set up a tree nursery and all schools participate in the green beautification of their school.
These actions aim to educate young people at an early age to have a green thumb, in order to contribute to a healthy environment and the good health of future generations.
Madaworks is a project of the Centre Valbio aimed at financing young girls so that they can improve their education, health and social life for a better future. Most of the girls have passed their exams, with no drop-outs.
In 2021, Madaworks plans to continue its collaboration with Marie Stopes Madagascar in order to sensitize young girls to the importance of health and the prevention of early pregnancies.
A workshop to launch the PHE activities of theNGO PIVOT was organised last November with the participation of different local actors in Ifanadiana. PIVOT intends to move forward along three main lines in the coming months: setting up a pilot
sanitation village, improving the sources of income of the target population, and providing environmental education.
The Marolambo Cercle d'Etude Multidisciplinaire sur l'Environnement et la Santé (CEMES) team and community representatives underwent capacity building and were then able to transfer their knowledge to the 35 community workers in Marolambo. Among the objectives set within the framework of the
project "Scaling up the demonstration of the health reflex on the Bilharziasis - Conservation - WASH trilogy in the Nosivolo Marolambo River", is the establishment of the Information and Awareness Raising Centre from December 2020. The centre is intended to inform and raise awareness among the population of Marolambo about this trilogy.
Health in Harmony is an international non-profit organisation aiming to reverse the deforestation of tropical rainforests in response to the climate crisis. At the beginning of 2021, the mobile clinic team offered consultations to the inhabitants of each village around the forest and reserve of Manombo, in the Atsimo Atsinanana region. The clinic is based on a system of non-monetary payment through
livestock products, handicrafts or agricultural products, as well as reforestation activities for the preservation of the forest and the environment.
In 2020, ACCESS was one of Madagascar's first partners in the response to COVID-19. The programme has also served nearly two million users of family planning methods, treated 223,000 cases of malaria, referred 177,000 births to skilled
attendants, and reached 2,500,000 people with key messages on health and WASH for a healthy environment for health. In 2021, ACCESS will implement more strategic activities to strengthen epidemic preparedness and save even more lives. The ACCESS programme also plans to strengthen its collaboration with environmental actors in its activities.