Editorial Note

Mendrika is a Malagasy word

that describes someone or something that is worthy of appreciation. When the word mendrika is used in reference to a person that person is said to be deserving of some form of appreciation. This first edition of the Bulletin Ezaka Mendrika produced by the USAID/Santnet2 health project will be published quarterly. The Bulletin is devoted to highlighting the commitment of this projects partners, community leaders, and community health workers to the health and welfare of the Malagasy people. This publication will be a forum for people who are involved in community health promotion to share, acquire, and suggest new ideas and techniques to achieve health results. Past experience has shown that when those most concerned about health such as community members and leaders are engaged in promoting it, they will succeed in moving their communities towards the ultimate goal of health for all. For this reason, Kaominina Mendrika (KM, champion commune) salama was conceived as the principal approach used in the USAID/ Santnet2 project to provide an opportunity for the community and its members to take responsibility for improving health conditions in their community. As U.S. Ambassador in Madagascar, I, along with health champions in champion communes, am proud to introduce this first issue of the quarterly Bulletin Ezaka Mendrika. This Bulletin will allow Madagascars health community to share new developments, information on related activities, program successes and important discussion topics. I encourage all of you to become a regular reader of this Bulletin and to actively share your experiences therein! HE Niels R. Marquardt,

Bulletin Ezaka Mendrika

Proud to be community health workers.
Madagascars community health workers (CHWs) are proud of their work. On February 11, 2010, four community health workers from the communes of Alakamisy Anativato and Mahaiza in the district of Betafo within the Vakinakaratra region were in Antananarivo. They attended the grants launching ceremony at the Panorama Hotel in Andrainarivo.

Edmond Rafanomezantsoa lives in the commune of Alakamisy Anativato. He is a very dynamic man. He is very happy to have been selected as a child health CHW in his village.

duties, including getting people to listen to him during his counseling sessions. Marcelline Rasoanirina is a maternal health CHW who works with many women.

mobilization tools on her back. These tools include management and information tools and health products for treatments. In addition, CHWs from Mahaiza ensure that they set a good example in their community.

U.S. Ambassador in Madagascar.

March 2010, Issue 1

I like mobilizing people and feel lucky to have been chosen by We should be a the USAID/ model for our Santnet2 Caption describing picture surroundings program to or graphic. because people implement are always reKM salama ferring to us as in our comtheir health mune. counselors, Although said Daniel RaEdmond, kotomandimby, who is a another CHW. farmer, (USAID/Santnet2) From left to right: , Edmond Rafanomezantsoa, faced some Daniel Rakotomandimby, Marcelline Rasoanirina and Genevive challenges in Ranivosoa, CHW in Betafo district. Marie Genevive the beginning Ranivosoa, a child of integrating his CHW Up to now, I find it very health CHW, agrees with duties and his responsibili- easy to fulfill my duties his statement. ties as a family man, I even if I am a mother of have overcome it and now three children at home. I Like the other 443 CHWs manage to handle every- have arranged my timeta- in the field, she enjoys ble myself. I do home vis- her daily duties and thing. its on Tuesdays and Sat- hopes that the CHWs will be able to improve the He is a rare male CHW urdays,explained Marcelline Rasoanirina. health of their communiin his commune but he easily fulfills his aware- She walks to these home ties. ness-raising activity visits with her bag full of

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USAID/Santnet2 is implemented by RTI International

Community health workers activities within the community

There are two different categories of CHWs. Maternal health CHWs provide the following services: - Family planning, reproductive health, and safe motherhood - Counseling services for women who choose to use a contraceptive method Child health CHWs provide the following services: - Promoting child health and nutrition, preventing child disease and recognizing the danger signs, and promoting essential actions in nutrition and immunization - Managing cases of child diarrhea, malaria, and pneumonia
(Photo: USAID/Santnet2 ) One of the role of CHW is child growth monitoring

- Monitoring childrens growth Apart from awareness raising, CHWs can also recognize illnesses in mothers and their children before they become serious. Because the CHWs can recognize early symptoms, they are able to make timely decisions to refer their clients to the health center. All CHWs are qualified to improve maternal and child health in their communities.

News
- The number of USAID/ Santnet2s implementing partners is growing. Thirty-one nongovernmental organizations have received grants as of February 11, 2010. The grants were awarded for various purposes including the implementation of KM salama, the fight against HIV/ AIDS and the popularization of health promotion messages.

Do not forget that Community actors are change agents

CHWs were selected within the KM salama process

KM salama is a way to engage the community to improve the health status of its resi- CHW monthly performance dents. Its major objective is (October 2009February 2010) to enable community actors to identify and tackle Child health Maternal health community health needs. -5 children Identifying, training, <1year> referred deploying, and supporting to the health cenCHWs are major compoter for vaccination nents of the KM salama implementation process. -7 Pregnant women using iron-folic acid supplements provided by CHW

TYPICAL CHW -Average age: 40 years old

-Educational (Years):7 achievement

- At the beginning of February 2010, a team from USAID/ Madagascar participated in a productive field trip with USAID/ Santnet2 staff to rural communes in the Toamasina region. Additional visits are scheduled for March.

-Gender: %40Male %60Female

March 2010, Issue 1

-Occupation : Farmer -20 children bene- -11 couple using FP The Social Development fiting from growth methods Committee within the commonitoring mune takes the lead in Data source: USAID/Santne2 identifying the best persons to be named as CHWs within the villages (fokontany) in the commune. CHWs should T H I S Q U A R T E R L Y B U L L E T I N W I L L B E Be able to read and write D I S T R I B U T E D T O A L L T H E K A O M I N I N A Live in a village situated 5 km M E N D R I K A S A L A M A C O M M U N I T Y A C T O R S . or more from the commune 1 0 , 0 0 0 C O P I E S W E R E P R O D U C E D health center

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USAID/Santnet2 is implemented by RTI International