Editorial

Children are precious; they are the wealth of a community, and we must give them every chance to grow normally and enjoy good health. For the future of your community, it is imperative to give priority to pregnant women and children when it comes to access to food. Pregnant women who are properly nourished give birth to babies with appropriate weight and height. Children who are properly nourished will reach the weight and height necessary to flourish. Well-nourished children are more resistant to disease. When they reach school age, they will be more attentive, and they will learn more easily. It is recognized that after the age of 2 years, any growth retardation cannot be reversed. Thus, children with stunted growth are more vulnerable to disease and will have fewer opportunities in school, and in adulthood, mothers will be exposed to high-risk pregnancies that can be fatal for them and their babies. The Santnet2 project is working to improve the health of children and mothers in the 800 Kaominina Mendrika (KM) salama communes. Today, we find that 1 in 5 children is underweight and likely to have stunted growth. Information from weighing sessions helps to target mothers of children diagnosed as underweight and to support them in preventing more serious growth retardation in their children. I know that for each child screened who is underweight, the mother receives nutrition advice, and in cases of severe malnutrition, the mother and baby are referred to health facilities. Community health workers also manage 6,000 malaria cases, 4,000 diarrhea cases, and 4,000 pneumonia cases among children under five in the 800 KM salama communes. This 9 edition of the Ezaka Mendrika Bulletin deals with the important issues of child survival as well as the prevention and management of diseases affecting children under five years old. You, as Social Development Committees, community leaders, and parents, should be aware of these critical issues. Any failure in our responsibility as parents, as raiamandreny, will have a dramatic impact on the future of the community. The work of community health workers, Social Development Committees, health facilities, and mothers will ensure the proper growth and good health of our children in the communes. This 9 edition reminds us of our roles and responsibilities to ensure child survival and child health. Once again, I would like to encourage you to read this bulletin and to share it with others. Have a good reading!! Chief of Party,
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Ezaka Mendrika Bulletin

Children in good health in a typical KM salama community
Children occupy an important children the wealth of a nation. Malagasy adage. Even so, fragile. They can be vulnerable to all make sure children experience survival is protecting children There are three key diseases that under 5: diarrhea, malaria, and diseases and to ensure their (CHWs), and Social Development place in Malagasy society. The Malagasy consider Ny Zanaka ho harena, according to a famous the health of children under 5 years of age is still sorts of diseases. It is therefore necessary to normal growth. The first step to ensure child from diseases. are harmful to child health and deadly for children pneumonia. To better protect children from survival, parents, community health workers Committee members have a role to play.

Parents

Community health workers

Parents play a major role in the home, where child survival begins: Parents must make sure children receive adequate and complete nourishment necessary for normal growth. Parents must monitor their childs growth. Parents must make sure children are vaccinated during the first 9 months after birth. Parents must ensure good health practices in the home, including using insecticide-treated mosquito nets. In case of illness, children must be taken to receive treatment at a health center or with community health workers.

CHWs play a secondary role in child survival: CHWs should teach parents preventative methods against child diseases. CHWs should closely follow the growth of each child from birth up to 5 years of age. CHWs give nutritional advice to parents. CHWs must always help parents in need, particularly in case of emergency. When children are sick, CHWs must treat malaria with ACT, diarrhea with oral rehydration solution, and pneumonia with Pneumostop. These medications are available to CHWs in KM salama communes.

Community leaders
Community leaders in KM salama communes play a tertiary role in child survival. They provide necessary support for CHWs in regard to stocking drugs, constructing work places for CHWs, and facilitating between the community and the health facility. Thanks to their leadership, members of the Social Development Committee play a role in activating village sanitation and environmental measures, which also ensure good child health.

Testimonies:
In their words.. Soja Robert Mangaiky village rural commune of Ampasy Nahampoana: Living in a very remote village is not always easy. [The] population relies on me to stay healthy and to fight against diseases. During [a] malaria outbreak, I played a big role to save [the] population. MAURICIA Violette , Mother child health CHW Antanetilava II village-rural commune of Mahanoro: I keep in touch with the community through home visits. Apart from awareness raising activities I conduct on mother and child health, I try to be a model for the community for practice of hygiene. Rudolph Thomas, Directeur Gnral of USAID Madagascar, funder of the Santnet2 project: Community health workers are particularly involved in the education and awareness of villagers for better health. They are trained and very skilled at recognizing danger signs among pregnant women and taking care of child illnesses. Mena Dsir and Venance, community health workers Beangaka village rural commune of Saranambana: Child diseases have greatly decreased in Beangaka, and parents are more responsible for the health of their children.

Volkan Cakir Lontine Razafindratsiry, community health worker and head of Sahatalevana village, rural commune of Tsarasambo: Because of my community-based services, parents are aware of the importance of health, including family planning. Rakotondrabe Cyrille, Supply point manager and SDC member of Ambolomoty: Resupplying CHWs with medicine is very important to guarantee availability of health services. Noel Razanamaly, father of Jeanne Marianselle and Marie Faustine, Antafotenina village-rural commune of Ifanadiana: Since we didn't have a CHW before, we always had to walk to ask for help or to buy medications. CHWs can take care of our children, can quickly determine if they have malaria, or even prescribe medicine. 9th EditionJune 2012

Velonarivo Vonjiniaina Paulin Razafimaro and Marie Thrse, a couple of CHW Ankazomenavony village rural commune of Belobaka: The villagers are more and more confident to our community-based services. They really appreciate our services.

Clestine Razanabao, community health worker Todiana village- Commune Ia lalamarina: I am satisfied with my community- based health services because they also give me personal benefits. I can earn some benefits from the products I sold to the clients.

Santnet2 is funded by USAID and implemented by RTI International