For many people in Madagascar, the USAID-funded Community-Based Integrated Health Program, locally known as MAHEFA, means increased access to improved health services. MAHEFA is also helping people make positive changes in their communities. Outlined below are some of the many people who benefit from and work with the MAHEFA program.

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The Elder

I am happy to know that they no longer have to travel more than 15 kilometers to get water from the river, like my generation had to, now that we have a well built by MAHEFA. Augustine, elder

“I have at least 20 grandchildren and so many great-grandchildren that I’ve stopped counting,” says 80-year-old Augustine Kalisy. “I am happy to know that they no longer have to travel more than 15 kilometers to get water from the river, like my generation had to, now that we have a well built by MAHEFA. ”
“My children and grandchildren have had cleaner water and fewer problems with diarrhea. When they do have diarrhea, they can now be treated by our community health volunteer (CHV).”

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The Listening Group Moderator

I think I must have it in my blood — I really enjoy sharing what I know and helping other people grow. Helene, listening group modertor

Helene Nako is a moderator for the listening group in her fokontany. Equipped with her radio, Helene leads weekly collective listening groups for members of her community. Developed by the MAHEFA program, these broadcasts cover health topics including maternal and child health, family planning, nutrition, WASH, and gender, and discuss how people can change health-related behavior for the better.

An elementary school teacher and a mother of six, Helene loves helping people. “I think I must have it in my blood — I really enjoy sharing what I know and helping other people grow.”

The Mother and Daughter

I want a better future for my daughter. Josephine, mother

A smiling duo, Josephine, 31, and Rosina, 16, are mother and daughter. They are also both regular family planning users. It was Josephine who first took her daughter to their local MAHEFA-trained CHV to discuss family planning options.

“I didn’t want her to become pregnant at a young age like I did,” she says. “I want a better future for my daughter.”

As for Rosina, a high school student, she aspires to become a teacher. She feels grateful for the services provided by her CHV. “She is a woman that we both feel very comfortable with, she puts us at ease,” says Rosina.

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The Military Veteran

I’ve transported more than 70 people with my bicycle ambulance — children, pregnant women, and the elderly. Robin, emergency transport volunteer

Sixty-five year old Robin Erinesy, a former military member, works as an emergency transport volunteer. He was trained and equipped by MAHEFA. “Since my days in the military, my vocation has always been to serve people. I’ve transported more than 70 people with my bicycle ambulance — children, pregnant women, and the elderly.”

“I like knowing that even at my age, I can still make a difference in my community. This work allows me to save lives and also keeps me physically fit.”

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The New Mother

Fleurette and I are both very healthy thanks to the MAHEFA program. Toky, new mother

Toky is a very cheerful 18-year-old woman who recently gave birth to her first child, Fleurette. When she found out that she was pregnant, she enrolled in her town’s mutual health insurance program and began paying the monthly fee of 300 Ariary (10 cents).

She is grateful that she did. “Following complications during my pregnancy, I had to be rushed to hospital. I was transported by a bicycle ambulance provided by MAHEFA. I paid nothing out of pocket, and I ended up saving 50,000 Ariary ($16) just on transportation alone.”

“Fleurette and I are both very healthy thanks to the MAHEFA program.”

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The Youth Peer Educator

I enjoy sharing my knowledge with people my age and helping them make positive health choices when it comes to sex. Lova, youth peer educator

Lova Ravaoarimanana, 22, is advocating for change in her community. As a MAHEFA-trained youth peer educator (YPE), Lova works closely with her fokontany’s CHVs to empower youth to make responsible reproductive health decisions and sensible family planning choices. Her peers come to her for accurate information about family planning, sex, sexually transmitted infections, and HIV and AIDS.

“To get people to talk about sex, I must be armed with a smile and an open mind every session,” she says. “Through my work as a YPE, I have learned a great deal myself. I enjoy sharing my knowledge with people my age and helping them make positive health choices when it comes to sex.”

The Community Health Volunteers

Our greatest accomplishment has been convincing our communities to no longer refer to the 'dadarabe' (traditional healer) for illnesses. Instead, they visit our health hut and we treat them or refer them to the nearest basic health center. Rahajamanana and Rakotoniaina, community health volunteers

Rahajamanana Andriamihaja, 51, and Rakotoniaina Andrisoa, 30, each from the fokontany of Miandrivazo, are among the 6,080 CHVs providing health services in their communities.

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The Medical Inspector

Miandrivazo’s Deputy Medical Inspector Jean Victor Rejany maintains a close relationship with CHVs like Andriamihaja and Andrisoa, whom he supports through frequent supervisory visits and by mentoring basic health center staff in his district. During supervisory visits, Jean Victor notices the evolution of the health status of his communities.

The Newborn

Instead of applying alcohol as with my first child, we used chlorhexidine, which was simple and easy. At the same time, I felt very confident that my baby will not have any infections. Today, my child is healthy. Soripatso, mother

Laurencia, the daughter of Soripatso, was treated with chlorhexidine when she was born. Part of MAHEFA’s CHV training program since 2013, chlorhexidine is a simple antiseptic that is applied to the freshly cut umbilical cord stump to prevent newborn infections.

“Instead of applying alcohol as with my first child,” Laurencia’s mother Soripatso explains, “we used chlorhexidine, which was simple and easy. At the same time, I felt very confident that my baby will not have any infections. Today, my child is healthy.”

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