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Two Lutheran health centers benefited from two informative health training sessions: the Lutheran Dispensary at 67 Hectares and the Lutheran Hospital at Ambohibao, both of which are situated in Antananarivo. Throughout this project, a SALFA team has ensured MCH/FP services at these health centers, three days per week during the training sessions mentioned above. With maternal service being an integral part of family planning, this team has also been responsible for nutritional surveillance of children, mainly through weighing and arm band measurements.
Another project, MAG/93/P05 entitled “Extension of MCH/FP SALFA Activities”, was also begun, which is centered around family planning services in 30 SALFA hospitals and dispensaries, along with ten NGO health centers and associated partners.
This was followed by MAG/97/P04 which is entitled “Support for Reproductive Health/Family Planning SALFA Activities.” The specific strategies are:

  • the intensification of IEC (Information – Education – Communication) activities and social mobilization;
  • the extension of service provisions in regards to new approaches (community base services, cooperation with the association of private physicians...)
  • the improvement of service quality, and
  • the integration of five facets prioritized by Reproductive Health within a pilot site which occurred at the Vohemar
Hospital/Antsiranana.

Lastly is the project MAG/04/02 entitled “Activity Reinforcements of Reproductive Health within SALFA.” This project is registered with the framework of the realization of the 4th program of UNFPA in Madagascar. At the moment, a fifth program is in full preparation.

Goal or Mission of Reproductive Health

Adhering to the national policy concerning Reproductive Health, the RH/SALFA Project has set as their mission to contribute to the reduction of infant and maternal mortality.

Methodology

This program actually follows that of previous programs. On the one hand, RH/SALFA works at SALFA centers dispersed around the island ,which number 30, and including both Dispensaries (CSB II) and Hospitals (CHD II); and, on the other hand, at sites with qualified partners, which number 10, and, for the most part, consist of CSB II. Forty doctors and paramedicals ensure the service provisions of RH/FP and Maternity without Risk at these centers.

Strategy Many requests regarding Reproductive Health

The intensification of social mobilization activities due to the utilization of all types of available communication channels within the Lutheran Church transmitting messages about Reproductive Health.

Increased accessibility to Reproductive Health services

Multiplication and diversification of service provision alternatives.

Quality of service and improved care

Expansion of Reproductive Health competence in regards to services rendered and undertaking the norms and standards of RH.

RH program management

Use the data as a privileged planning tool and for decision-making;
Decentralize the training activities and supervision, especially in regards to the Community-Based Health Agents;
Reinforce management capacity, follow-up, and evaluation of the centralized team and those responsible in the outlying areas.

 Objectives
  • To augment the use of RH service provisions;
  • To improve the knowledge and the promotion of behaviors and practices concerning RH material.
Realized Activities

Concerning "increased Reproductive Health requests"

  • 89% of foreseen activities were realized;
  • All existing channels within the Malagasy Lutheran Church have been used for spreading RH messages;
  • From 2000 to 2003, the number of new Family Planning clients went from 8,441 to 4,550, those of regular users went from 23,765 to 10,446 and defaulters from 10,542 to 5,970.

For the "accessibility of augmented RH services"

  • 91% of foreseen activities were realized;
  • From 2000 to 2003, the number of Community-Based Health Agents (CBHA) increased from 19 to 65;
  • Integration of at least three RH services at all different level SALFA sites;
  • Seven sites with Norplant implantation;
  • HIV/AIDS testing within SALFA laboratories.

In matters of "improved quality of service"

  • Nearly all the SALFA sites offer, at the least, three different types of modern contraception;
  • Training of medical chiefs at SALFA sites in ACQ or Continuous Quality Control or Improvement.

In "program management"

  • 81% of these activities were realized;
  • Rate of financial absorption during the last program was 89,36%.

Future perspectives
  • Reinforcement of the capacity of people receiving benefits through SIG or System Information in Management;
  • Augmentation of the percentage of sites offering more than three RH methods;
  • Increased number of sites offering Methods of Long Duration (MLD) in regards to Family Planning.
  • Working with other sponsors/partners.

Photos

Five photos are included, showing the activities of Reproductive Health/SALFA.

 Outstanding features
  • Utilization of all Malagasy Lutheran Church channels;
  • Management computerization at 67 Hectares Lutheran Dispensary;
  • Integration of Reproductive Health in a degree course for paramedicals at SEFAM (Lutheran Nursing School);
  • Integration within the sites and taking care of salaries for the previous health motivators supported by the RH project.
Team members
  • One National Project Director
  • One Technical Coordinator
  • One IEC/CC Coordinator
  • One Project Manager
  • One Accountant
  • One Secretary
  • Two chauffeurs (drivers)
  • All personnel within the RH/SALFA sites