Madagascar

Madagascar is again a member of the African Union and Southern African Development Community (SADC), following successful national elections that installed a democratically elected president in 2014. Many bilateral donors had suspended all but humanitarian aid after the 2009 coup, but most have resumed development programming in the country. However, inadequate roads to reach dispersed populations in remote areas, recent natural disasters -- including locusts and both flooding and drought -- and extreme poverty pose significant challenges to the country’s aspirations for development.

The government of Madagascar has named economic recovery, infrastructure, education, energy, and health as areas for focus. The Ministry of Health (MOH), in collaboration with key health partners, has developed and implemented interventions to build an integrated electronic health management information system (HMIS) to strengthen and facilitate the reporting of health information at regional and district levels. MEASURE Evaluation was supporting the work of an integrated HMIS while also ensuring that, in the meantime, the surveillance system can respond rapidly to notifiable diseases, such as malaria, plague, polio and hemorrhagic fevers. As Madagascar moves toward consideration of pre-elimination strategies for malaria, a strong surveillance system is necessary for close monitoring of the number of malaria cases and documentation of detailed information on cases for active case detection.

In 2015, MEASURE Evaluation conducted a Performance of Routine Information System Management (PRISM) assessment to measure the performance of both the routine health information system (RHIS) and the infectious disease surveillance and response system (IDSR). The PRISM assessment showed major deficiencies in data quality and use of information for decision making, as well as data access problems for infectious diseases, and more particularly malaria. As a result, MEASURE Evaluation provided technical assistance to the MOH to strengthen the collection, analysis, and use of high-quality routine health and surveillance data and to improve capacity within the ministry to manage HIS, surveillance resources, and staff.

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