Announcements March 16, 2021

Ensuring PPE for All CHWs in Madagascar

by Mathilde Hutchings, Director of Partnerships


In Ifanadiana District, community health workers (CHWs) are the foundation of the healthcare system. In a region where the majority of the population faces geographic barriers to seeking care in formal health facilities, CHWs ensure that essential care is reachable on the frontlines of rural communities. As such, it is crucial to consider the protection of CHWs in the midst of an infectious disease pandemic, when their work is made even more vital as first responders serving the members of their remote communities.

CHWs are providing the first line of response in the COVID pandemic – from case identification, to contact tracing, referral to higher levels of care, and treatment followup. Like all other health workers, they deserve and require adequate protection to ensure not only their own safety, but also that of their patients and communities.

Too often, however, CHWs are overlooked as essential health workers when ministries of health take stock of their needs for supplies such as personal protective equipment (PPE). In early 2020, the Covid-19 Action Fund for Africa (CAF-Africa) was launched to change that.

As a member of the Community Health Impact Coalition (CHIC), PIVOT has been given the opportunity to serve as the lead in-country partner for Madagascar for the initiative, which aims to secure and distribute enough PPE to provide for all CHWs in more than twenty African countries.

We are thrilled to be partnering with CAF-Africa and the Madagascar Ministry of Public Health to lead this initiative in Madagascar. Last week, we gathered 13 representatives from 7 partners in a workshop to launch the initiative. Together, as we await the 12 million pieces donated, we’ll be puzzling through all of the hard questions about how to receive, store, distribute, and count the PPE as it is donated. We’ll organize to ensure all CHWs are trained in the proper donning, doffing, use, and disposal of PPE. And we’ll together tackle difficult decisions along the way, such as what to do in the event that facility-based healthcare workers don’t have enough PPE, and if/when/how to reallocate stock from that which was donated for use by those at the community level. 

This opportunity is a milestone for PIVOT: it is the first time we are working at a national level with multiple partners, NGOs and Ministry alike, to address a public health need across the country, all the way to the last mile. It will undoubtedly generate valuable lessons as we start thinking about our plans to scale our work across other regions of Madagascar. 

Most important of all, this initiative will provide much-needed protection for CHWs as they serve their communities. The pandemic has provided a reminder, in Madagascar and around the world, that the vitality of our health workforce is essential if we ever hope for our health systems to be responsive to population needs and resilient in the face of health crises. With the help of the CAF-Africa initiative, we are eager to provide CHWs across Madagascar with the protection they need to get through this period of pandemic, but also to amplify the importance of recognizing community health workers as a crucial part of global health the world over in the long-term.


To learn more about CAF-Africa’s ongoing effort to get PPE to CHWs across the continent, check out this interactive progress map and explore the rest of their website!