New Study Highlights Impact of Pivot’s Enhanced Community Health Program

13 Mar New Study Highlights Impact of Pivot’s Enhanced Community Health Program

Posted at 16:56h in Research by

 

Community Health Workers (CHWs) provide essential primary care in rural regions like Ifanadiana District, Madagascar. A new study in PLOS Global Public Health highlights the findings from an evaluation of Pivot’s enhanced community health (ECH) program. The pilot program improved patient access to primary care services, increasing CHW visits with children under-five by 269% from October 2019 to March 2021. 

Within the ECH program, trained CHWs provided care for children under-five and pregnant women through household visits and at community health posts. CHWs were supervised twice monthly and received financial incentives for their work. In addition to increasing utilization, the program also improved quality of care, with 85% of sick children diagnosed and treated correctly, compared with 58% in areas without ECH. 

The study reinforces that high quality, accessible care is essential to improving the health of communities and increasing access. “This [paper] is an important contribution in addressing a central challenge for improving health care in rural areas,” commented Matt Bonds, Pivot Scholar and Co-Founder.

Findings from the study have informed the scale-up of Pivot’s support for community health activities across Vatovavy Region. Over the next year, Pivot’s ECH program will expand to support 2,500 CHWs who will be trained, equipped, and supervised, providing care to 151,000 children under-five and nearly 200,000 women of reproductive age. 

The study was led by Bénédicte Razafinjato, Pivot’s Director of Monitoring, Evaluation, Accountability, and Learning (MEAL) and Karen Finnegan, Managing Director of Pivot Science and a Research Associate at Harvard Medical School.  

 

Figure: The enhanced community health program increased visits to CHWs across Ranomafana commune, but especially in fokotany (groups of villages) farther from the health center, demonstrating the vital role CHWs play in improving access to care for remote communities.




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    • Molecular Diagnostics

      Pivot has partnered with the Ministry of Public Health and Centre ValBio to develop the first molecular diagnostics laboratory for COVID-19 outside of the capital city.  We additionally have partnered with the Pasteur Institute of Madagascar on novel analysis of dried blood spots from I-HOPE survey for serological analysis of measles, malaria, schistosomiasis, Hep B, and COVID-19.

       

      Learn more: 

      Integrating Health Systems and Science to Respond to COVID-19 in a Model District of Madagascar, Rakotonanahary, R.J.L., et al., 2021, Frontiers in Public Health

      Reconciling model predictions with low reported cases of COVID-19 in Sub-Saharan Africa: Insights from Madagascar, Evans, M.V., et al., 2020, Global Health Action

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      Learn more:

      Estimating the local spatio‐temporal distribution of malaria from routine health information systems in areas of low health care access and reporting, Hyde, E, et al., 2021, International Journal of Health Geographics

      Reconciling model predictions with low reported cases of COVID-19 in Sub-Saharan Africa: Insights from Madagascar, Evans, M.V., et al., 2020, Global Health Action

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      • True baseline
      • True representative sample
      • Sample from inside and outside of the initial catchment population
      • Collection by third party professionals at the National Institute of Statistics who collect identical data nationally
      • Tracks same individuals over time
      • Includes biomarkers such as dried blood spots used for molecular analyses

       

      Learn more: 

      Baseline Population Health Conditions Ahead of a Health System Strengthening Program in Rural Madagascar, Miller, A., et al. 2017, Global Health Action

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      Learn more: 

      Integrating Health Systems and Science to Respond to COVID-19 in a Model District of Madagascar, Rakotonanahary, R.J.L., et al., 2021, Frontiers in Public Health

      Reconciling model predictions with low reported cases of COVID-19 in Sub-Saharan Africa: Insights from Madagascar, Evans, M.V., et al., 2020, Global Health Action

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      Learn more:

      Estimating the local spatio‐temporal distribution of malaria from routine health information systems in areas of low health care access and reporting, Hyde, E, et al., 2021, International Journal of Health Geographics

      Reconciling model predictions with low reported cases of COVID-19 in Sub-Saharan Africa: Insights from Madagascar, Evans, M.V., et al., 2020, Global Health Action

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      Learn more:

      Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar, Razafinjato, B., et al., 2020, medRxiv

      Rapid response to a measles outbreak in Ifanadiana District, Madagascar, Finnegan, K.E., et al., 2020 medRxiv

      Networks of Care in Rural Madagascar for Achieving Universal Health Coverage in Ifanadiana District, Cordier, L.F., 2020, Health Systems & Reform

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      Learn more:

      Estimating the local spatio‐temporal distribution of malaria from routine health information systems in areas of low health care access and reporting, Hyde, E, et al., 2021, International Journal of Health Geographics

      Improving geographical accessibility modeling for operational use by local health actors, Ihantamalala, F.A, et al., 2020, International Journal of Health Geographics

      Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar, Razafinjato, B., et al., 2020, medRxiv

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      Learn more:

      District-level health system strengthening for universal health coverage: evidence from a longitudinal cohort study in rural Madagascar, 2014-2018, Garchitorena, A., et al. 2020, BMJ Global Health

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      Assessing trends in the content of maternal and child care following a health system strengthening initiative in rural Madagascar: A longitudinal cohort study, Ezran, C., et al. 2019, PLOS Medicine

      Baseline Population Health Conditions Ahead of a Health System Strengthening Program in Rural Madagascar, Miller, A., et al. 2017, Global Health Action

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      Children under 5 are those most likely to die from preventable causes like malaria, pneumonia and diarrhea. We implement protocols for the Integrated Management of Childhood Illness to guide health workers in diagnosis and treatment and to assess nutrition and vaccine status in low-resource settings.