Improving Maternal and Child Health in Madagascar

Overview

Madagascar remains far from achieving the United Nations Sustainable Development Goal (SDG) targets for reducing maternal and child mortality (SDG 3.1 and 3.2). National statistics indicate that 436 mothers per 100,000 live births die from birth-related complications and under-five mortality stands among the highest globally at 64 per 1,000 live births. High rates of preventable childhood diseases further exacerbate child mortality, with respiratory infections alone accounting for 35% of under-five deaths. SEED sought to address these challenges by improving the attitudes and knowledge of community members towards maternal and child health in Fort Dauphin.

One of the key achievements in year 2

Between April 2025 and April 2026 this project has delivered two rounds of the Maternal and Child Health (MCH) curriculum, reaching 840 mothers, 840 pregnant women, and 840 grandmothers across each of the 11 communities of Fort Dauphin. This was delivered by 28 community health workers (ACs) and through the curriculum it has successfully addressed MCH topics, including the causes, symptoms, and prevention of common childhood illnesses, nutrition, breastfeeding practices, antenatal care, skilled childbirth, key MCH practices, and childhood vaccinations. To complement these sessions, ACs also conducted 12,600 follow-up household visits between April 2025 and April 2026. These visits enabled ACs to reinforce the learning for all participants, provide clarification and address participants’ questions, as well as share information with participants’ families. This component is essential to ensuring other key household decision-makers are engaged

Next steps

Following more than a decade of implementation, the next phase of Project Votsira shifts towards adaptive, community-led programming. Urban Votsira: Phase VI in Fort Dauphin will pilot the Asset-Based Community Development (ABCD) approach, building on community strengths. Responding to Phase V findings of high baseline knowledge, fathers will be engaged through one-to-one communication. Rural Votsira: Phase I in Mahatalaky will prioritise learning through research with caregivers, healthcare providers, and community leaders. Two six-month education cycles and training for ACs and CSB staff will strengthen community services, supporting improved maternal and child health across the Anosy Region.

We would like to thank all our donors. Your support has made it possible for SEED to improve 'Mother and Child Health', in Anosy Madagascar.