Technical Brief: Impact of the Leadership Development Program Plus on Maternal and Child Health Outcomes in Madagascar

  • By: Sylvia Vriesendorp, Aishling Thurow, and Karina Noyes
  • Published Date: September 2017
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Madagascar is one of 40 states participating in the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA). The Campaign focuses on using positive messaging, sharing good practices and lessons learned, and intensifying program and communication activities to significantly reduce the number of preventable deaths among mothers, infants, and children. Through its Ministry of Public Health (MOPH), Madagascar is seeking to use CARMMA as a foundation for reducing maternal deaths from 478 to 200 per 100,000 live births between 2012 and 2019, and neonatal mortality rates from 26 to 16 per 1000 live births over the same period. To achieve these objectives, the MOPH must prioritize improving skilled care to prevent maternal and child deaths, expanding vaccination coverage, increasing the number of deliveries assisted by a skilled birth attendants, and increasing the number of pregnant women attending antenatal care (ANC) visits.

It is widely recognized that strengthening governance and management at all levels of a health system significantly contributes to improvements in health indicators by improving staff motivation and efficiency, service delivery, and the quality of the care. Thus, to help the Madagascar meet its ambitious reproductive, maternal, newborn, and child health (RMNCH) objectives, USAID’s Leadership, Management, and Governance (LMG)/Madagascar Project provided technical assistance to the MOPH between October 2015 and June 2017. The LMG Project delivered its Leadership Development Program Plus (LDP+) to improve the capacity of (a) central- and regional-level MOPH managers to coordinate the delivery of essential quality RMNCH services, (b) district managers to support the effective delivery of those services at health facilities, and (c) health facility staff to improve the quality and reach of their services. The LDP+ guides teams in using a Challenge Model to solve health challenges, including building an understanding of the existing health care situation (defining challenges as opposed to problems), formulating a desired result, analyzing the root causes of past failures in achieving that result, and developing strategies for resolution.