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Madagascar recently launched a national community health strategy, which outlines plans to institutionalize its 35,000 community health volunteer (CHV) cadre (known locally as agents communautaires, or ACs) and strengthen community health. Historically, CHVs have been supervised by health providers based at basic health centers. However, competing workload demands have resulted in CHVs receiving inadequate or no supervision. To address this gap, Madagascar’s USAID Accessible Continuum of Care and Essential Services Sustained (ACCESS) Program is currently supporting the rollout of a new peer CHV supervision model in the country.
The importance of supervision of CHVs is recognized with an emphasis on the need for “regular and systematic supervision.” However, while the strategy to recruit CHVs to serve as supervisors of other CHVs is a strategy piloted or employed in several countries, such as in Malawi and Uganda, there is very limited evidence on its impact. This program evaluation aims to 1) document how Madagascar’s peer supervision model works, what aspects of the model work well/do not work well and why, and identify areas for refinement/improvement of the model; 2) assess the implementation fidelity; 3) determine the feasibility and acceptability of the model among key stakeholders; and 4) evaluate the peer CHV supervision model in terms of its principal outputs and outcomes.
Research Question: What approaches are effective and sustainable for improving supervision of community health volunteers providing malaria case management and other health services at community level?
Study team: LSHTM, UCSF, local partner TBD
Timeline: July 22, 2022 – Sept 30, 2024