USAID/Madagascar Mikolo Project supports Madagascar’s national policy for the implementation of community-based service delivery, to increase access to and availability of community-based primary health care, especially for women of reproductive age, children under age five, and infants living in remote areas of Madagascar. This evaluation of the Mikolo Project is to: 1) to learn to what extent the project’s goals and objectives have been achieved; and 2) to inform the design of a future community-based health services activity. The evaluation explored if Mikolo will achieve its objectives, how it improved the Government of Madagascar’s use of data for decision-making, and how effective is Mikolo’s management structure. This evaluation utilized qualitative methods (i.e., document review, key informant interviews, focus group discussions and observations), supplemented by a review of existing quantitative data (e.g., project data and Community Health Volunteer (CHV) monthly report data). Working closely with the Madagascar Ministry of Public Health (MOPH), Mikolo has been successful in achieving most of its targeted outcomes in support of community health service delivery. Areas for improvement include training, support, and supervision for CHVs; community engagement for demand creation and healthy practices; and referral systems. Working with local NGOs and MOPH, data quality has improved, but more work is needed to improve the use of these data.
Final Performance Evaluation of USAID Madagascar Mikolo Project