With over three-quarters of Madagascar’s population living below the poverty line, community health volunteers (CHVs) often provide a vital service for the region, as they are trusted members of and/or have an unusually close understanding of the community they serve. This trusting relationship enables CHVs to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. More than 13,000 CHVs in Madagascar are serving the needs of its predominately rural population.

URC began working in Madagascar in 2011 when the USAID mission in Madagascar requested an external assessment to evaluate the overall functionality of existing support systems (programs) in supporting CHVs who provided maternal and child health and reproductive health and family planning services in rural communities. Our work helped to bring together CHVs, supervisors, program implementers, and other key stakeholders to build consensus on program functionality and identify areas for improvement.