USAID Health Care Improvement (HCI) | Madagascar Community Health Volunteer Assessment


The USAID Mission in Madagascar requested an external assessment to evaluate the overall functionality of current support systems (programs) in supporting community health volunteers (CHVs) who provide maternal and child health and reproductive health and family planning services in Madagascar’s rural communities. HCI led the qualitative assessment using the Community Health Worker Assessment and Improvement Matrix (CHW AIM). CDC led a quantitative study of CHV performance and factors affecting their performance. HCI then undertook a synthesis both studies to draw conclusions. 


  • HCI led the qualitative study in August 2011 and applied the methodology described in the CHW AIM toolkit to assess the functionality of 1) the USAID/SantéNet2 (SN2) project and 2) CHV activities supported by UNICEF. This study used focus groups and interviews to explore the perceptions and experiences of key stakeholders on the pertinence, usefulness, strengths, and weaknesses of both international organizations in supervising the CHV work
  • HCI wrote (and published in English and French) reports on the qualitative assessment and synthesis.
  • HCI published infographics presenting images of key findings from the qualitative, quantitative, and synthesis reports, with the works done by CDC.
  • HCI organized and UNICEF and the President’s Malaria Initiative in Madagascar co-sponsored a final dissemination workshop (in Madagascar). The workshop disseminated the assessments’ findings, facilitated a root cause analysis of the weaknesses identified in the assessments, and enabled the development of practical strategies to improve CHV activities with respect to implementation coordination that would improve CHV performance and the functionality of programs supporting CHVs. The 64 participants included representatives of the Ministry of Health, UNICEF, USAID, SN2 and its sister project MAEFA, and several local NGOs working in community health. Sarah Smith presented the findings from the qualitative and synthesis assessments, while the CDC’s Alyssa Finlay presented the quantitative findings.
2011 to 2013
US Agency for International Development (USAID)
USAID Mission in Madagascar
United Nations Children's Fund (UNICEF)
USAID SantéNet2
Research Triangle Institute (RTI)
Regions/ Countries 
Geographic Scope 
Analamanga, Atsinanana, and Androy regions