Think about the last time you went to the doctor. Did you feel confident that the staff were all doing a good job? Did it seem like they cared about your health? Not everyone has a health center where they trust the staff. In a lot of Madagascar, people don’t go to the health center because they don’t trust that it will help them. But CARE Madagascar has been able to change that.
“Now nurses are recognized for their competence and are accepted socially.”
That statement captures the biggest change in the Reinforcing Nutrition Actions project—the communities and health centers are working together. As a result, kids are healthier, and families are eating better.
RAN-AINA ran from 2014-2017 in Madagascar with $1.2 million from the European Union. It reached 18,000 people directly and 82,068 people indirectly.
What have we accomplished?
- Kids are healthier: Kids are 35% less likely to be stunted (permanent damage to their growth potential), 66% less likely to be underweight, and twice as likely to be vaccinated as they were before the project.
- Families have more diverse diets: Kids are 21 times more likely to have diverse diets, and women are 3.6 times more likely to have good dietary diversity than in 2014.
- Women get more help at home: Women are 5 times more likely to have help from men in improving health and nutrition for their families.
- Food and water are safer: Families are 2.5 times more likely to use good food safety practices, 5.5 times more likely to wash their hands, and 80% more likely to treat water so it’s safe to drink.
- Health services have improved: Women are 64% more likely to give birth in a health center, and 17% more satisfied with health services.
- Women have more power: Women get more support from their husbands, are more able to take on jobs outside the home, and have better ability to make decisions.
How did we get there?
- Focus on communication: RAN-AINA used movies, skits, and door-to-door education to improve people’s knowledge and skills about health issues. People were 7.7 times more likely to know key information about WASH, and 89% more likely to know and apply safe food preparation and storage techniques.
- Work closely with health centers: The project worked with local health centers and workers to improve services, provide extra nutritional treatment during the hungry season, and extend their services on growth monitoring and nutritional counselling.
- Get communities involved: Communities and local governments got together to create nutrition action plans. One activity many communities started was organizing wagons to take women to public health centers for their appointments.
- Work with men and boys: They got men to be champions for equality in a program called “Mirror Dads,” and set up dialogues where men and women could talk about changing their workloads at home.
- Bring communities and governments together: The project used the Community Score Card to bring communities, health centers, and governments to plan better services.
- Support savings groups: RAN-AINA created 447 savings groups with 9,178 members to help families save money to meet their nutrition and health goals.
Want to learn more?
Check out the final evaluation.