Celebrating achievements, pointing the way forward in Madagascar

In September 2021, the SHOPS Plus project in Madagascar concluded its six-year program with a virtual end-of-project event that highlighted accomplishments and shared lessons learned. The event had over 50 representatives from the Ministry of Health, USAID, implementing partners, and private health facilities and associations in attendance. Project director Susan Mitchell opened the event and Sophia Brewer, Health, Population and Nutrition Director at USAID/Madagascar gave introductory remarks.

Sarindra Ramanitrivonony, SHOPS Plus Chief of Party in Madagascar, presented key results from two focus areas in Madagascar, strengthening private provider capacity and laying the foundation for public-private engagement, and facilitated panel discussions with local partners and collaborators to share lessons learned and offer future insights.

Strengthening private provider capacity

To address the lack of access to continuous professional development opportunities among private sector providers, the project trained providers in quality assurance and continuing quality improvement, business and financial management, and reporting into the National Health Information System. To ensure continued access to the trainings after SHOPS Plus ends, the project identified and coached local organizations to deliver these trainings and worked with the School of Medicine at the University of Antananarivo to integrate the training content into the university curriculum for medical students.

At the end-of-project event, Dr. Yvan Ranaivoson, director of the Institute of Technology, Education and Management, Dr. Tiana Fanantenana Razafindrakoto, chief doctor of the TPFV Clinic, and Ms. Oméga Ranorolala, president of the National Order of Midwives, offered their perspectives on these accomplishments. Dr. Razafindrakoto, who attended multiple SHOPS Plus trainings, stressed the importance of maintaining access to trainings for private health facilities. He said, “We call on all partners working in the health sector to prioritize training supported by monitoring and evaluation. In this era of rapid technological and scientific development, we, private health facilities, greatly need your support to enable us to disseminate the latest health information and provide appropriate care for the patients under our responsibility.”

Laying the foundation for public-private engagement

To build a solid foundation for effective public-private engagement for health, SHOPS Plus worked with local partners to better understand and organize the private health sector. In particular, the project facilitated the organization of the private sector through the creation of the Federation of Health Mutuelles, the Association of Private Hospitals, and the Private Health Sector Group, and through the first private sector trade fair. In addition, SHOPS Plus conducted the first private health sector census that identified and mapped more than 3,000 private health facilities in the country.

At the end-of-project event, Dr. Larissa Randriamialy, technical assistant at the District Public Health Service for Antananarivo Renivohitra, and Dr. Barbara Rakotonarivo, president of the Private Health Sector Group, discussed the implications of having these new organizations. Dr. Rakotonarivo highlighted how the Private Health Sector Group has become the official voice of the private health sector to the Ministry of Health. “The Private Health Sector Group has been recognized by the Ministry of Health as a real strategic interlocutor in the development, implementation, and monitoring of all sectoral policies and regulations affecting the field of health,” Dr. Rakotonarivo said.

The future of private sector engagement in Madagascar

SHOPS Plus leaves behind a burgeoning private health sector that is better prepared to provide high quality services to the Malagasy population and engage with the public sector to increase access to care. While the project has made important contributions to the growth, strengthening, and representation of the private sector, it is critical that private sector actors in Madagascar build upon this work going forward.

As Bewer said in her opening remarks, “Private sector engagement leverages expertise, innovation, and resources to build national self-reliance capacities. The private sector should therefore play an important role in the creation and implementation of opportunities that improve the lives of individuals and communities.”

View the recording of the event here.

SHOPS Plus impact in Madagascar: By the numbers

	844,623 couple years of protection provided.
	Over two billion liters of water treated.
	More than 225,000 people counseled; 2,326 IUDs and 26,070 implants inserted.
	125,522 calls on key health issues, including the plague and measles, answered through the MinSaP 910 hotline.
	1,623 private providers trained in quality assurance/ continuing quality improvement (QA/CQI); 590 trained in business and financial management; and 349 trained in HMIS reporting.
	45 individuals from 14 local organizations trained on independently delivering the SHOPS Plus QA/CQI and business management trainings.
	478 loans totaling $2,938,506 disbursed to private providers in health and WASH sectors.
	3,090 private health facilities identified and mapped in the first national private health facility census.
	3 new organizations representing the private health sector created.