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Apr 11, 2005
Madagascar experiences dramatic improvements in women’s and children’s health

Mothers and children in Madagascar have experienced a two-fold improvement in health in recent years. Breast feeding, use of family planning, vitamin A supplementation, and vaccination coverage are all on the rise, according to the latest MEASURE DHS survey released April 8 in Antananarivo.

Children’s nutritional status has improved since the last DHS survey of Madagascar in 1997. The number of mothers who start breastfeeding their children within one hour of birth has almost doubled, as has the number of mothers who exclusively breast feed their infants under six months of age. Supplementation of vitamin A reached 76 percent of children, compared to only 4 percent in 1997.

Full vaccination coverage for children age 12-23 months has increased from 36% in 1997 to 53% in 2003-2004. Treatment of diarrhea through the use of oral rehydration therapy has almost doubled since the 1997 survey and is now used to treat 43 percent of children with diarrhea.

“These improvements are the result of interventions that USAID has implemented in Madagascar over the last several years based on data we have provided them,” explained MEASURE DHS Director Martin Vaessen. “In the 15 years we have been studying health-related issues in African countries, this is probably the most dramatic rise we have seen in the use of preventative medicine, and ultimately, Madagascar will be a country with lower incidence of childhood illnesses.”

This study also found that women have, on average, 5.2 children, down from 6 in 1997. This is largely due to an increase in knowledge and use of modern contraceptive methods, particularly in rural areas where current use of modern methods rose from 7 percent in 1997 to 16 percent in 2003-2004. Overall, 18 percent of women in union now use a modern method of family planning, roughly the same percentage as in Tanzania (1999), Uganda (2001) and Ghana (2003). Injectables (10 percent) and the pill (3 percent) are the most popular methods. Periodic abstinence is practiced by 8 percent of women.

Undernutrition still represents a major challenge for Madagascar authorities. Almost half of the children under age 3 are stunted (short for their age) and 14 percent are wasted (too thin for their height), both signs of malnutrition.

The 2003-2004 study implemented biological testing (biomarkers) for the first time to measure the prevalence of anemia and syphilis and to assess the immunity level of women and children against tetanus and the immunity level of children against measles. Results show that 7 in 10 children age 6-59 months have some level of anemia, as do nearly half the women age 15-49. Four percent of men and women have recently had syphilis. Three in five women are completely immunized against tetanus, compared to 53 percent of children. Sixty-three percent of children are immunized against measles.

About MEASURE DHS: The Demographic and Health Surveys (DHS) project is a global data collection effort funded by USAID and carried out by ORC Macro and in-country implementing organizations. These nationally representative household surveys collect data on demographic patterns, fertility, health, and nutrition for policy and program planning. The 2003-2004 survey in Madagascar is the third DHS survey implemented in that country; the first two took place in 1992 and 1997. Together, the data allow for analysis of trends in health indicators.

About the 2003-2004 Madagascar DHS: This survey is based on interviews with 7,949 women age 15 to 49, and 2,432 men age 15 to 59, from the six provinces of the country. The Direction de la Démographie et des Statistiques Sociales (DDSS) [Directorate of Demography and Social Statistics] of the Institut National de la Statistique (INSTAT) [National Statistical Institute] carried out the survey with technical support from ORC Macro through the MEASURE DHS project. Funding was provided by the World Bank through its projects: the Programme Multisectoriel pour la Prévention du Sida (PMPS) [Multisectoral Program for the Prevention of AIDS], CRESAN 2, and SEECALINE; the United Nations Children’s Fund (UNICEF); the United Nations Fund for Population Activities (UNFPA); and the U.S. Agency for International Development (USAID).