Summary

Key program components

Marie Stopes Madagascar builds the capacity of providers within the network to deliver high-quality sexual and reproductive health services, focused on long-term family planning methods. Franchises are located in peri-urban and rural areas. The 104 clinics, which are located in 12 out of 22 regions of the nation, are comprised of 1 doctor per clinic at the time being.

Community Health Workers also play an integral part in developing informed demand within the community by doing interpersonal communication through household visits and small-group sensitization.

A voucher project was launched in the final quarter of 2010. The voucher covers counseling on all FP methods, comprehensive FP options and STI counseling and screening. HIV services are provided at selected outlets. Currently, 42 BlueStar franchisees in two provinces are testing a new Integrated SMS System, which, among other functions, facilitates voucher verification and payment.

BlueStar Madagascar currently faces challenges in finding private doctors in rural and peri-urban zones, as there are fewer than 700 accredited doctors nationwide. And given the wide geographic area of coverage, to achieve national impact, it also faces troubles in monitoring and evaluating teams. But on the positive end, the efforts of the organization have been fortified by the strong public and private partnership (Ministry of Health, National Board of Directors) that has been successfully established.

Quality assurance and performance monitoring methods include:

• Regular site visits (4/year)

• Internal clinical audits (1/year)

• External clinical audit (1/year)

• Mystery clients (1/year)

• Client exit interviews (1/year)

The program uses the findings of these assessments to create recommendations for providers and work plans for improvement. The program reports that the quality technical assurance checklist is its most useful quality-related tool.

In 2013, BlueStar Madagascar plans to fractionally franchise seven public sector clinics and launch a program with e-vouchers for youth.

98,000 total visits (recorded in 2012).