SEED Madagascar

Following five years as a key member of the Community Health team, we put the spotlight on Gerard to talk about his time at SEED and Project Votsira.

What’s your role at SEED Madagascar?

I am the project coordinator for Project Votsira.

How long have you been working for SEED?

I joined SEED Madagascar in 2014 as the coordinator of Project Safidy. I was involved in activities at some schools in Fort Dauphin. In the high school I oversaw the creation of the anti-AIDS club and trained the members about relationships, unwanted pregnancy, STIs, HIV, contraception, and sexuality. In October 2015, I joined project Votsira to work on maternal and child health issues. 

Can you tell us about Project Votsira?

Votsira began in 2011 with a research phase in 11 boroughs of Fort Dauphin. We found that there was high incidence of maternal and infant mortality, birth complications, and STIs. So, in 2013 we launched phase II, a pilot health education course for 220 mothers. Following the course, there was an increase in exclusive breastfeeding and attendance at prenatal appointments.

From 2015-2017 Phase III moved into capacity building activities, training 11 community health workers to deliver courses for ‘preparing for a healthy pregnancy and birth’, as well as conducting home visits with expectant mothers. 352 focus group sessions and 1,408 home visits were completed.

Then from 2017-2019, Project Votsira focused on developing a child health course in collaboration with the Ministry of Health. The course taught the community about common childhood illnesses such as malaria, diarrhoea, pneumonia, and acute respiratory infections.

Why do you think Votsira is important?

Votsira is important because it helps to give mothers essential knowledge about how to keep their children healthy and where to seek health advice. Votsira tackles behaviours such as the consultation of "Reninjaza" (traditional healer) for childbirth.

What have you learned in your time you have been working on Project Votsira?

I have learned a lot about people’s behaviour, how it takes time and patience to influence a community to make lasting changes.

Can you tell me some highlights of the project?

The percentage of mothers who consult Reninjaza for childbirth has significantly reduced. Also, 90% of caregivers who took the child health course can identify the causes, preventive measures and symptoms of malaria, diarrhoea, pneumonia and acute respiratory infections.

Have you faced any challenges in your role?

The belief in "Hevo" (a culturally understood childhood illness) provokes great debate during the focus groups because people think this is a disease which should be treated with herbs and water, administered by a traditional healer. The reality is that the child has severe dehydration from diarrhoea. It was difficult to convince the mothers and elders, but at the end of our discussions, they accepted it.

What are the major challenges for health in Fort Dauphin? 

For maternal and child health, there are two things we can think about:

1. The Fady or "taboo" which are difficult to talk about
2. The challenge to change risky behaviours, because habits are second nature to all of us! 

What would like you to achieve for SEED/Votsira in 2020?

I would like to give my maximum capacity to SEED in order to fulfil our vision. For the project, I would like the next phases to be accomplished with success and efficiency in terms of the impact on beneficiaries.