Geographic barriers to achieving universal health coverage: evidence from rural Madagascar.

Poor geographic access can persist even when affordable and well-functioning health systems are in place, limiting efforts for universal health coverage (UHC). It is unclear how to balance support for health facilities and community health workers in UHC national strategies. The goal of this study was to evaluate how a health system strengthening (HSS) intervention aimed towards UHC affected the geographic access to primary care in a rural district of Madagascar.

Estimating the local spatio-temporal distribution of malaria from routine health information systems in areas of low health care access and reporting.

Background: Reliable surveillance systems are essential for identifying disease outbreaks and allocating resources to ensure universal access to diagnostics and treatment for endemic diseases. Yet, most countries with high disease burdens rely entirely on facility-based passive surveillance systems, which miss the vast majority of cases in rural settings with low access to health care. This is especially true for malaria, for which the World Health Organization estimates that routine surveillance detects only 14% of global cases.

Measles outbreak in 2018-2019, Madagascar: epidemiology and public health implications.

Introduction: In October 4, 2018, a measles outbreak was declared in Madagascar. This study describes the epidemiology of the outbreak and determines public health implications for measles elimination in Madagascar.

Methods: Data have been collected using line list developed for the outbreak.

[Adherence of private sector providers to uncomplicated malaria management policy in Madagascar].

Introduction: This study aims to assess the adherence of private health providers to the use of malaria rapid diagnostic tests (RDTs) and to the prescription of artemisinin-containing combinations (ACT) in patients with uncomplicated malaria.

Methods: We conducted an analytical, retrospective and cross-sectional study in 11 Madagascar's health districts divided into four epidemiological strata in September and in October 2015. A total of 43 health providers from 39 private health care facilities (PHF) were interviewed and visited.