@article{fdi:010077250,
  title = {{B}aseline population health conditions ahead of a health system strengthening program in rural {M}adagascar},
  author = {{M}iller, {A}.{C}. and {R}amananjato, {R}.{H}. and {G}architorena, {A}ndres and {R}abeza, {V}.{R}. and {G}ikic, {D}. and {C}ripps, {A}. and {C}ordier, {L}. and {R}ananiraka {R}azanadrakato, {H}.{T}. and {R}andriamanambintsoa, {M}. and {H}all, {L}. and {M}urray, {M}. and {S}afara {R}azanavololo, {F}. and {R}ich, {M}.{L}. and {B}onds, {M}.{H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {A} model health district was initiated through a program of health system strengthening ({HSS}) in {I}fanadiana {D}istrict of southeastern {M}adagascar in 2014. {W}e report population health indicators prior to initiation of the program. {M}ethods: {A} representative household survey based on the {D}emographic {H}ealth {S}urvey was conducted using a two-stage cluster sampling design in two strata-the initial program catchment area and the future catchment area. {C}hi-squared and t-tests were used to compare data by stratum, using appropriate sampling weights. {M}adagascar data for comparison were taken from a 2013 national study. {R}esults: 1522 households were surveyed, representing 8310 individuals including 1635 women ages 15-49, 1685 men ages 15-59 and 1251 children under age 5. {M}aternal mortality rates in the district are 1044/100,000. 81% of women's last childbirth deliveries were in the home; only 20% of deliveries were attended by a doctor or nurse/midwife (not different by stratum). 9.3% of women had their first birth by age 15, and 29.5% by age 18. {U}nder-5 mortality rate is high: 145/1000 live births vs. 62/1000 nationally. 34.6% of children received all recommended vaccines by age 12 months (compared to 51.5% in {M}adagascar overall). {I}n the 2 weeks prior to interview, approximately 28% of children under age 5 had acute respiratory infections of whom 34.7% were taken for care, and 14% of children had diarrhea of whom 56.6% were taken for care. {U}nder-5 mortality, illness, care-seeking and vaccination rates were not significantly different between strata. {C}onclusions: {I}ndicators of population health and health care-seeking reveal low use of the formal health system, which could benefit from {HSS}. {D}ata from this survey and from a longitudinal follow-up study will be used to target needed interventions, to assess change in the district and the impact of {HSS} on individual households and the population of the district.},
  keywords = {{MADAGASCAR} ; {IFANADIANA}},
  booktitle = {},
  journal = {{G}lobal {H}ealth {A}ction},
  volume = {10},
  numero = {},
  pages = {art. no 1329961 [10  en ligne]},
  ISSN = {1654-9880},
  year = {2017},
  DOI = {10.1080/16549716.2017.1329961},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077250},
}