The Ministry of Health (MOH) of Madagascar committed in 2015 to increase the country’s modern contraceptive prevalence rate (MCPR) from 33% in 2012 to 50% in 2020. Contraceptive use is substantially lower in rural areas (37% MCPR) as compared to urban areas (51% MCPR) (ENS/OMD 2012-2013).
Task sharing with community health workers (CHWs) is a promising strategy to expand contraceptive coverage, make access more equitable, and utilize health workers’ skills cost-effectively. CHW programs are considered a High Impact Practice by USAID, especially in places like Madagascar with geographic barriers to health services.
In 2015, the MOH decided to introduce DMPA-SC—including community-based provision—to increase women’s options.