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Introduction.
Madagascar, the world's fourth largest island with a population of 13.25 million, is a paradox of poverty and promise. One of the world's poorest nations with a per capita gross national product (GNP) of $223 per year, Madagascar has moved peacefully from a dictatorship to a multi-party democracy, while making important strides toward a liberalized, market economy. Supporting these positive trends, the USAID program aims to accelerate economic growth by stimulating private investment and employment and by balancing population growth with the country's unique natural resources.
Assistance to Madagascar supports United States interests by promoting free enterprise, opening new or formerly protected markets for American firms (e.g., tourism, exotic natural materials) and U.S. products (e.g., telecommunications, construction and agriculture); fostering democratic values and institutions; and preserving one of the planet's most exceptional sources of biodiversity, where 80% of the flora and fauna are found only in Madagascar and whose agricultural, pharmaceutical, and commercial potential still is neither fully known, nor even partially exploited.
The Development Challenge.
Madagascar is a rural, subsistence agricultural society where rice is the heart of the economy, diet and culture. High population growth at 2.8% contributes to the relentless decline in the standard of living, while severely threatening Madagascar's rich and unique ecology. Indeed, with half the households now below the poverty line, widespread poverty itself has become a serious threat to the fledgling democracy. Fifty-one percent of children under five are chronically undernourished. Infant and child mortality is also high at 163 per 1,000 live births. Forty-five percent of the population is under 15. These factors produce a high labor-force growth rate and increasingly high unemployment levels.
This bleak picture is in striking contrast to the country's rich resource base. The adequate rainfall, reasonably good soils, agro-climatic variation, mineral wealth and good education levels found in Madagascar are inconsistent with the World Bank's 1995 World Development Report which ranks Madagascar as the 13th poorest country out of 132 nations and with the degree of abject poverty evident everywhere.
Transformation to a market economy began toward the end of the socialist dictatorship. Between 1986 and 1990, the economy grew by 13%. The transition to democracy followed in 1991. Four free-and-fair elections later, Madagascar has an invigorated civil society and an improved human rights record, but the institutions and traditions of a democratic market economy, such as an independent judiciary and rule of law, are in their infancy. However, the successful democratic transition was not costless as the economy declined, further increasing poverty. Since 1994, the Government of Madagascar (GOM) has carried out several difficult reforms, but a coherent macroeconomic reform program is still hostage to political in-fighting, institutional immaturity and individual self-interest.
Madagascar's main debt accumulation occurred in the 1980s. External debt was $5 billion in 1995, leading to a crushing debt service equal to 57% of export receipts. In the face of a stalled economy, Madagascar suspended and is seeking to reschedule debt service payments. The U.S. Government provided debt relief for Title I food in 1992. Because of its extreme poverty and lack of viable institutions, Madagascar is not an early candidate for graduation from development assistance.
Other Donors.
In FY 1994, the United States provided about 7.6% of all donor assistance to Madagascar, in addition to France (31.9%), International Development Association (18.5%), Japan (11.9%), Economic Development Fund (8.5%). Currently, major donors include the World Bank, France, the European Union, Switzerland, the United Nations, Italy, Germany and Japan.
FY 1997 Program.
USAID assistance supports Madagascar's efforts to redress its poverty through accelerated economic growth in the near term, while addressing two longer-term challenges: natural resource degradation and high population growth.
To restart economic growth, USAID is working on financial, marketing and legal systems and institutions. USAID's purpose is to open access to poor people and to micro and small businesses. USAID provides business and financial services and helps firms identify new markets and business opportunities in agricultural production and processing, leading to higher productivity and incomes in two neglected, but high potential regions. USAID also supports farm-to-market road rehabilitation by small, local contractors and with maintenance by local citizens. USAID works nationally with non-governmental organizations (NGOs), with women's groups, and with human rights groups, and business and civic organizations to strengthen civil society and democratic participation.
To sustain economic growth, establishing a balance between population growth and natural resource use is vital. The primary threat to long-term economic growth in Madagascar is the persistence of traditional, extensive agricultural and land management practices which are inappropriate in the face of increasing population pressure on the land.
To reduce natural resource degradation and advance the U.S. Government's goal to preserve biodiversity, USAID was a founding member and is the biodiversity leader in Madagascar's innovative, 15-year Environmental Action Plan (EAP) -- Africa's first. USAID is a partner with international and local environmental NGOs to: conserve biodiversity within Madagascar's national parks, improve the management of national parks and forests, encourage environmentally-sound income-producing activities for the rural poor, and strengthen Malagasy natural resource management institutions.
High population growth is a major contributor to the country's declining standard of living. USAID strategy will reduce the total fertility rate to take pressure off the country's natural resource base. USAID supports a rapid expansion of culturally acceptable family-planning and child-survival services throughout Madagascar.
A plan will be developed over the next year to reduce the USAID program in Madagascar. The program currently addresses four goals. Over the next three years, the program's focus on Economic Growth will be reduced.
USAID expects to remain engaged in Natural Resources Management, Family Planning and Child Survival and Democracy and Governance. The USAID Mission currently has 13 direct hire employees; this presence will be reduced by roughly one half.
Agency Goal: Encouraging Broad-based Economic Growth
Madagascar's widespread poverty can be alleviated only by rekindling economic growth and creating jobs for the rapidly growing labor force. USAID strategy combines financial market reform and Government policy changes to create an overall environment which will encourage private sector investment and growth. At the same time, lack of market access for high-potential, but neglected, agricultural zones has restrained Madagascar from producing the agricultural surpluses needed to raiseincomes and to sustain higher economic growth rates. Agricultural productivity is limited by the lack of technology and inputs, while marketing is constrained by inadequate transportation and communication infrastructure. By increasing access to domestic and international markets for these high potential zones, USAID will help raise small farmer incomes and boost the sales and employment of rural small and medium-sized agribusinesses.
Since 1994, USAID's financial market reform efforts have achieved a steady stream of successes. For the National Savings Bank (NSB), they include a major restructuring, independent management and repayment of a long-standing debt of $1.5 million by the GOM. The NSB was profitable in 1995 for the first time in recent history as it provided better services and increased interest rates for customers. The number of depositors grew from 254,770 in September 1993, to 323,863 by September 1995. The Central Bank improved its monetary-policy management as inflation was reduced from 55% in 1994 to 37% in 1995. USAID also promotes commercial law reform and increased civil-society participation in public policy debates. The GOM has requested USAID's help in modernizing the legal and judicial framework to encourage private sector growth. Finally, civic organizations are seeking USAID assistance to become more effective advocates in the public policy arena.
USAID commercial agricultural promotion efforts are also showing results. More Malagasy agribusinesses are purchasing U.S. agricultural and manufacturing equipment. USAID rice-research shows that new rice seed varieties can double yields without fertilizer and achieve 300-400% increases with fertilizer. USAID assistance led to sales of $5.9 million in non-traditional exports to South Africa, Europe and the United States in the past two years.
Inadequate transportation infrastructure is a major rural constraint to development. By increasing market access of high potential zones, USAID will quickly help raise small farmer incomes and boost rural sales and employment. USAID will rehabilitate 170 miles of farm-to-market roads in 1996, opening highly productive areas for the first time in decades.
Agency Goal: Protecting the Environment
Madagascar's natural resource base is seriously threatened by human poverty and unsuitable government policies. Slash-and-burn agriculture has destroyed over 80% of the tropical forest cover, and the resulting greenhouse gases impact negatively on global climate change. Soil erosion is among the worst in the world. An estimated 80% of Madagascar's species are found nowhere else on earth. The destruction of this treasure trove of biodiversity, the loss of habitat and the extinction of rare plants and animals are of global concern, most critically with regard to new genetic materials needed for advances in medicine and agriculture.
To preserve this unique heritage of biodiversity, USAID partners show local people alternative income-producing activities which reduce pressures on the rain forests. Rural people are being taught how to manage their natural resources in non-destructive and sustainable ways. USAID-funded efforts build the capacity of local communities and help change policies which empower local populations. For example, local community groups now receive 50% of park-entry receipts and a share of forest-cutting fees. USAID support has created Madagascar's first environmental impact assessment law, and has established an innovative private environmental foundation. A debt-swap supports agro-forestry and tree planting and has reduced uncontrolled burning by 71% from 1991 to 1995.
USAID supports the Malagasy EAP through innovative activities which maintain biodiversity and strengthen national and local institutions responsible for natural resource management. USAID support has expanded the amount of land under protection and developed Madagascar's first National ParksService. Using sophisticated spatial analysis, including geographic information systems, of the pressures on these parks, USAID partners, including Peace Corps, PACT, Conservation International, World Wildlife Fund, Cooperative for American Relief Everywhere (CARE), Wildlife Conservation Society, and universities such as Cornell and State University of New York/Stonybrook, are decreasing destructive practices and making local populations responsible for sustainable resource use. Activities with the Malagasy Forest Service have doubled its field presence by adding 400 field agents, set market rates for valuable tropical hardwoods, increased revenue to the National Forestry Fund by seven-fold in 1995, and developed participatory forest-management plans which involve local beneficiaries in forest management. Also, revenue-sharing with local populations increased 47% in protected areas in 1995, while tourist visits to parks and reserves increased by 111%.
The EAP second phase starts in 1996 and USAID will again be a major financial and technical contributor. USAID support will further shift management responsibility to Malagasy institutions, expand local participation, increase ecotourism and private sector involvement, and encourage Madagascar's strong commitment to the country's expanded National Parks system.
Agency Goal: Stabilizing World Population and Protecting Human Health
At Madagascar's current annual population growth rate of 2.8%, the population of 12.2 million (1993) will double by the year 2018. This poses a serious development obstacle as the island's carrying capacity is limited by low agricultural productivity. Such growth also requires unprecedented increases in jobs, health care services and schools, none of which meet present needs. The 1992 Demographic and Health Survey confirmed that Madagascar meets all the criteria for selecting a population and health strategy focus. The USAID program focuses on the rapid expansion of family planning, with an increasing emphasis on child survival. Increased access to quality family planning and child survival services together will lead couples to desire fewer births. Quality family planning services and fewer children dying in infancy should decrease the number of children that couples have.
USAID's support responds to the priorities of the GOM and its people. Madagascar's National Population Policy (NPP) calls for a reduction in fertility, increased access to family planning services, and improvements in child survival. The NPP was developed by representatives of non-governmental organizations (NGOs), religious groups, and GOM agencies from many different sectors. Over the last three years, government and non-government representatives have demonstrated their interest and support not only by participating in USAID-financed activities, but also by playing lead roles in coordination, monitoring and service delivery.
USAID interventions have increased availability and use of modern contraception, enabling women to reduce the number of unwanted births and, therefore, improve reproductive health. Increased availability and use of condoms supported by USAID will also reduce the risk of contracting the Human Immunodeficiency Virus (HIV) and sexually transmitted diseases for men and women.
By 1992, earlier USAID family planning support had contributed to a dramatic drop in the average number of children born per woman, to 6.1. Current efforts have expanded the volume of activities and range of approaches. Contraceptive protection provided through the public and NGO sectors has increased from 124,000 couple-years of protection in all of 1994 to 136,000 in the first half of 1995 alone. The number of sites providing family planning services has increased seven-fold, from 72 in 1987 to 492 in 1995. A recent world-wide audit of USAID population programs by the Inspector General's Office found that the USAID exceeded planned outputs in six of eight performance indicators.
USAID is supporting Malagasy child survival efforts to increase the use of effective child survival practices and services. Program interventions focus on an integrated approach toward the major causes of childhood death and disease: diarrheal disease, poor nutritional practices, acute respiratoryinfection, and lack of essential immunizations. USAID child survival activities will focus heavily on the family and on local communities, encouraging those who care for children to know how to prevent illness and what to do in case of sickness.
The major challenge for FY 1997 and beyond is to further expand the number of sites providing quality family planning and child survival services, increasingly in the rural areas, while enhancing local capacity to provide these services. The significant impact to date in this entire sector reinforces broader interest and will support greater success.
Stability, greater participation, accountability, rule of law and decentralized decision-making are all necessary to attain USAID's goal of broad-based, market-led sustainable economic growth in Madagascar. Under the headings of democracy and improved governance, USAID will undertake activities in accountability and transparency; information, openness and free press; rule of law and legal reform; and effective civil society within an expanded public policy dialogue. These activities are interrelated and will be found throughout the USAID program. Specifically, USAID will increase support for democratic institutions by improving the capacity and the role of civil society in the public policy arena, through assistance to the National Assembly, by supporting legal and judicial reform, and by increasing financial accountability and transparency. USAID encouraged the Government of Madagascar to establish a Commercial Law Reform Commission. Last December, the Prime Minister created the Commission by executive order. Over one hundred Malagasy judges and lawyers have been trained in free-market based legal systems.
Agency Goal: Providing Humanitarian Assistance
USAID's Title II program, locally managed by Catholic Relief Services (CRS), reached approximately 78,000 beneficiaries participating in maternal child health, school feeding and general welfare programs in 1995. CRS has redefined its country program structure by decentralizing responsibility for program management and developing plans for a Food Assisted Child Survival/Focused Nutrition Program. This new approach features resource targeting to high-risk children under two and pregnant women, and community-based programs, both of which offer tremendous potential for enhanced program impact. In addition, data from the 1995 Knowledge, Practices and Coverage survey suggest that the mothers who participate in the CRS Title II program have a higher level of knowledge and employ better health practices than non-participating mothers. When compared to data for the 1992 Demographic and Health Survey for Madagascar, participating mothers use oral rehydration therapy more frequently for a child suffering from diarrhea (40% versus 29%); are more likely to have a child immunized against measles (65% versus 54%); and are more likely to have at least two tetanus injections prenatally (94% versus 44%). Although the results from these two surveys are not completely comparable, they strongly suggest that the child survival activities associated with the Title II program are improving the health status of Malagasy children.
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Environment |
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| USAID Strategic Objectives | ||||||
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1. Establish Competitive Market Environment for Micro and Small Firms - Dev. Fund for Africa |
1,000,000 |
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1,122,800 |
2,122,800 |
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2. Increase Market Access for Neglected Regions - Dev. Fund for Africa |
1,339,800 |
1,339,800 |
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3. Reduce Natural Resource Depletion - Dev. Fund for Africa |
7,796,600 |
7,796,600 |
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4. Reduce Total Fertility - Dev. Fund for Africa - P.L. 480, Title II |
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7,489,572 |
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3,624,000 |
7,489,572 3,624,000 |
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Totals - Dev. Fund for Africa - P.L. 480, Title II |
2,339,800 |
7,489,572 |
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1,122,800 |
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USAID Mission Director: Donald R. Mackenzie
Purpose: Foster an environment in which private competitive markets can flourish.
Background: The standard of living in Madagascar is lower than it was twenty years ago as a result of a prolonged period under a socialist dictatorship. A democratically-elected government has been in place since 1993, but much of the policy and regulatory structure of the socialist era has yet to be replaced by a modern framework which supports and encourages private initiative.
USAID Role and Achievements to Date: USAID has concentrated on the financial sector where we support a revitalized, financially strong National Savings Bank and a strengthened and independent Central Bank. The National Savings Bank mobilizes private savings and investment and is the only financial institution serving low-income households throughout the country. The number of depositors has increased by 70,000 since U.S. assistance began in 1993 and deposits are two-and-a-half times higher. Despite high budget deficits, the Central Bank has used prudent monetary policies to reduce annual inflation from 55% at the end of 1994 to 37% at the end of 1995 and to meet monthly monetary growth targets agreed to with the International Monetary Fund.
Description: USAID focuses on three activity areas: commercial law reform; financial sector modernization; and broader participation by citizens in the public policy arena. The first activity responds to the desire of the business community to have access to a judicial system that will provide swift and fair treatment. In FY 1996 and FY 1997, USAID efforts will publish legal texts which are currently unavailable to judges and lawyers, train Malagasy judges and lawyers in commercial law, and provide expert assistance in legal reform and court administration. The second area is implemented through the Financial Market Development program. The variety and quality of financial services offered to low-income households has expanded and these service improvements will continue. In the third area, under the Participation and Poverty program, USAID will improve the ability of civil society groups to represent the interests of their members in public policy arenas and to become more active advocates of those interests. USAID will involve groups currently excluded from public policy debates. Support will also be provided to Government specialists to improve the quality of policy analysis.
Host Country and Other Donors: As a condition for USAID assistance for the National Savings Bank, the Government of Madagascar (GOM) recapitalized the National Savings Bank with a $1.5 million transfer. The GOM also agreed to tie the rate of interest received by the Bank on its deposits at the Treasury to the Treasury Bill rate. This action increased Treasury interest payments to the Bank by $775,000 in 1995, much of which went to depositors through higher interest rates. The World Bank provides assistance to privatize two state-owned banks, strengthen the Bank Supervisory Board, and computerize the Central Bank. USAID and the World Bank are jointly supporting commercial law reform.
Beneficiaries: All Malagasy households and businesses will benefit from an improved policy environment and an improved judicial system, except those who are able to take advantage of current weaknesses in public administration and the legal system for personal gain. Civil society groups around the country will benefit from increased capacity and increased advocacy.
Principal Contractors, Grantees, or Agencies: USAID implements current activities through a minority-owned U.S. firm and local training institutions. Future activities will be implemented through a U.S. university, a U.S. private voluntary organization, local non-government organizations and U.S. firms.
Major Results Indicators:
PROGRAM: MADAGASCAR
TITLE AND NUMBER: Increase Market Access for Neglected Regions, 687-S002
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1997: $1,339,800 DFA
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2004
Purpose: To increase access to domestic and international markets for high potential but neglected regions.
Background: Lack of market access for high-potential, but neglected agricultural zones has restrained Madagascar from producing the agricultural surpluses needed to raise incomes and to sustain higher economic growth rates. Agricultural productivity is limited by the lack of technology and inputs while marketing is constrained by inadequate transportation and communication infrastructure. By increasing the access of high potential zones to domestic and international markets, USAID will help raise small farmer incomes and boost the sales and employment of rural small and medium agribusinesses.
USAID Role and Achievements to Date: USAID supports the revitalization of agricultural markets in the neglected regions to generate sustainable economic growth. USAID is also working with the private sector to ensure that farm households and small agribusinesses have the resources to sustain increases in commercial production and marketing activities. The major commercial agricultural promotion activity under this strategic objective started in September 1994. Through an input supply fund, Malagasy firms import and use U.S. equipment, materials and commodities in their agricultural marketing activities. USAID is currently awaiting delivery of Chevrolet trucks, Caterpillar equipment and John Deere tractors totaling $513,000. As a result of targeted USAID assistance, 62 agribusiness clients are increasing production and marketing and improving product quality. During the 1995-96 dry season, USAID funded the rehabilitation of 78 miles of farm-to-market roads, opening up rich agricultural production areas, many for the first time in decades. Farmers have reported on national radio that the prices for their products have improved substantially because of better market access due to USAID road rehabilitation. These producers have formed local associations to ensure maintenance of the roads.
Another USAID activity has shown farmers that new rice seed varieties can double yields without fertilizer and achieve 300-400% increases with fertilizer. Nine new varieties of rice have been released for public use since 1994 and three new varieties resistant to the Rice Yellow Mottled Virus will be released in 1997. The ongoing non-traditional, agricultural-export effort has clearly demonstrated that rural-based enterprises can generate production and sales with appropriate technical assistance and market information. During the last two years, these activities have led to direct sales of $5.9 million by bypassing traditional export brokers and developing South Africa, Europe and the United States as alternative markets for Malagasy agricultural products.
Description: USAID's commercial agricultural promotion program will: (a) help rural small and medium agribusinesses expand operations and improve productivity; (b) find new domestic and international markets for Malagasy agribusinesses; and (c) rehabilitate 437 miles of farm-to-market roads in two neglected but high-potential zones. Private importers pay in local currency for the equipment, materials and supplies made available through our input supply fund. That local currency is then programmed, with the Government of the Republic of Madagascar (GOM), to fund contracts with local construction firms to rehabilitate farm-to-market roads. Labor-intensive methods of road rehabilitation provide an additional source of income to farmers in the target areas and give them the training needed to undertake basic road maintenance as well.
Host Country and Other Donors: The World Bank and the European Union will construct and/or rehabilitate key primary and secondary roads into which the USAID farm-to-market roads will feed. Inaddition, Japan provided $1 million to help fund the rehabilitation of selected USAID rural roads in 1995-96. USAID is exploring additional financing from Japan and the European Union for 1996-97. The World Bank and France also support institutional strengthening and urban infrastructure in four urban areas within USAID's two high potential zones. The GOM contribution involves local currency for road contracts, managing the local-currency fund, and helping with technical oversight of road rehabilitation activities. Private sector contributions from Malagasy firms include funding of complementary road maintenance works and monetary as well as in-kind contributions toward the cost of technical assistance and training offered under this strategic objective.
Beneficiaries: Agribusinesses and rural producer associations in the high potential zones of Mahajanga and Fianarantsoa provinces, exporters of non-traditional products, and the import-export centers of Antananarivo and Tamatave.
Principal Contractors, Grantees, or Agencies: USAID implements activities through two U.S. firms, three Malagasy sub-contractor firms, and the International Rice Research Institute.
Major Results Indicators:
Purpose: To reduce natural resources depletion in target areas by conserving biodiversity in national parks; improving management of forest resources; increasing income opportunities for resources users; and increasing natural resource institutional capacity.
Background: Madagascar's natural resource base is seriously threatened. The scale and intensity of deforestation, loss of biological diversity, soil erosion and associated declines in overall land productivity are unparalleled. The economic cost of decreased agricultural productivity due to soil loss and fertility decline, loss of productive forests, damage to infrastructure because of soil erosion, and the costs of infrastructure maintenance and redesign is estimated to equal between 5% and 15% of Madagascar's gross domestic product (GDP) annually. Awareness of these problems led the Government of Madagascar (GOM) and the donor community to develop a 15-year national Environmental Action Plan (EAP) in 1990 as a framework for investment to protect natural resources and, at the same time, foster ecologically and economically sustainable development.
USAID Role and Achievements to Date: USAID has been a lead donor to the EAP since 1990, providing support in the areas of biodiversity conservation, forest management, policy development, and institutional strengthening. Key results include the establishment of a Malagasy institution to manage national parks and reserves and coordinate regional development plans to diminish pressure on the national parks. USAID also supports the National Office of the Environment in policy formulation and monitoring. In 1995, the National Assembly approved a new law requiring environmental review for all investments in Madagascar and the GOM established a private environmental endowment fund to finance local-level environmental management efforts. Community-based management plans have been developed for four natural forests and will guide increased local community involvement in the management of natural resources. Revised stumpage fees for commercial timber species have resulted in a seven-fold increase in forest revenue collection which supports the sustainability of the National Forest Service operations.
Description: The second five-year phase of the EAP (1996 - 2001) focuses on the transfer of natural resource management responsibility to Malagasy institutions. USAID will focus on results in six different areas: (1) development and application of environmental policies, legislation and procedures; (2) national parks management and ecotourism development; (3) promotion of multiple-use forest ecosystems and sustainable soils and water management; (4) participatory community management of renewable natural resources; (5) environmental information management system; and (6) sustainable financing mechanisms. All USAID activities will concentrate on local empowerment to ensure consideration of social and cultural dimensions, local participation and customer focus.
Host Country and Other Donors: The Government of Madagascar strongly supports the EAP, providing 20% of the total program costs. The EAP provides an overall framework for the intervention of all donors in the environmental sector with the goal to maximize the use of available resources and to avoid the duplication of efforts. Other donors active in the EAP are the World Bank, Switzerland, Germany, United Nations Development Program (UNDP), France and Japan.
Beneficiaries: The primary beneficiaries of the Environmental Program are the subsistence farmers and natural resource consumers who live in the villages surrounding the national parks and protected areas. Notably, 35% of the households in priority areas in those zones have adopted alternatives to destructive practices, and 39 community associations/non-government organizations are recipients of grants whichpromote sustainable natural resource management and capacity building of village groups. Further, 13 village development committees last year received a share of park entrance fees for community-managed projects thereby establishing a conservation/development link.
Principal Contractors, Grantees, or Agencies: USAID implements activities through U.S. firms, the Peace Corps, the United States Geological Survey, U.S. and local NGOs, and U.S. universities.
Major Results Indicators:
Natural habitats contained in Malagasy 1,045,865 (1989) 1,500,000 (1998)
National Park System (no. of hectares)
Number of qualified national park and 0 (1992) 39 (1998)
reserve management plans implemented
Number of qualified forest-management 0/0 (1992) 8/4 (1998)
plans developed/implemented
Percent of village households in priority 0% (1992) 50% (1998)
zones that have adopted program-
sponsored alternatives to destructive
practices
PROGRAM: Madagascar
TITLE AND NUMBER: Reduce Total Fertility, 687-S004
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1997, $7,489,572 DFA; $3,624,000 P.L. 480, Title II
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2002
Purpose: To reduce the total fertility rate from 6.6 in 1991 to 5.6 in 1999.
Background: Madagascar's 2.8% per year population growth rate is characterized by both high fertility and high infant-child mortality rates. Less than 10% of Malagasy women are current users of contraception and have access to and use of key child-survival, and nutrition interventions remain low. Stunting is found in 51% of children under five.
USAID Role and Achievements to Date: USAID supports increased access to services through expanded numbers of sites and outreach programs, training for service-providers and program managers, and improved standards, supervision, logistics and information systems. As a result, contraceptive prevalence has increased from 5% in 1992 to an estimated 9% in 1995. The number of service sites has increased from 150 in 1992 to 492 in 1995. Successful outreach programs are underway and contraceptive social-marketing will begin in 1996.
Description: USAID focuses on three activity areas: (a) increasing the use of modern contraceptives; (b) expanding the use of key child survival and nutrition interventions by health workers and caretakers; and (c) improving sustainability through improved data for decision-making and better policies. USAID works with a wide range of public and private sector partners to implement its family planning and child survival programs. These organizations are responsible for developing service delivery systems, clinical and management training, contraceptive and equipment purchases, communications programs and community mobilization resulting in increased access to and use of quality family planning and child survival services. Integration of these services is particularly important for child survival, since appropriate case management of the sick child is key to reducing mortality.
The P.L. 480, Title II program is an integral component of USAID's child survival programming. Three prominent features of this program are resource targeting to pregnant women and high-risk children age two and under, a transition from a center-based to community-based focus, and community health education.
Host Country and Other Donors: United Nations Population Fund (UNFPA) and Germany provide strong, complementary assistance for family planning. Japan is becoming more active. The World Bank assists national drug policy formulation and Acquired Immunodeficiency Syndrome/Sexually Transmitted Disease prevention. The United Nations Children's Fund plays the lead role in childhood immunization programs. The Government of Madagascar provides an estimated $8 million in host country contributions annually.
Beneficiaries: Women of child-bearing age and children under five years represent 42% of Madagascar's estimated 1996 population of 13.25 million. USAID programs will reach approximately 2.5 million women and children by 1999.
Principal Contractors, Grantees or Agencies: USAID implements activities through a U.S. non-profit institution, the Peace Corps, local public sector institutions, and a wide variety of U.S. and local NGOs.
Major Results Indicators: