48IV-G0001 Madagascar: Anosy Integrated Village Development
Program
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of text to watch a PowerPoint overview of the Anosy Integrated
Village Development Program.
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*Interview with Agnes Rasamimampianina, National Supervisor
for Anosy Integrated Village Deveopment Program. Click on black
arrow point (bottom left) to play video.
I. Background
The Lutheran Church in Madagascar operates one of the largest
health care systems supported by Global Health Ministries: 8
hospitals, 22 health centers and 14 clinics. GHM finances numerous
project and all shipments of medical supplies and equipment
to Madagascar in collaboration with SOA (Salfa Overseas Assistance),
with total annual grants and allocations averaging nearly $130,000
over each of the last five years for such projects as Rural
Clinic Support, SEFAM (School of Nursing), Continuing Education
and Residencies, Pharmacotherapy services for the mentally ill,
purchase of equipment and vehicles. Short-term missions for
training and consultation in surgery and nursing curriculum
development have also been financed in recent years. There is
an unusually faithful, gifted and generous community of former
Madagascar missionaries and their families who insure by their
prayers and contributions that support for the Malagasy health
ministry is sustained.
Since the fall of 2006 representatives of this community began
discussions with Global Health Ministries about establishing
a program in which the varied interests of donors might be met
through contributions to a single program. Following board review
in October, the Madagascar Village Development Project was approved
to encompass our traditional health emphasis along with water
projects, schools, nutrition, evangelists and economic development.
Modeled after an existing SALFA project called "Mahafale
Villages," the program appropriately broadens GHM's definition
of "health" and creates new and exciting opportunities
to collaborate with the ELCA and its on-going, parallel investment
in this concept in Madagascar’s Tandroy region.
II. The Assessment Process
It was decided in the Spring of 2006 to send a survey team to
Madagascar to work with SALFA to develop plans for the program
in more detail. Tom Berkas, a former missionary to Madagascar
was sent by GHM to Madagascar in July 2007 to do some initial
interviews and help with planning for the subsequent September
visit of the other 5-member volunteer assessment team. The GHM
survey team visited Southeastern Madagascar in September 2007
and met with SALFA leadership to carefully develop an effective
and accountable plan of implementation to address what we learned
are the urgent needs of our Malagasy brothers and sisters in
Christ. We worked together to organize 21 on-site visits and
49 interviews with key organizations involved with health, development
and evangelism work (church programs, government programs, NGOs,
etc) so that we may build on and integrate existing efforts
in this area.
After the information was collected, the assessment team and
local partners reviewed the findings of the assessment to facilitate
the full participation of all parties concerned to help develop
a “common road map”, and identify potential goals,
objectives, timeline, and budget to achieve this in a collaborative,
sustainable manner that builds on SALFA’s holistic community
development in the southern region of Madagascar.
III. How Integrated Village Development Will Work
Briefly, the program will operate on a ten year time frame with
a definition of "health" that goes far beyond its
traditional preventative and curative dimensions to also include
education and evangelism, sanitation and clean water, improved
agricultural practices and small business development. A traditional
public health outreach team will provide education, clinical
services, referrals and immunizations, but will also conduct
assessments of village "health" in the other areas
mentioned and engage the involvement of other Church branches
dealing with development and agriculture, as well as established
local NGO's in health, nutrition, economic development and sanitation
to address identified needs. Projects that may be aided through
financial support will become proposed budget items for each
year of the program.
The team will move from one village to the next within the Anosy
region (North and West of Fort Dauphin) in this process, and
will begin with the Toby Nenilava in Fort Dauphin and the Manantantely
Bible School as both objects of the program's services (as model
"villages") and as collaborator/assets in bringing
their respective contributions to village health in the region.
There is growing consensus among those involved in third world
development initiatives that this "holistic" or "integrated"
model of service is more effective than those that have a single
focus. In addition, such a model provides donors a good way
of satisfying a variety of charitable interests with a single
gift. This, indeed, was part of the motivation for originally
exploring the development of this approach.
The program will begin to be implemented in 2008. A timeline
for the work of the Program Supervisor follows that will give
an idea of what objectives we will pursue during the year. We
would appreciate the opportunity to update you on this program
periodically in the near future. It promises to be a dynamic
and exciting initiative, and an addition we can celebrate to
our ministry and its long history of mission in Madagascar.
Please pray for God's blessings on this ministry, that it will
be found faithful to our calling to proclaim Christ’s
good news by continuing his healing ministry in the Anosy Region.
IV. Program Budget for 2008

| Evangelism |
Budget |
Donated
to date |
Balance
to be raised |
Budget
Totals |
| Manantantely Bible School Rehabiliatation |
26,000 |
9,346 |
|
|
| Catechist Graduation Tool Kits @$250/kit |
4,000 |
|
|
|
| Total |
|
|
|
30,000 |
| Primary Health Care |
|
|
|
|
| Medical Supplies |
5,000 |
|
|
|
| Manambaro Program Office Rehabilitation |
5,000 |
|
|
|
| Nurse |
1,280 |
|
|
|
| Health Worker |
1,000 |
|
|
|
| Driver |
1,000 |
|
|
|
| Vehicle fuel and Maintenance |
3,000 |
|
|
|
| Office Supplies |
1,500 |
|
|
|
| Total |
|
|
|
17,780 |
| Wells/Sanitation |
|
|
|
|
| Toby Nenilava latrine/patient housing |
33,350 |
|
|
|
| Total |
|
|
|
33,350 |
| Management and Supervision |
|
|
|
|
| Program Supervisor |
1,200 |
|
|
|
| Quarterly travel |
1,200 |
|
|
|
| Project Coordinator |
2,650 |
|
|
|
| Office expenses |
1,500 |
|
|
|
| Vehicle |
15,000 |
|
|
|
| Training |
10,000 |
|
|
|
| Total |
|
|
|
31,550 |
| Education |
|
|
|
|
| Toby Nenilava Library |
600 |
|
|
|
| Total |
|
|
|
600 |
| Miscellaneous |
1,000 |
|
|
|
| Total |
|
|
|
1,000 |
| Unrestricted Donations |
|
57,066 |
|
|
| Grand Total Program to date |
|
66,412 |
47,868 |
114,280 |
| |
|
|
|
|
| |
|
Donated
to date: 3-19-08 |
Balance
to be raised |
Budget
totals |

V. Program Supervisor Timeline for 2008
1. Announce position opening for Regional Program Coordinator,
test and interview candidates: January through March 1.
2. Hire and orient Regional Program Coordinator: March.
3. Develop Training plan for Program: January through March.
4. Program Supervisor and Coordinator establish and orient regional
and local program committees and collaborating local partners:
March and April.
5. Complete training for: Regional Program Coordinator, Nurse,
Health Educator (May); Mpiandry (August); Catechists/Evangelists
and spouses (October through December).
6. Finalize Work Plans and evaluative performance standards
for
RPC, Nurse and Health Educators: May.
7. Supervisory Review of monthly activities reports of Project
Staff: monthly.
8. Supervisor Complete September and last quarterly visit for
performance review and development of budget and work plan with
program staff for 2009: December.
VI. Program Coordinator Job Description
Skills/Criteria:
-Malagasy Christian
-Able to supervise, manage and inspire staff
-Familiar with area, programs, Church and NGO’s in the
South (Anosy) region
-Good trainer/educator
-Good communication skills, fluent in Malagasy and French (English
helpful)
-Good organizational skills
-Computer skills
-Manage budget
Duties:
-Develop and manage each year’s project budget, including
budget for contract trainers if used, like FaFaFi trainers and
for Maternal Child Health/Nutrition training by Mme Monique.
-Supervise center lead staff, including lead nurse, health educator/assistant,
vehicle driver, various “contract trainers” from
FaFaFi, Medair, Maternal Child Health/Nutrition and other NGOs,
village health worker volunteers, etc.
-Train about concepts/activities of Integrated Village Development
and Primary Health Care, including:
o local control in setting priorities
o demonstrated local “ownership” of any project
before initiating
o understanding of and commitment to a broad definition of health,
healing intervention and healthy practices to include environmental,
spiritual, educational, economics and livelihood, sanitation
and water, together with disease prevention and treatment
o Engaging local (NGO and other) resources to be called upon
to address identified community needs beyond which lead staff
are expected to address
-Develop excellent knowledge of and working relationships with
all local resources that could be called upon to address local
needs as they are identified by the lead team and collaborators,
including:
-
Maternal Child Health/Nutrition program
(Faravehivavy); Mme Marie Monique
Rasaoamampionona
-
MEDAIR, Christophe Roduit
-
ASOS, Dr. Harinesy
-
Aza Fady, Brett Massoud
-
Care International, Jean Philippe Jarry
-
Andrew Lees Trust: Daniel
-
PSI, Dr. Bakoly
-
SanteNet, Mamy Holiarimanga Andriamitantsoa
-
USAID, Lisa Gaylord, Jennifer Talbot
-
World Bank: Ganesh Rasagam, Director (based
in Tana) Roger Christen and Rakotosamimanana Rollis, Fort
Dauphin
-
Rio Tinto Staff Divisions
-
SEFAM, Dr. Julie Razaonandrianina
-
Local Micro-lending institutions, Fivohy
-
Chef de Anosy Region
- Ministry of Health and Family Planning: Regional Director
(vacant in December 2007)
-Develop excellent knowledge of and
working relations with key partners in the implementation
of the Integrated Village Development Program, including:
-
Malagasy Lutheran Church (FLM): Rakoto
Endor Modeste (FLM President) and Georges Samuel (General
Secretary)
-
FLM Lutheran Health Care Department (SALFA):
National: Andreas Richard (Director), Lanto Rabenasolo (Chief
Financial Officer), Agnes Rasamimampianina (Sociologist, part
of Nutrition Team), Dr. Mamy Ralaivita (Tuberculosis Program,
Technical Director)
-
Fort Dauphin SALFA clinic: Dr. Sahondra
Rasoarimanana
-
Manambaro Hospital: Dr. Emmanuelson Randrianaina
-
Amboasary clinic: Ijo Maharo
-
Antanimora clinic: Dr. Rakotozandry Andriamampionona
Thierry
-
FLM Development Department (FANILO): Noel
Andrianandrasana (National FANILO Director); Zafiamy Samuel
Lurard (Faradofay synod)
-
FLM Agricultural Extension Program (FAFAFI):
Livera Bevazaha (Director, Faradofay synod); Fenolily (Extension
agent in Ambovombe, also FANILO director here)
-
Manantantely Bible School: Mara Tovosoa
Florent
-
Toby Nenilava (Fort Dauphin): Mr. Tip (Toby
President); Edwin Razafintsalama (Toby Treasurer); Jeanne
Razafisoa (Supervisor of Mpiandry (Shepherds)
Rondro Rasoaneloranana Bernadine (Teacher)
-
Norwegian Mission Society (NMS): Dr. Hanne
Smordahl (coordinator for NMS/FLM Integrated Rural Development
Project-Ambovombe)
-
FLM Synod Presidents: Faradofay: Mosa Celestin
( and Monja, Synod Vice President); Ambovombe Androy: Ialy
Jean de Dieu
-
Tafaka Masina (Evangelism Program): Faradofay
synod: Solo Jean Mananga; Androy synod: Retsiraiky Zacharie
- MELCAM: Barbara Hinderlie, Doug Cox, Pat Bentsen
-Oversee development, implementation and evaluation of integrated
program activities, including the following during 2008:
-Evaluate needs//proposals for essential facilities improvements/renovations,
take bids and
contract to:
- enhance capacity of Manambaro Hospital to serve as hub for
integrated project (upgrade facility, equipment, services)
- complete vital repairs to key buildings of Manantantely Bible
School (student housing needs structural repair, water source,
latrines, etc., as proposed by the school's director, Pastor
Florent, as needed to support operations of the integrated project
only);
- complete key repairs of patient housing and facilities at
Fort Dauphin Toby (Toby Nenilava) (roof, laundry and bathroom
faciliity, etc. as proposed by the president and treasurer of
the Toby).
-Purchase vehicle for use by project in collaboration with Manambaro
Hospital and Project Coordinator, and hire/supervise driver.
-Reactivate Primary Health Care team in Manambaro to serve as
hub of integrated project approach. Hire and train lead nurse
and health educator/assistant at this site, prepare work space
and acquire tools and furnishings needed to carry out program.
-Train staff to do integrated approach out of various sites (Manambaro,
Tolagnaro, Ambovombe) such as training mpiandry (shepherds) at
Tolagnaro Toby to include more teaching for Toby patients about
health, agriculture, literacy, self-sufficiency skills, etc.
-Integrate training on health, agriculture and development in
Catechist/Evangelist curriculum and program for their wives.
-Implement concentrated development training seminar for current
catechists and evangelists out in the field.
-Oversee all sites -Manambaro, Fort Dauphin Toby, Manantantely,
Ambovombe (when and if this site begins operation and the service
of a project coordinator is acceptable to SALFA and GM-ELCA).
Work with Fort Dauphin Toby and Bible School as “pilot villages”
in initial phase.
-Carry out integrated program approach in pilot sites and extend
integrated approach out to new villages surrounding initial sites.
-Develop approach for identifying and acquiring supplies for self-sufficiency
tool kits for catechists and evangelists graduating from Bible
School (e.g., bee hives, seeds, drip irrigation, a cell phone,
or a cow).
-Grant writing, Fund Development
-Prepare and submit reports to donors (collect data from centers
and assemble reports)
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