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Social mobilization campaigns help reduce child mortality in Madagascar

By Daniel Timme

Worldwide, under-5 mortality has declined from more than 12 million deaths in 1990 to 7.6 million in 2010 – yet thousands of children still die every day from preventable diseases. On 14-15 June 2012, the Governments of Ethiopia, India and the United States, together with UNICEF, convened the Child Survival Call to Action, a meeting to mobilize the world toward one ambitious but simple goal – ending preventable child deaths. This story is part of a series highlighting global efforts to improve child survival.

TULEAR, Madagascar, 25 June 2012 – Onja is a star, the lead singer of Tinondia, one of Madagascar’s most famous bands. Eliane, by contrast, is not famous at all. Eliane grew up in the poor, glamour-less world of a slum in the south-western city of Tulear.


22 June 2012: UNICEF correspondent Christal Thompson reports on a UNICEF programme that is convincing families in Madagascar to have their children vaccinated.  Watch in RealPlayer


The women don’t have much in common, but they do share a common goal: to reduce the number of children who die of preventable diseases.

To this end, they are using their respective talents to convince communities to undertake simple measures that can make the difference between life and death.

Community health workers save lives

Washing hands and not defecating in the open, for example, can prevent children from getting diarrhoea, one of the biggest killers of children in the world. Going to the local health centre to have children vaccinated against common diseases can save them from senseless death.

© UNICEF video
A mother listens as a community health worker explain the benefits of vaccination in Tulear, Madagascar.

But too few people in Madagascar know these life-saving measures. Thomas didn’t know. Holding her chubby, healthy son Dolin at the basic health centre in Tulear, she said that she wouldn’t have brought the boy to be vaccinated if it wasn’t for Eliane, who persuaded her at the local market.

Eliane is one of 164 social community workers who received UNICEF training in interpersonal communication last November. Community health workers conduct essential and effective outreach to families, largely because nobody knows better how to talk to parents in a community than people from the community itself.

The community health worker programme is an essential pillar of a wider social mobilization programme that UNICEF and partners are running in Madagascar. Carnivals, discussions on local radio stations and concerts are other pillars of this programme.

Social mobilization amid crisis

As the country struggles with an ongoing socio-economic crisis, UNICEF is amplifying its efforts to keep up basic health services.

“This crisis has led to cuts in budgets. Most of these social services, most foreign aid, especially for health, has been frozen. And this is having heavy consequences on health, on nutrition, on water, on sanitation,” said Dr. Paul Ngwakum, UNICEF Madagascar’s Head of Child Survival.

© UNICEF video
Hygiene messages are promoted at a public festival in Tulear, Madagascar.

Until the political crisis broke out in 2009, the country had been on track to reach Millennium Development Goal 4, the goal to reduce under-5 child mortality to 20 out of 1000 live births by 2015. This achievement was put at risk by the crisis.

The health sector in Madagascar will need more funding to resume progress. In the meantime, UNICEF is relying on dedicated health workers like Eliane and their social mobilization activities to lay the groundwork for immunization and hygiene campaigns.

These campaigns are also supported by artists like Onja, who use their fame in a responsible way: As the sun sets in Tulear, Eliane and other members of the community listen to the catchy melody of Onja’s band, Tinondia, at a public festival.

Onja sings, “Have your children vaccinated. It’s free of charge!”

It is a refrain the crowd repeats again and again, a message with the power to save countless children’s lives.



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