Children who are properly cared for heal quickly

Miraniaina Narindrarisoa, 26 years old and mother of three, lives in the fokontany of Ampandrotrarana, located 15 kilometres from the basic health centre (CSB2) in Manandona, Antsirabe II district, Vakinankaratra Region. On 5 August, 2021, her youngest child aged 13 months, Tanjoniaina Iriantsoa came to the Manandona CSB2 for her fifth outpatient consultation.

"He fell ill for the first time three days after his birth and I immediately took him to the health centre," says his mother Miraniaina. "The consultation was free, we also received free medicine, and he recovered very quickly. Since then, I take him to the health centre as soon as he has a cough, a cold or a fever. When children are treated quickly and properly, there are no complications, they heal quickly. Moreover, the consultation is free even on weekends. You just have to take a voucher beforehand."

Voucher System

Like all basic health centres in the Vakinankaratra Region, Manandona CSB2 has implemented the voucher system since November 2019 as part of the Nutritional Outcomes Improvement Project (PARN) financed by the World Bank. Every day, including weekends, this system provides free care for children under 5, pregnant and post-partum women as regards all illnesses.

"The voucher is the supporting document for beneficiaries with regard to free care. The CSB compiles them monthly and then receives a refund after they are verified at various levels. The reimbursement funds allow us to buy other medicines and offer them free of charge to children under 5, pregnant and post-partum women," summarizes Dr Saholinirina Clarisse Ramaholiarisoa, head of Manandona CSB2.

Thanks to the voucher system, attendance at CSBs for the treatment of illnesses for children under 5 has significantly increased: In 2021, level of attendance increased by 11% compared to 2020. "At the start of the implementation of the voucher system, we had trouble getting the refunds because the supporting documents were not filled out correctly. Then, UNICEF taught us how to pre-check supporting documents before transmission, as well as how to better coordinate and plan our activities, and how to better manage our resources. Our reimbursement has become faster, thus allowing us to have medicines and to provide permanent free care for children under the age of 5, pregnant and post-partum women, "explains Dr Saholinirina Clarisse Ramaholiarisoa.

Thanks to funds received from the World Bank, UNICEF provides technical assistance for strengthening the health system in regions where the Nutritional Outcomes Improvement Project (PARN) is implemented. UNICEF technical support helps improve the national information system, as well as coordination, bottom-up planning and management of various resources at the regional, district and peripheral levels.