COAG No. 72068718CA00001 1 TABLE OF CONTENT I- EXECUTIVE SUMMARY ....................................................................................................................... 5 II. INTRODUCTION ............................................................................................................................... 12 III. MAIN ACHIEVEMENTS DURING QUARTER 1 .................................................................................. 12 III.1. IR 1: ENHANCED COORDINATION AMONG THE PUBLIC, NONPROFIT, AND COMMERCIAL SECTORS FOR RELIABLE SUPPLY AND DISTRIBUTION OF QUALITY HEALTH PRODUCTS .................................................................................................. 12 III.2. IR2: STRENGTHENED CAPACITY OF THE GOM TO SUSTAINABLY PROVIDE QUALITY HEALTH PRODUCTS TO THE MALAGASY PEOPLE ............................................................................................................................................. 18 III.3. IR 3: EXPANDED ENGAGEMENT OF THE COMMERCIAL HEALTH SECTOR TO SERVE NEW HEALTH PRODUCT MARKETS ACCORDING TO HEALTH NEEDS AND CONSUMER DEMAND ......................................................................................... 40 III.5. IR 4: IMPROVED SUSTAINABILITY OF SOCIAL MARKETING TO DELIVER AFFORDABLE, ACCESSIBLE HEALTH PRODUCTS TO THE MALAGASY PEOPLE ....................................................................................................................................... 50 III.7. IR5 - INCREASED DEMAND FOR AND USE OF HEALTH PRODUCTS AMONG THE MALAGASY PEOPLE .......................... 58 III.8. CROSS-CUTTING ACTIVITIES ...................................................................................................................... 65 IV. SUCCESS STORIES ......................................................................................................................... 76 V. ENVIRONMENTAL MITIGATION AND MONITORING REPORT ............................................................. 77 VI. SUMMARY OF THE SUB-ACTIVITIES NOT COMPLETED IN QUARTER 1 ............................................. 79 VII. KEY CHALLENGES AND SOLUTIONS ............................................................................................... 81 VIII. MAJOR ACTIVITIES PLANNED FOR NEXT QUARTER (YEAR 2, JANUARY – MARCH 2020)................... 82 IR 1: ENHANCED COORDINATION AMONG THE PUBLIC, NONPROFIT, AND COMMERCIAL SECTORS FOR RELIABLE SUPPLY AND DISTRIBUTION OF QUALITY HEALTH PRODUCTS ......................................................................................................... 82 IR 2: STRENGTHENED CAPACITY OF THE GOM TO SUSTAINABLY PROVIDE QUALITY HEALTH PRODUCTS TO THE MALAGASY PEOPLE ............................................................................................................................................................. 82 IR 3: EXPANDED ENGAGEMENT OF THE COMMERCIAL HEALTH SECTOR TO SERVE NEW HEALTH PRODUCT MARKETS ACCORDING TO HEALTH NEEDS AND CONSUMER DEMAND .......................................................................................................... 83 IR4: IMPROVED SUSTAINABILITY OF SOCIAL MARKETING TO DELIVER AFFORDABLE, ACCESSIBLE HEALTH PRODUCTS TO THE MALAGASY PEOPLE ............................................................................................................................................. 83 IR5: INCREASED DEMAND FOR AND USE OF HEALTH PRODUCTS AMONG THE MALAGASY PEOPLE ...................................... 84 CROSS-CUTTING ................................................................................................................................................. 84 IX. FINANCIAL SUMMARY .................................................................................................................. 86 ANNEXES ............................................................................................................................................... 87 ANNEX A - PERFORMANCE MONITORING PLAN (PMP) ........................................................................................... 88 ANNEX B – YEAR 1 WORKPLAN UPDATE ............................................................................................................... 98 ANNEX C - ENVIRONMENTAL MITIGATION AND MONITORING REPORT .................................................................... 129 ANNEX D - SUCCESS STORIES ........................................................................................................................ 138 ANNEX E – STOCK INVENTORY AS OF DECEMBER 2019 (USAID AND PMI FUNDED) ....................................... 148 ANNEX F – STOCK STATUS BY END OF DECEMBER 2019 ............................................................................... 151 ANNEX G: DESCRIPTIONS OF THE SEVEN QUALITY DIMENSIONS FOR THE RDQA ......................................................... 153 2 ACRONYMS A2F Access to Finance LLIN Long Lasting Insecticide-treated Net ABM AccèsBanque Madagascar RLA Regional Logistic Advisor ADDO Accredited Drug-Dispensing Outlet LMIS Logistic Management Information AFD Agence Française de Développement System A2F Access to Finance MEL Monitoring, Evaluation and Learning AMM Agence de Médicaments de MCH Maternal and Child Health Madagascar MDA Market Development Authority cCD Community-based Continuous MEL Monitoring, Evaluation and Learning Distribution MENETP Ministère de l’Education Nationale et CCDS Comité Communale pour le de l’Enseignement Technique et Développement Social Professionnel CGL Comité de Gestion Logistique MERL Monitoring Evaluation Research and CHV Community Health Volunteers Learning CILCMIM Comité Interministériel de Lutte contre MOPH Ministry of Public Health le Marché Illicite des Médicaments MSH Management Sciences for Health CISCO Circonscription Scolaire MYS Ministry of Youth and Sport CMS Credit Management System NGO Non-Governmental Organization CNFM Conseil National des Femmes de NHMIS National Health Management Madagascar Information System CSR Corporate Social Responsibility NMCP National Malaria Control Program CSB Centre de Santé de Base NSP National Supply Plan CoAg Cooperative Agreement ONP Ordre National des Pharmaciens de COGS Cost of Good Sold Madagascar CPT Certified Peer Trainer PA Point d’Approvisionnement DCA Development Credit Authority PAIS Plan d’Action d’Intégration des Intrants DEPSI Direction des Etudes de la Planification de santé et du Système d’Information PARC Point d’Approvisionnement Relais DFC United States International Communautaire Development Finance Corporation PBO Pyrethoid and Piperonyl Butoxide DGFS Direction Générale de Fourniture des PDPN Plan Directeur Pharmaceutique Soins Nationale DGMP Direction Générale de la Médecine PMI President’s Malaria Initiative Préventive PMP Performance Monitoring Plan DHIS-2 District Health Information System - 2 PPR Performance Plan and Report DPS Direction de la Promotion de la Santé PPN Politique Pharmaceutique Nationale DLMT Direction de Lutte contre les Maladies PSHP Private Sector Humanitarian Platform Transmissibles PSI/M Population Services DRENETP Direction Régionale de l’Education International/Madagascar Nationale et de l’Enseignement Pha-G-Dis Pharmacie de Gros de District Technique et Professionnelle Pha-Ge-Com Pharmacie à Gestion DPLMT Direction de la Pharmacie, des Communautaire Laboratoires et de la Médecine RBM Roll Back Malaria Traditionnelle RH Reproductive Health DRSP Direction Régionale de la Santé RDT Rapid Diagnostic Test Publique 3 DSFa Direction de la Santé Familiale SBCC Social and Behavior Change DSS Division Santé Scolaire Communication DSSB Direction des Services de Santé de SHOPS Plus Sustaining Health Outcomes in Base the Private Sector Plus EFOI Entreprendre au Féminin Océan Indien SILC Savings and Internal Lending EMMP Environmental Mitigation Monitoring Communities Plan SLRC Service de la Législation, de la FANOME Financement pour Réglementation et du Contentieux l’Approvisionnement Non-stop en SP Sulfadoxine Pyriméthamine Médicaments SPD Superviseurs de Point de Distribution FEFO First Expiry – First Out STTA Short-term Technical Assistance FP Family Planning TA Technicien Accompagnateur GAS Gestion des Approvisionnements et TMA Total Market Approach des Stocks TMI Total Market Initiative GBV Gender Based Violence ToT Training of Trainers GESI Gender Equality and Social Inclusion TWG Technical Working Group GFEM Groupement des Femmes UCP Unité de coordination des Projets Entrepreneurs de Madagascar UHC Universal Health Coverage GF Global Fund UNFPA United Nations Population Fund GHSC-PSM Global Health Supply Chain – UTGL Unité Technique de Gestion Logistique Procurement and Supply Management USAID United States Agency for International GOM Government of Madagascar Development HPN Health Population and Nutrition VSLA Village Savings and Loan Association HRD Health Regional Director WHO World Health Organization IMPACT Improving Market Partnerships and ZAP Zone d’Administration Pédagogique Access to Commodities Together IR Intermediate Result IPTp Intermittent Preventive Treatment during pregnancy ISM Integrated Social Marketing 4 I- EXECUTIVE SUMMARY Intermediate Results 1: Enhanced coordination among public, non-profit, and commercial sectors for supply and distribution of health products Under the leadership of the Ministry of Public Health (MOPH) through the DEPSI, DAMM, and the DPLMT the Total Market Approach (TMA) roadmap was finalized, including the detailed action plans for the three objectives identified by the TMA TWG: