1. Mutual Benefit Health Insurance MANAKARA MADAGASCAR

2. 1) Woman’s Situation in Madagascar Each woman = a mother, a spouse, a companion, a daughter-in-law, a daughter and a sister Consequence: paramount role/numerous duties

3. 2) Women from AIC Manakara Widows, abandoned or separated from their husband. With dependant children /often unemployed Lacking : - social security - family allowance - living allowance Health : - precarious - constantly undernourished - unhealthy living conditions

4. 3) What about medical cares? Every medical treatment (consultation, surgical operation, injection, medical equipment,…) has to be paid ; In case of hospitalisation, the patient must even pay for the smallest item used to treat him (cotton wool, compress, alcohol, syringe,…).  It is so expensive to be healthy!!!

5. 4) Actions of AIC Manakara §1. Training, education and raising awareness For the mothers Training twice a week, 1hour/week: - health matters - matters of hygiene - VIH/SIDA prevention -promotion of breastfeeding - fighting against abortion and family planning

7. For teenagers - For girls/ boys : program of education for life - Set up in the beginning of November 2006 - Includes: - hygiene and health matters; - prevention against AIDS virus, - unwanted or too early pregnancies - and abortion.

9. For preschool children - Importance of hygiene (washing your body, your hands before each meal, your fingernails …) - Often in songs

10. §2. Vaccination program –Against:- poliomyelitis, - measles, - tuberculosis, - tetanus.

11. §3. Taking part in national campaigns –promotion of breastfeeding –National campaigns of vaccination (poliomyelitis, tuberculosis, measles,…) –distribution of vitamins A, vermicides,… –distribution of impregnated mosquito nets and of medicines ( palu STOP) during campaigns of struggle against malaria

12. §5. Creation of a Mutual Benefit Health insurance (set up in October 2005) OBJECTIVES -Millennium Development Goal n°5 : improve maternal health -Millennium Development Goal n° 8 : develop a global partnership for development

13. SETTING UP -Participation of the mothers: - starting from their knowledge first (what do you know about …), then correcting, completing or improving their answers. - In order to help them learn, we use posters because many of them are illiterate and we repeat frequently to further memorization. -Nominal Contribution paid each month (200 Ariary, more or less 0,07 Euros). -Distribution of soap for a derisory price (once a week)

15. -Providing basic medicines (isobetadine, aspirins, calcium, tetracycline, paracetamol, syringes, vitamins, chloroquine, …) bought in the local pharmacies. -Taking care of the medical expenses at the health center or public hospital : a midwife and a doctor are available at any time. -Monitoring each mother (personal notebook and a notebook for each family with a list of the medicines in stock and overview of the payments of the contribution and the spending made).

17. SUBSIDIES - Subsidies from MEMISA (Belgian association) to grant basic medicines ; - Twinning with AIC Saint Louis (île de France Paris) in the beginning of 2007 - Contribution from the mothers

18. RELUCTANCIES - Because of a short-term vision: they are not ill at the moment, so they do not understand why they should contribute now. - When they are ill, they rush to pay their contribution to be able to benefit from the AIC support - Importance of the testimonies of the mothers who were helped by the Mutual Benefit health Insurance to convince the most reluctant of the importance of contributing.

19. TESTIMONIES -Mrs. Christine had a crisis of malaria, and could receive the injections of quinine and paracetamol that she needed. « I can go on taking care of my three dependant grand-children, since my daughter died two years ago». -Bao Josephine : « My son had a tractor accident, and split his head. He was badly shaken and bled a lot. Thanks to the Mutual Benefit Health Insurance, he could go to hospital where he received all the necessary treatments free of charge». -Mrs. Sara : « I had the flu. Very badly !!! And my tension shot up. I needed injections and tablets, so thanks to the mutual health insurance, I went straight to the health care center and I had all the treatments free of charge. How would have taken care of my children if I had been very ill ?»

20. 5) Conclusions An example to be followed by everyone… For a better health for everyone…