ORS/Zinc status – Madagascar

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MadagascarMadagascar (9th)*

Population: 27.69m (2020)
Area: 587,041 sqkm

Diarrhoea deaths: 10,970 (2019)

ORS coverage: 19% (2019)

ORS + Zinc coverage: 6% (2019)

 

 

 

 

* Madagascar has the ninth highest number of diarrhoea deaths in the World

National EML download: LNMEIS 2019 – Version 1.4.2 – Madagascar (August 2019)

National policy
ORS+Zinc in National Clinical Guidelines
✅ National Essential Medicines List last updated in 2020 or 2019 [needs verification]
ORS included in the National Essential Medicines List
Zinc included in the National Essential Medicines List
✅ Co-packaged ORS & Zinc included in the National Essential Medicines List (since the 2019 edition)

Zinc availability
✅ Zinc available “over the counter”
❓ Any retailer can sell Zinc without the need for a licence

Outlets for Zinc tablets:
✅ Pharmacies
✅ Drug stores/shops [needs verification]
❌ Supermarkets
✅ General retail outlets [needs verification]
✅ Community Health Workers
❌ Door-to-door sales people
✅ Government hospitals/clinics
✅ Private hospitals/clinics
✅ Campaigns and outreach

Co-pack availability
✅ Co-packaged ORS and Zinc available [Currently, the co-packaged form is not available everywhere except in some health facilities supplied by UNICEF as part of the drought emergency in the south of the country. Jun-2022.]
❓ Discussions underway about introducing co-packaged ORS and Zinc

Outlets for co-packaged ORS and Zinc tablets:
❌ Pharmacies
❌ Drug stores/shops
❌ Supermarkets
❌ General retail outlets
❌ Community Health Workers
❌ Door-to-door sales people
❌ Government hospitals/clinics
❌ Private hospitals/clinics
❌ Campaigns and outreach
✅ Other: Currently, the co-packaged form is not available everywhere except in some health facilities supplied by UNICEF as part of the drought emergency in the south of the country.

Co-packaged ORS and Zinc brands (may not be exhaustive)
Renata Limited (2022 UNICEF delivery as part of the drought emergency response).

Co-packaged ORS and Zinc manufacturers (may not be exhaustive)
None

Co-pack costs
Typical cost of a ORS/Zinc co-pack in the PUBLIC sector
500 Ariary (0.12 USD): as part of social marketing supported by NGOs.
Typical cost of a ORS/Zinc co-pack in the PRIVATE sector
2 000to 2 600 Ariary (0.50 to 0.60 USD)

Diarrhoea programmes currently on-going

Name Organisation Funder Diarrhoea specific Target area
Projet PARN (Projet d’Amelioration des Resultats Nutritionnels) Ministere de la Sante Publique World Bank No 8 regions
Community IMCI through the child health service of the Ministry of Health, NGOs, United Nations system agencies Ministere de la Sante Publique
and
PSI (NGO)
USAID and UNICEF No National

Additional information
Comment from one correspondent:
The combined ORS+Zinc kit form is certainly included in the list of essential medicines [since 2019] but currently the availability of this form in the country is very low. The central medical stores is in the process of launching a call for tenders this year for the combined form. (Jun-2022)

Information based on 2 questionnaire and 1 comment

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Making co-packaged ORS and Zinc the "go to" treatment for childhood diarrhoea

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