BABSON PARK, FL — Madagascar has one of the poorest healthcare systems in the world, spending $14 USD on healthcare per capita. This is well below the average of $94 USD per capita spending on healthcare in the Sub-Saharan region. The PIVOT organization has taken a data focussed approach to help improve the healthcare systems in Madagascar.

After working in Rwanda with Partners In Health, PIVOT founder Matt Bond saw the importance of statistical analysis when it comes to long term change within a healthcare system. Bond aspires to have a lasting impact on Madagascar’s health system. In addition, he develops interventions that can be implemented across the world to help improve health conditions. With the support of the Harvard Medical School, PIVOT focusses its efforts towards interventions that have significant statistical results within Madagascar’s medical system.

Madagascar’s Healthcare Challenges

PIVOT has established its goal to improve accessibility to healthcare facilities. Around 60% of the population lives more than three miles away from a medical facility. Additionally, many communities are unable to access medical treatments due to the uneven distribution of medical professionals and supplies. This issue is highlighted with the current COVID-19 pandemic. As of May 19, 2020 Madagascar has confirmed 322 cases of COVID-19. Madagascar has a Healthcare Access and Quality index rating of 29.6 out of 100. This is well below the sub-Saharan average rating of 40 out of 100. A healthcare system with such a low rating may struggle with the increased demand for medical attention. Madagascar’s government has set a strict curfew in order to reduce the spread of COVID-19, however, the healthcare system will still be challenged by the pandemic.

The Data

The initial studies conducted by PIVOT began in 2014, with 8000 subjects to be followed up with every 2 years. The study collected data on over 840 variables, from basic demographics to access to healthcare. The long term studies aim to identify changes in mortality rates and access to medical resources. In addition, this extensive study required collaboration with the National Institute of Statistics of Madagascar. The results indicated maternal mortality rates to be one in 14, twice the estimated previous national Madagascar health predictions.

Astrophysicist Jim Herrnstein, helped Bond found PIVOT and their data focussed approach to healthcare in Madagascar. Herrnstein believes that the scientific method used to back PIVOT’s interventions highlights which projects are beneficial to the overall health of Madagascar’s population. The data suggest that single-layered interventions such as providing mosquito nets are important. However, it does not offer widespread and long term solutions. Initiatives such as hiring and training healthcare workers have decreased maternal mortality rates and increased delivery care accessibility by 20%.

The data collected is not just based on Madagascar’s population; PIVOT also researches and tracks environmental factors that can affect health and well-being. These studies focus on the environmental factors that contribute to malaria rates, childhood diarrhea and access to healthcare. The environmental terrain is an obstacle itself when it comes to healthcare access. Between 60-70% of Madagascar’s people will travel between three to six miles by foot to reach medical facilities. Additionally, only 34% of the population has access to clean water, which contributes to the rates of communicable diseases.

The Results

Within the first two years of operation, PIVOT has made a substantial impact on Madagascar’s healthcare system. The data suggests that access to healthcare for fever-related symptoms has increased by over 25 percent in areas where PIVOT has established interventions. The use of maternal health services has increased by 63 percent, and the overall use of healthcare facilities by Madagascar’s population has tripled.

PIVOT has proven the importance of using data to support healthcare interventions in Madagascar. The organization’s scientific approach has allowed them to target specific elements within Madagascar’s healthcare system to most effectively improve the medical environment. PIVOT continues to track the population’s well-being and use of medical facilities to ensure their programs continue to benefit the health of Madagascar’s population. 

– Laura Embry

Photo: Flickr