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Madagascar Country Office – Covid-19 response

  • From May 17th to July 29th 2020, the positive COVID-19 cases growth curve decupled exponentially from 304 to 10,432 cases with 0.89% of fatality rate in 19 out of 22 affected regions (all except Androy, Atsimo Atsinanana and Melaky).
  • The epicenter remains the capital Antananarivo with very high community transmission. The hospitalization capacity was reached in central hospitals which led to care decentralization for asymptomatic and paucisymptomatic patients whilst hospitalization is offered in priority for moderate, severe and critical patients.
  • UNICEF supports moderate, severe and critical patients’ care by supplying oxygen (O2) to central hospitals, helping saving lives of most severe patients.
  • Thus far, 240,000 families have received a cash transfer of 100,000 Ariary (26 USD) to meet their basic needs. In collaboration with the Government and through the Cash Working Group, UNICEF coordinates the second wave of emergency social assistance in the most affected urban and periurban areas. However, UNICEF’s appeal for emergency social protection support, remains unfunded.
  • Around 300,000 children received self-study booklets while distribution to another 300,000 children is being organized. UNICEF is monitoring the promoted health measures to be put in place prior the tentative examination dates for grade, 7, 3 and Terminal.
  • 600,000 people in most affected cities benefitted from a subsidized access to water, via Avo-Traina programme while more than 20,000 taxi were disinfected and supported with hydroalcoholic gel and masks in Antananarivo.

Situation Overview and Humanitarian Needs

Presidential instructions related to the continued health emergency status of the country remain. Confinement of two largest cities (Antanananrivo and Tamataves) as well as confinement between regions is on-going while additional clusters of COVID19 infection required initiation of confinement. In June and July 2020, testing capacity was increased from 1 to 4 laboratories, all located in the capital, reaching an average of 854 test analysed daily. This led to an exponential increment in identified cases and it improved the waiting time between the test and the results release. This is illustrated in the capital city Antananarivo map below showing the situation on July 2nd, 10th and 20th. However, important transportation issues remain at decentralized level to access testing timely and in sufficient number. Without adequate diagnosis, regional authorities struggle to implement adequate triage measures, infection prevention and control and isolation of suspected cases while access to oxygenotherapy relies mostly on partners’ support in all treatment centres. To mitigate hospitalization bed congestion, the Ministry of Health authorized recently home-based care for mild COVID-19 cases, but adequate dissemination of this new guidelines remains to be done. In line with the national COVID-19 response plan and national guidelines for case management, the Ministry of Health and Health cluster partners prepared the decentralization of the capacity strengthening plan but funding remains insufficient to cover the needs. Meanwhile the number of cases is on the rise and although mortality rate remains low, technical and financial support is dire.

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