Originally published by SHOPS Plus

Following the outbreak of COVID-19 in early March 2020, the Madagascar government imposed a nationwide lockdown, restricting travel and limiting business activity within the country. Despite these constraints, the United States Agency for International Development (USAID)-funded Sustaining Health Outcomes through the Private Sector Plus (SHOPS Plus) access to finance team continued to support private health facilities in providing essential healthcare services to their communities.

Coaching healthcare facilities

The team conducted coaching sessions in person and by phone with partner healthcare providers in Analamanga and Antsinanana, the regions most affected by the pandemic. They used the coaching sessions to determine how the facilities were affected by the health crisis, and to provide counseling on how to adapt.

Some of the major issues identified by the providers included:

• A decline in client visits due to patients’ fear of contracting the virus in healthcare facilities
• Transportation challenges
• An inability to pay for health services due to pandemic-related financial hardships
• A corresponding decrease in revenue at the healthcare facility (as much as 75 percent, with individual practices being the hardest hit)
• Difficulties maintaining stocks of supplies (personal protective equipment and disinfecting products) due to their high cost, decreased income of the providers, and ongoing expenses such as regular staff wages and operational costs

“Thank you for your advice, which has been essential to our medical center, and thank you for not forgetting us during this hard time.” —Dr. Laivao, Health Center Soava

The team provided guidance to each facility on cash management and new methods of generating revenue during the crisis. To improve cash management, SHOPS Plus assisted providers with restructuring their bank loans (if required) and reviewing all expenses to prioritize those critical to keeping their facilities open and operational. The team brainstormed alternative solutions to help the providers find new ways of generating income in the evolving work environment, such as conducting house visits (implemented by two partners so far) and establishing visible safety and hygiene protocol within the facilities to reassure clients. The team received positive responses to these coaching sessions. They also found that, despite the challenging economic circumstance, providers were making efforts to make their loan payment and keep their obligations current.

With SHOPS Plus support, these providers have been able to continue serving the healthcare needs of their communities.