Community Health Adviser

The COVID-19 pandemic continues to impact Peace Corps domestically and internationally.

The information provided for each assignment is subject to change, including the tentative departure date.

Project Description

The goal of Peace Corps Madagascar’s health project is to support global and national efforts to end preventable child and maternal deaths through a life cycle approach, by promoting the adoption of accelerator behaviors and strengthening basic primary health care knowledge and practices in rural areas of Madagascar.

Madagascar is a beautiful tropical island, hosting more than 10% of the World’s biodiversity with untouched but endangered rain-forests. While serving as a Community Health Advisor, you will work alongside implementing community partners to facilitate health education and community outreach, as well as prevention and training programs. Implementing community partners may be local health professionals, Community Health Workers and mothers.

Most often you will use health behavior change approaches and tools to design activities for women, mothers, caregivers, and men using proven effective approaches such as Care Groups, pregnant women’ groups, Caregivers group, Youth Clubs and Camps. Dissemination of health messages may also take place during home visits and through one-on-one mentoring. You may also have the opportunity to coach community health workers, building their professional capacity and increasing their effectiveness.

Peace Corps Community Health Advisors act as catalysts on a wide range of activities aligned with government and community priorities that seek to impact maternal, child and youth health. The primary focus is maternal and child health, and working with pregnant women and caregivers of children under 5. Therefore, your main role will be that of an educator, a facilitator, a liaison, a mentor, and a resource to assist your community.

Your work may focus on:
• Behavior Change through the use of evidence-based methodologies (e.g. Care Group model, which you will receive an intensive training on during In-Service Training)
• Maternal Health: working with Care Group mothers to encourage at least the four antenatal care visits (ANC) for safe pregnancies
• Child Health: working with Care Group mothers and training in essential nutrition actions and preparation of hygienic and nutritious food
• Disease Prevention: working with Care Group to improve infant and young child health through prevention of childhood illnesses (e.g. respiratory infections); and malaria prevention and control
• Youth Health: Promoting healthy living, positive youth development, and reproductive health through clubs, camps, and/or in-school programs.

Community Health Advisers are also expected to work with community members to develop secondary projects such as promoting sports for girls, improving community facilities, etc. And while much of the work will take place during weekday daytime hours, some community activities may take place on weekends. Many Volunteers also work with their village officials to prepare large community-wide awareness events around International Malaria Day, Global Handwashing Day, etc.

Peace Corps Madagascar promotes gender awareness and girls’ education and empowerment. You will receive training on gender challenges in Madagascar and you will have the opportunity to implement gender-related activities that are contextually appropriate. During your service, you will look for ways to work with community members to promote gender-equitable norms and increase girls’ sense of agency. As part of your work, you will also report on these efforts and their impact.

COVID-19 Volunteer Activities

In the past year, the world has been impacted by the COVID-19 pandemic. As a Volunteer, you will be trained in how to best protect yourself from COVID-19 exposure and understand the impact of and steps to reduce stigma related to COVID-19. You may also have the opportunity to engage with your community on implementing or enhancing COVID-19 mitigation activities, such as COVID-19 prevention and risk reduction strategies including social distancing, hand washing, mask wearing, addressing myths and misconceptions related to these practices, and vaccine hesitancy. Activities will be tailored to address the COVID-19 circumstances in the communities where you will serve.

Required Skills

Qualified candidates will have an expressed interest in working in the health sector and one or more of the following criteria:
• Bachelor of Arts/Bachelor of Science degree in any field
OR
• 5 years' professional work experience

Desired Skills

Competitive candidates will have experience with one or more of the following:
• Working with communities on planning and organizing health education and community outreach activities;
• Experience in a position of leadership;
• Experience working in any public health endeavor such as maternal and child health, nutrition, and youth health.

Required Language Skills

There are no pre-requisite language requirements for this position.

While not mandatory, Peace Corps/Madagascar prefers that Volunteers have a background in Romance language (French) as it is an important skill in country. Peace Corps/Madagascar therefore suggests that invitees take an intensive French course before departing USA for service. They may not use this much in their daily work since the primary spoken language is Malagasy (the sole language in which Volunteers will be trained during Pre-Service Training), but many partner technical reports, newspapers, and food menus are in French.

Living Conditions

Madagascar is a huge island nation – the 4th largest island in the world – and its terrain is diverse; the climate can change drastically from the Coast to the Highlands. Volunteers are placed throughout the East Coast, the Highlands and the South East, and living conditions can vary greatly from one Volunteer site to another. Volunteers should be flexible, resilient, and willing to live in very modest conditions. Community Health Advisers typically live in small villages, often with a population less than 2,000.

Housing: Volunteers live in private one or two-room houses. House material often depends on the region, with walls made out of local wooden material in the Coast and bricks in the Highlands. Volunteers have individual outdoor bath houses and latrines, but often no running water or electricity. Some families in the community may have access to generators that can provide electricity/battery recharge, but that is not standard.

Communication: Almost all communication is conducted by cell phone. You will have an opportunity to buy your phone during Pre-Service Training if you did not bring an unlocked phone from the States. Call costs are based on the amount of minutes used and texts sent and are deducted immediately. Incoming calls and texts, even from the US, are free. It is possible for many to access very slow Internet or messaging apps through the purchase of local data plans for smartphones.

Transportation: On a case by case basis, Peace Corps may provide a bike, helmet, and basic bicycle maintenance training to assist you in daily routines such as biking to nearby markets or visiting sites around your village if needed. You may also be required to walk or bike between 3 to 10 Kilometers to reach a main road or an outlying village where community partners live and work.

Food: In Madagascar, rice is the staple. Other foods include cassava, sweet potatoes, potatoes and corn. Meat and fish could be expensive or difficult to find depending on the region where you serve. Fish is more present in the coast and meat in the highlands. If meat or fish are not available, a variety of beans and peanuts can be used as source of protein. Vegetables vary by region but most of them are produced in the Highlands. Madagascar is graced with wonderful, though seasonal, fruits such as pineapples, peaches, plums, bananas, etc. But during the off-season, specific fruits may be unavailable and also unevenly distributed across country. You will do your shopping at the local market, but some items might have to be purchased at a larger town nearby.

Strict vegetarians and vegans may be challenged, especially during Pre-Service Training, and should be mindful of food customs in Madagascar: turning down a plate because it has meat may be seen as rejecting a gift. Volunteers have found it possible but difficult to maintain a vegetarian diet in Madagascar.

While people in Madagascar may be generally tolerant, values concerning sexual orientation and gender identity may be different than some parts of the U.S. Same-sex marriages are not permitted under Malagasy law. Volunteers will need to be mindful of cultural norms, and use their judgment to determine the best way to approach sexual orientation and gender identity in their communities and host countries. Staff and currently serving Volunteers will address this topic during pre-service training, and identify support mechanisms for incoming trainees.

The cultural environment of Madagascar is an extremely social and welcoming one. Most Volunteers find it very easy to make friends. Although Madagascar has a rich history and fascinating culture, it is one of the poorest countries in the world; many Volunteers experience emotional reactions to poverty and all that correlates to it. Volunteers must be emotionally mature and prepared to manage stress from living in such different conditions.

Malaria is highly endemic and PCVs must be prepared to take chemoprophylaxis without exception.

Learn more about the Volunteer experience in Madagascar:
Get detailed information on culture, communications, housing, and safety (including crime statistics) in order to make a well-informed decision about serving.

Couples Information

Madagascar welcomes couples. Your partner must also apply and qualify for this position.

Madagascar is a patriarchal society, so the male is often times seen as the head of the family. Some couples will often face situations where the community seeks to first listen to the husband. Couples have to find their own culturally appropriate strategies to challenge their coworkers about their views on gender roles and gender equality. As in many patriarchal societies, Malagasy people tend to believe that men are more capable to conduct intensive manual labor compared to women (such as agriculture, for example). Therefore, couples must find ways to support each other when faced by these different gender roles expectations.

Medical Considerations

Before you apply, please review Medical Information for Applicants to learn about the clearance process and other health conditions that are difficult to accommodate in Peace Corps service.


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