Fig 1. Map of the Ifanadiana district in southeastern Madagascar.
Ifanadiana has an estimated population of 200,000 people, approximately one third of which live within PIVOT’s initial catchment area. The district is comprised of 13 communes (demarcated by black lines) and 195 fokontany (the smallest administrative unit, demarcated by blue lines). Each of the communes contains a primary health center (Centre de Santé de Base 2: red diamonds and green squares). Between 2014 and 2016, PIVOT and the MoH renovated, staffed, and equipped four of them (red diamonds). The households surveyed by the PIVOT-MoH longitudinal cohort study that were located in villages nearest to a PIVOT-supported health center were categorized into the intervention group (red dots); the households located in villages nearest to a nonsupported health center were categorized into the non-intervention group (green dots). Map of Madagascar in the top right corner, with the Ifanadiana district colored in red. Base maps obtained from INSTAT and GADM.org. INSTAT, National Institute of Statistics; MoH, Ministry of Health.