Sweating the small things

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Science  01 Mar 2019:
Vol. 363, Issue 6430, pp. 918-923
DOI: 10.1126/science.363.6430.918

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An eclectic group of scientists is trying to build a health system piece by piece in Madagascar, one of the poorest countries in the world. They are working in a rugged, rural district, trying to strengthen all levels of health care at the same time, from rural clinics to the district hospital. The emphasis is on meticulous data gathering and rigorous analysis so the team can document what works, fix what doesn't, and create a model health system that could be scaled up to cover all of Madagascar and, perhaps, be adapted for other countries. So far, it seems to be paying off, with dramatic improvements in key population health indicators in the pilot area.

  • * Reporting and photography for this story was supported by the Pulitzer Center.

    Leslie Roberts is a former news editor at Science.

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