Commune and Fokontany levels. It is the main interface between the health system and the community. It is under the technical supervision of the Ministerial Department for Health. 296.In 2012, a Guidance Policy in Reproductive Health was adopted. The overall objective was to improve the quality of the life of individuals, couples, families, communities for everything related to reproductive health in all its dimensions. 297.In order to achieve the above mentioned goal, the focus will be on the following policy guidelines: - Ownership, participation and community empowerment for Reproductive Health; - Development of solidarity mechanisms and cost sharing; - Access for all to quality care in reproductive health; - An integrated approach to the health of the woman and the newborn; - The development of human resources for health; - A culture of performance ; - Institutional support at central, regional and district levels; - Strengthening the partnership, collaboration within and between sectors - Advocacy for resource mobilization; - Decentralisation in the management of human and financial resources and reproductive health input supply chain - Optimizing the use of Information and Communication Technologies in RH ; - Strengthening operational research in RH. 298.The health of the mother and the child is one of the Malagasy government priorities. From 1992 to 2009, through the implementation of a package of activities to improve the health of the mother and the child, a net decrease in mortality levels of children under 5 was obtained with a drop of 45 points for infant deaths and 91 points for the infant and child deaths. However, the level of neonatal death shows a slow evolution with a decrease of 18 points which is half of infant mortality. 46