Madagascar – Health system reform

To achieve the Sustainable Development Goals (SDGs) in health, Madagascar is prioritizing community health as a key approach. In recent years, interventions aimed at improving the health status of the population have been strengthened through public health actions, particularly targeting vulnerable groups such as mothers and children, the fight against communicable and non-communicable diseases, and health emergencies and epidemics.

However, the population is still insufficiently protected because healthcare facilities are not always functional. The system suffers from dysfunctions characterized by a lack of staff and the dilapidated state of much of the healthcare network's assets.

The urban pneumonic plague epidemic had a significant impact on public health development programs. Indeed, from September to December 2017, most routine activities were suspended. The WHO must continue its mandate, particularly for priority programs such as UHC, health emergencies, and epidemic prevention, to ensure quality support to the government.

The recent Covid-19 pandemic has prompted the Malagasy government to build extensive research, testing, care, and treatment infrastructure. This emergency deployment is also in line with the Malagasy President's 5th Velinaro commitment to empowering the national healthcare system.

In order to provide the best possible service to users, the Ministry of Public Health set itself objectives for the beginning of 2020. Thus, 12 "Manarapenitra" Hospitals and 10 Basic Health Centers (CSB) were built in isolated areas, in addition to the rehabilitation of the Manarapenitra Hospital in Morondava, the Ambatofinandrahana District Reference Hospital Center (CHRD) and existing CSBs. 60 CSBs were also reopened to ensure maximum coverage. As infrastructure is multiplying throughout the island, the Ministry is continuing its efforts to equip them with standard equipment.

As a result, more than 400 Health Facilities have been equipped with functional solar refrigerators to comply with the cold chain standard for the conservation of vaccines in Madagascar, 10 CHRD have also had their operating theaters equipped with materials and equipment to provide the population with services such as surgical emergencies or caesareans. 62,958 blood bags are available for the permanent supply of the 70 Blood Transfusion Centers and Blood Transfusion Points.