Those living in Madagascar are vulnerable to malaria, and the malaria death rate among children ages 0-4 is 904 per 100,000. Fewer than one percent of children sleep under treated bednets. The tuberculosis death rate is 57 per 100,000 for all ages, a very high rate for a country relatively untouched by HIV/AIDS.

Civil war was barely averted in the wake of a contested presidential election in 2001-2002. Marc Ravalomanana appeared to win the contest and western donor nations recognized him as Madagascar's legitimate leader. Most African nations did not immediately recognize Ravalomanana, and Madagascar was initially excluded from the newly formed African Union (AU). Didier Ratsiraka, the loser in the contest and a former president, went into exile in France.

Sources: Synergy Project, United Nations Statistics Division, AEGIS, September 18, 2003, Madagascar Integrated Strategic Plan, FY 2003-2008, (USAID, November 2002), IRINnews.com (December 17, 2003)

• Finalized a National Strategic Plan for 2002-2006.
• Developed a national plan for monitoring the progress of the disease.
• Created a national program for prevention of mother-to-child-transmission (PMTCT).
• Established an office of HIV/AIDS programs in the Ministry of Health.

Source: Synergy Project

Demographic data contained in this section was obtained from the following sources: The Population Reference Bureau’s 2009 World Population Data Sheet was used for total population, life expectancy at birth, infant mortality, fertility, birth rate, death rate, % of married women 15-49 using modern methods of contraception, % of population 15-49 with HIV/AIDS in 2007/2008, and the GNI PPP per capita (2008). Literacy rates were found in the Population Reference Bureau’s publication 2005 Women of Our World. HIV prevalence data for 2001 and 2003 was obtained from the UNAIDS Barcelona 2002 report; HIV prevalence and orphan data for 2005 was obtained from the UNAIDS Report on the Global AIDS Epidemic 2006. Data on the % women who have discussed AIDS prevention with their husband or partner can be found in ORC Macro and USAID’s Women’s Lives and Experiences: Changes in the Past Ten Years (Research Findings from the Demographic and Health Surveys). Childhood malaria mortality data was accessed in 2003 from the United Nations Statistics Divisions’ Millennium Indicators. Tuberculosis data was obtained from the United Nations Statistics Division’s Millennium Indicators: MDGInfo 2006. In some cases information was unavailable.

USAID has estimated that about 65 percent of the Malagasy population lives within 5 kilometers of a Ministry of Health facility. Throughout the 1990s the government of Madagascar increased the portion of the national budget devoted to the health sector, reaching a level of about 10 percent of government expenditures in 2000.

The Malagasy Lutheran Church also plays an important role in the health care infrastructure of Madagascar, supporting 8 hospitals and 14 clinics.

Five of the most important hospitals in Madagascar are:

• Befeletanana General Hospital in Antananarivo (1,300 beds)
• Hopitaly Loterana Antanimalandy in Mahajanga
• Hopitaly Loterana Manambara in Tolanaro (Fort Dauphin)
• Centre Hospitalier Regional in Toliara, and
• Hopital Principal de Toamasina

Sources: WHO, Madagascar Integrated Strategic Plan, FY 2003-2008, (USAID, November 2002), Medics Travel, Evangelical Lutheran Church in America

L'Institut Pasteur de Madagascar ( website )

Source: PubMed abstract

Universite d’Antananarivo, Faculte de Medecine

Universite de Madagascar (Mahajanga), Faculte de Medecine