of maternal deaths caused by their late arrival in healthcare centres


children had heart surgery in 2015


Women and children

The Island’s overall health situation has deteriorated since the political crisis in 2009. Women are the first to suffer. By failing to arrive on time in healthcare centres, many of them die during childbirth.  Whilst use of contraception has increased, access to modern, effective methods is very difficult and the rate of abortions is estimated at 1 in 10 births. In addition, mortality amongst infants and young children remains high, and is often caused by nutrition problems.


Childhood heart disease

As everywhere else, some children in Madagascar suffer from heart disease. But on the island, where the health system is very fragile, their care is more difficult than elsewhere. There are only two hospitals in the capital which are capable of making an accurate diagnosis and carrying out closed heart interventions .But, owing to the high cost of treatment (screening, diagnosis, treatment, and surgery), only some families are able to obtain treatment for their children suffering from heart disease. The rest are condemned to living with their illness, or to dying from it. 

© Bruno Fert
© Bruno Fert

What we do

Women & Children

Improving mother and child health

A health centre in the village of Analamaho, comprising treatment room, labour room and rest room for women who have just given birth. © Bruno Fert


In 2016

We have helped:

  • 19,732 women who had an ante-natal consultation

  • 12,630 women who had an assisted delivery

  • 57,048 people who were able to use contraceptives regularly

Doctors of the World is working on improving emergency obstetric and neo-natal care in Madagascar, in order to limit the number of deaths of infants and women in childbirth. The study of community relationships with healthcare centres has given us a better understanding of the needs and enabled us to consider appropriate solutions. Thus the teams lobby for basic healthcare centres to integrate mother and infant care into their activities. For this reason, medical staff are trained specifically in this type of care and the centres are refurbished and equipped to receive women and children in good conditions.  Almost 200 community health workers have undergone awareness training on issues around mother and infant health

Did you know?

The PASMI consortium (Project on access to mother-child healthcare) is made up of six international NGOs: Doctors of the World (consortium leader), ACF (Action against Hunger), GRET, Handicap International, MFPF (French movement for family planning) and Santé Sud (Health South). 

A doctor examining a pregnant woman. © Bruno Fert
A doctor examining a pregnant woman. © Bruno Fert

Women & Children

Operating on children with heart disease

For 20 years, Doctors of the World has organised for a surgical team from Reunion to come and work with Madagascan teams at Antananarivo on infant cardiac surgery.  The association provides equipment for the new operating theatre at CENHOSOA hospital so that it suitable for this type of intervention and trains Madagascan practioners so that in future they will be able to operate alone. Doctors of the World also takes care of the transfer of patients requiring open heart surgery to Reunion or mainland France.

In addition, the heads of health centres in several areas of the island were trained in the detection of tell-tale signs of paediatric heart disease, so that the children can be referred to the hospital.


In 2016

We have:

  • Performed closed heart interventions on 22 children  

  • Performed open heart surgery on 26 children

  • Provided 757 paediatric cardiology consultations

  • Trained 55 leaders on clinical screening for heart disease

Families wait for a cardiac consultation at the health centre run by Doctors of the World. © Bruno Fert
Families wait for a cardiac consultation at the health centre run by Doctors of the World. © Bruno Fert
First intervention by Doctors of the World in Madagascar.
Programme launched to eliminate STIs in Tananarive.
Programme launched to provide paediatric heart surgery in Tananarive.
Launch of Operation Sourire in Madagascar.
Programme set up to support detainees in the island’s prisons.
Abdominal surgery in Tananarive.
Programme launched to manage disaster-related risks.
Work in prisons comes to an end.
Doctors of the world leads the NGO consortium on mother and child health.

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