HIV testing rate (percentage who know their status)


of women gave birth before the age of 18

1.145 million

people in an emergency and crisis situation in the south of the island

Humanitarian emergency in Madagascar : the reality on the ground

These alarming figures highlight the need for a humanitarian mission in Madagascar.


Madagascar: an alarming humanitarian situation

Madagascar stands out on the African continent for having a particularly restrictive law on abortion and very strong resistance to the law being relaxed. Many women undergo illegal abortions.

Alarming indicators, particularly concerning sexual and reproductive health.

Health indicators on the island of Madagascar are alarming, particularly figures concerning sexual and reproductive health (SRH): there is a maternal mortality rate of 426/100,000, only 46% of births are attended by qualified health personnel, only 39% of births take place in a healthcare facility, there is a prenatal consultation rate of 56.7%, and a rate of use of modern contraception of 38% in sexually active young people between the ages of 15 and 19. Haemorrhages, non-expulsion of the foetus, retained placentas, uterine ruptures and infections are among the complications of abortion, which constitute the second cause of maternal mortality in Madagascar (16% of the maternal mortality rate).


In the context of the COVID-19 pandemic and, more broadly, in the face of inequalities in access to medical care for the Malagasy people, the need for medical aid in Madagascar is obvious.


Primary healthcare and forgotten areas

Madagascar remains a country with a fragile health system and faces recurrent crises. Life expectancy at birth is only 65 years for men and 68 years for women. In crisis-hit areas, particularly in the south of the country, the indicators are alarming: in the Androy region, the mortality rate for children under five is 74/1,000, and only 1% of the population has access to basic sanitation. The particularly severe drought in the area in 2020 led to high food insecurity, and in the last three months of the year, the overall acute malnutrition rate reached 13.5% of the population in the Androy region. 


The COVID-19 pandemic in Madagascar: a humanitarian emergency

Madagascar has faced diseases with high epidemic potential for many years, including plague and measles, with over 1,000 measles deaths recorded in 2018 and 2019. And 2020 brought with it another disaster, as the country had to adapt to the onset of the COVID-19 epidemic. The epicentre, initially in the town of Tamatave, shifted to the capital Antananarivo after a few weeks, causing major disruption to the capital’s health facilities and having a major impact on people’s access to healthcare. By the end of 2020, Madagascar had over 18,000 cumulative COVID-19 positive cases and 270 deaths.

© Bruno Fert
© Bruno Fert

Our humanitarian aid in Madagascar

Our humanitarian aid in Madagascar is based on several issues, including the health of Malagasy women and reconstructive surgery.

Improving sexual and reproductive health of women and children...

Médecins du Monde France, a humanitarian organisation working for health, started an SRH programme in 2017, which aims to contribute to the reduction of maternal mortality and morbidity associated with the lack of access to high-quality health services, particularly among adolescents and young people (aged 10-24). Our NGO works to strengthen the role of civil society and public authorities related to sexual and reproductive health in Antananarivo, the capital of Madagascar.

...and working hand in hand with local organisations

This humanitarian action in Madagascar aims to improve the prevention and management of unwanted pregnancies using a rights-based approach, through three main components:

  • A community component, in partnership with local organisations, aimed at strengthening the capacities of adolescents and young people to become actors of their own health;
  • A medical component, aimed at improving accessibility to and quality of SRH adapted to the needs of adolescents and young people in seven basic health centres;
  • An advocacy component; aimed at promoting the rights of adolescents and young people to decide regarding SRH.

In the context of the COVID-19 health crisis, activities of the humanitarian mission in Madagascar were adapted to a situation which could change from one day to the next (confinement, curfew, etc.).


Humanitarian mission Madagascar: did you know?

The Sexual and Reproductive Health programme in Madagascar is implemented in partnership with three national youth organisations (Tanora IRAI, Tanora GARANTEEN and Tandem), and two national NGOs (ASOS and Mira Aina) in relation to the community component.

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

Humanitarian mission for the most vulnerable postponed in Madagascar

An exploratory mission to the Androy area and more specifically to the Ambovombe District, one of the areas identified as the most vulnerable in the country in terms of health indicators, took place in January 2021. The objective of this mission was to assess and analyse the factors influencing the health of the population in order to define an intervention based on the information collected and to carry out an analysis of the constraints and opportunities (internal and external to MdM). The goal of the project is to “contribute to improving access to healthcare for the people of the Androy region”.


Women and children smile again with paediatric surgery

As part of Operation Smile, children suffering from maxillofacial lesions, burns and congenital malformations of the visceral system are operated on and monitored by Médecins du Monde teams in Madagascar.
These surgical missions, for adults and children, take place four to five times a year, in the capital Antananarivo and in the provinces and provide medical aid that can change the lives of many people in Madagascar.


In 2020

As part of our humanitarian mission to Madagascar, we have unfortunately:

  • had to cancel the humanitarian missions initially planned by French surgeons who could no longer travel, as their surgical schedule was saturated and flights were stopped.


But did prepare a “100% Malagasy” humanitarian mission to be held in February 2021 at the JRA Hospital in the capital, which will allow 26 children to undergo reconstructive surgery.


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

At-risk populations

Improving access to HIV screening and treatment

An essential humanitarian mission: dealing with COVID-19 in Madagascar

In addition to regular healthcare programmes, Médecins du Monde remains vigilant in emergency situations linked to climatic hazards, particularly cyclones, but also epidemic outbreaks and conflicts that could possibly lead to violence. When the COVID-19 pandemic arrived in 2020, Médecins du Monde supported the Madagascar Ministry of Health. MdM worked in a consortium with Action Contre la Faim, Care, and the community organisation ASOS from April 2020.


In 2020

as part of our medical aid plan in Madagascar, we:

  • deployed a team of 12 doctors and 12 paramedics to three university hospitals in the capital to support the Ministry of Health’s medical staff, set up triage circuits and limit the risks of contamination within the health facilities;
  • supported 18 basic health centres in the capital with training and mentoring activities as well as donations of personal protective equipment, medical supplies and hygiene materials;
  • trained more than 600 health workers in treating COVID-19 and managing severe cases in the regions of Analamanga, Ihorombe, Atsimo Andrefana, V7V and Haute Matsiatra.


our institutional support

L'Organisation mondiale de la santé soutient Médecins du Monde
Médecins du Monde’s first intervention in Madagascar.
Start of programme to tackle STIs in Antananarivo.
Paediatric cardiac surgery programme begins in Antananarivo.
Launch of Operation Sourire in Madagascar.
Programme to support detainees in prisons in Madagascar.
Abdominal surgery in Antananarivo.
Start of disaster risk management programme.
Prison intervention concluded.
Médecins du Monde leads the NGO consortium on mother and child health.
Opening of HIV and sexual and reproductive health programmes.
Médecins du Monde worked in a consortium with Action Contre la Faim, Care, and the community organisation ASOS from April 2020.

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