Madagascar is a large, beautifully diverse and unique island located in the Indian Ocean, off the coast of Mozambique in south-eastern Africa.
Population estimate (2018): 26,580,834
Capital City: Antananarivo
Currency used: Madagascar Ariary
Gross National Income per capita (2013) (PPP international $): 1
Time zone: GMT +3
Population growth rate (2018): 2.71%
Total fertility rate per woman: 4.03
Languages: French, Malagasy and English
Key ethnic groups: Madagascar has more than 20 ethnic groups, the largest ones being the biggest ones are Merina 26%, Betsimisaraka 15%, Betsileo 12%, Tsimihety 7%, Sakalava 6%, Antaisaka 5%, Atandroy 5%, South Asians, East Asians, Arabs, French and others 24%.
Religion: Approximately 50% practice traditional religion, 45% Christian, around 5% Muslim.
Climate: Depending on region and altitude Madagascar has a tropical and subtropical climate with two seasons; a hot and rainy season from November to April and a cooler, dry season from May to October. The east coast receives large amounts of rainfall most of the year and is therefore home to island’s rainforest, and occasionally hit by tropical storms and cyclones during the rainy season. The central highlands are drier and cooler due to the higher altitude, and the west coast is the driest region. In the capital Antananarivo average temperatures range from 9ºc to 20ºc in July and 16ºc to 27ºc in December.
Life expectancy at birth (2012): 62/65 (male/female)
Probability of dying between 15 and 60 years: 241/191 (per 1000 population, 2016)
Total expenditure on health per capita (2014): $44
Number of doctors per 1000 population (2007): 0.161
Nursing and midwifery personnel density (per 1000 population, 2004): 0.316
Neonatal mortality rate (per 1000 live births, 2012): 22 [13-37]
Maternal mortality ratio (per 100.000 live births, 2010): 240 [160-400]
Top 10 causes of death (2013):
Influenza and Pneumonia: 14,584 people /10.32% of total
Stroke: 12,326 / 8.72%
Tuberculosis: 10,060 / 7.12%
Diarrhoeal diseases: 9,180 / 6.5%
Coronary heart disease: 8,600 / 6.09%
Road traffic accidents: 7,610 / 5.39%
Malaria: 7,412 / 5.25%
Birth Trauma: 5,077 / 3.59%
Low birth weight: 5,073 / 3.59%
Hypertension: 3,792 / 2.68%
The healthcare system in Madagascar comprises a public and a private sector and traditional medicine practices. The country offers free public healthcare to its citizens. The public sector consists of Basic Health Centres, District Hospitals and Regional Hospitals. Basic Health Centres are located throughout the country; they provide basic health prevention services and prenatal care. District Hospitals provide primary health care, diagnostic services and other forms of non-specialised care. Regional Hospitals are located in cities and urban areas; they provide maternal care, general surgery, emergency and specialised services. The largest public hospitals are located in the capital Antananarivo. The public sector receives limited funding, resulting in shortages of modern equipment, medical supplies and staff. Furthermore, access to healthcare is a challenge in the country, with over 60% of the population living more than 5 km from a health centre, in areas difficult to reach and without communication.
The private sector provides the best healthcare facilities in the country. The sector is primarily funded by the Malagasy Lutheran Church and international organisations. Due to better funding, private facilities are better equipped, have more staff employed and have higher hygiene standards. However, treatment is also more expensive accordingly.
Doctors in Madagascar are well-trained, many received their training in Europe or Cuba, but the limited resources available sometimes compromises the quality of care they are able to deliver.
Traditional medicine is practiced throughout the country, but particularly in rural areas. Natural plant-based products are the most commonly used methods of traditional medicine practice in Madagascar.