Home Institution

University of Vermont

Publication Date

Summer 2011

Program Name

Madagascar: Traditional Medicine and Health Care Systems


At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of medical care among the people of Antananarivo. The city is filled with an overwhelming presence of poverty and illness, as is the rest of the country.

Despite the idealistic claims of the government and the supposedly “free” access to medical care in public facilities, it is clear that the current health care system is not working in practice. Policy and practice are not the same thing. Even the best (and good intentioned) policies can crumble and deteriorate when they are actually implemented. There are many factors that can determine how effective the policy actually is. In health care policies these factors are extensive. There are economic, cultural, environmental, religious, political and ethical issues at play. I hope to better understand both the health care system in place in Madagascar and the factors that are influencing its efficiency and effectiveness. From there I will explore the ways in which the system could be improved through the integration of traditional medicine. If we can understand why a policy is unable to translate into reality, we have a better chance of discovering the best possible ways to improve it.


Community Health and Preventive Medicine | Health Services Research | Inequality and Stratification | International Public Health | Medicine and Health | Public Health | Public Health Education and Promotion


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