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Colby College

Publication Date

Fall 2010

Program Name

Madagascar: Biodiversity and Natural Resource Management


From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the percentage of the national budget spent on medical services was 9.2% and new hospitals and medical centers were being built. By 1994, it had dropped to only 2% (Metz, 1994). Two thirds of the population lives at least 5 km from the nearest medical centers and, according to UNICEF in 1993, 35% of the population completely lacked adequate access to health services.

With lack of health care infrastructure from the government, many Malagasy people turn to private health care providers. One private organization that is found throughout Madagascar is SALFA, which stands for “Sampan’Asa Loterana momban’ny Fahaslamana,” the Malagasy Lutheran Church Health Department. Founded in 1979, these centers used to be run by the American Lutheran ministry, who pulled out in the 1980’s due to lack of funding and the political situation of Madagascar (John Kent, 9 Oct 2010). Today, as a Malagasy organization, its goals are to continually assure education and training to medical care professionals, on-going maintenance of equipment, current medical statistics and literature, and forms of care, especially for women, infants and children. There are a total of 90 certified physicians and 18 dental surgeons who work for 28 centers around Madagascar (SALFA website, 2010). According to sources at Antanimalandy, however, SALFA is not really functioning any longer due to corruption and bankruptcy; an ineffective organization, just like the government’s health care system. Therefore all of the SALFA hospitals are practically disjointed and on their own in terms of acquiring medications which used to be highly facilitated by the SALFA system (Fjose, 19 Nov 2010).


Health Policy | Public Health | Surgery


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