Supporting health enterprises to increase access to quality care for underserved populations in Madagascar

In Madagascar, the private sector is an important source of care for the country’s underserved population; over one quarter of the poorest wealth quintile of caregivers seeking child care outside the home went to the private sector (Madagascar Demographic and Health Surveys, 2009). Health enterprises are often an untapped opportunity to improve underserved populations’ access to care through the private sector. SHOPS Plus partnered with Orange Fab to host a competition for digital health startups and entrepreneurs. Orange Fab is affiliated with the global telecommunication company Orange, and is dedicated to promoting digital entrepreneurship around the world. In June 2020, MEDDOC, a digital platform to manage appointments and medical consultations with private providers, won the competition’s digital health category.

The onset of the COVID-19 pandemic motivated MEDDOC CEO and founder Dominique Manova to launch a digital platform. “Our mission is simple: Improve access to health care in Madagascar by providing the population with simple and innovative tools to manage their own health,” he explained. With MEDDOC, patients will be able to safely and efficiently identify private providers in their area and book appointments online at times and locations most convenient for themؙ—thereby making it easier for them to access critical maternal, child health, and family planning services.

Strengthening entrepreneurs’ ability to improve health outcomes

As part of its technical assistance, SHOPS Plus helped four competition finalists to better understand the health market, access pertinent health information, improve their business models with a focus on underserved populations, and hone their pitches to a jury of digital entrepreneurs and investors. “It was a very enriching experience!” commented Manova. “Thanks to coaching from Orange Fab and SHOPS Plus, along with the advice and feedback from the jurors, we now have a more mature and feasible project.”


A man talking in front of a crowd
Local entrepreneur Dominique Manova pitches the health enterprise MEDDOC at the SHOPS Plus-supported Orange Fab competition. Photo credit: Pierre Meric, Orange Fab.


Supporting health enterprises to become key players in the Malagasy health system

A 2019 SHOPS Plus study of the entrepreneurial ecosystem in Madagascar’s health sector found that although the health sector offers opportunities for startups, there are several obstacles to success. These include inadequate business skills competencies, insufficient market information, and limited access to finance. SHOPS Plus assisted the MEDDOC team to make their vision for a health enterprise a reality in two ways. The project coached the team to strengthen and improve their business model, and linked MEDDOC with private health providers trained in quality of care and the Ministry of Health to gain a better understanding of the health market. “We are fortunate to have a partner like SHOPS Plus who knows the Malagasy private health sector very well,” said Manova. “SHOPS Plus facilitates and supports us in interactions with relevant institutions, such as the National Medical Order and the Ministry of Health’s information system department, and facilitates our access to the health market.” Thanks to the support from SHOPS Plus, MEDDOC now has knowledge and connections needed to explore financing opportunities.

Looking forward

In the last year of the project, SHOPS Plus will continue to support MEDDOC as well as collaborate with other local partners to promote new health enterprise initiatives. “We hope that within five years the Malagasy population will use our platform to book their medical consultations, and that our activities will be more diversified,” Manova said. With the growth of MEDDOC and other initiatives supported by SHOPS Plus, health enterprises will become a meaningful channel through which the private health sector can increase access to key health services such as family planning, maternal and child health services across Madagascar.

To learn more about the partnership with Orange Fab and the competition, read the article announcing the partnership here.




Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.

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