Strengthening public-private engagement

Mutuelles are an important foray by the private sector into offering health insurance at the community level and the promotion of universal health coverage. The SHOPS Plus private sector assessment found that mutuelles in Madagascar face many of the same obstacles as mutuelles in other countries: they are generally small and fragmented, operate with limited know-how, and have inefficiencies at all levels of administration. Stakeholders highlighted during the private sector assessment validation and dissemination workshop that the greatest need at this time is to organize and coordinate mutuelles in Madagascar. To address this need, SHOPS Plus is helping health mutuelles launch a federation which will help facilitate coordination, learning, and overall growth for its members. 

SHOPS Plus is also bringing together key private and public stakeholders in dialogue sessions themed around priority topics such as quality of services in the private sector, health information services, and planning for sustainable private sector training opportunities. These dialogue sessions will begin to create a culture and habit of public and private engagement and will identify areas where the private and public sector can collaborate to better serve the population of Madagascar.  

In 2015 – 2018 SHOPS Plus helped identify ways to strengthen the government’s commodity, logistics, and supply system, SALAMA, to ensure efficiency and sustainability. SALAMA is the only public sector pharmaceutical wholesaler in Madagascar, with sales totaling approximately 9-15 percent of total pharmaceutical purchases. One of the main threats to optimal function of SALAMA’s existing cost recovery system, Fonds d’Approvisionnement Non-Stop aux Médicaments Essentiels (FANOME), is the cross-subsidization of free-of-charge products by paid products. SHOPS Plus completed a study of the financial solvency of FANOME, developing a financial model and identifying and sharing policy recommendations that allow the main entities involved in FANOME to be consistently solvent in regard to FANOME products and the free-of-charge products which FANOME products are meant to subsidize. This study was completed in close collaboration with GHSC-PSM and the Ministry of Health.

Learn more about public-private engagement.

See all Madagascar program components.



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.