In Madagascar, utilization of public health services is low, particularly among poor women and their families. Increasingly, the private sector is stepping in to expand use of family planning and reproductive health services.
Madagascar’s geography of highlands, deserts, forests, and poor quality roads makes it difficult for people to access public health care, even though it is free. Only 31% of the population use services provided at basic health centers. Government medical supplies are prone to stockouts and entirely unavailable in some areas. Family planning initiatives in cities have met with some success, but there remain significant gaps in access to quality family planning services. Up to 21% of maternal deaths are linked to giving birth, with just 44% of live births attended by a skilled birth attendant. Though contraceptive prevalence has risen, the rate remains under 30%. It is estimated that 19% of married women have unmet need for family planning.
As the public sector struggles to serve the health needs of its citizens, the private sector has increasingly stepped in. SHOPS Plus is working to leverage the potential of the private sector to address existing health issues. The project focuses on expanding access to and use of priority family planning and reproductive health products in Madagascar.