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Madagascar is the fourth largest island in the world and is located off the southeast coast of Africa. The island remains as one of the poorest countries of the world with more than 78% and 69% of the rural populations in Mahajanga and Antananarivo provinces, respectively, living in poverty (Paternostro et al, 2001). Madagascar has a life expectancy of only 57 years of age, and under-5 mortality estimated at 123 per 1,000 live births in 2006.

The main causes of death across all ages are diarrhea, measles, and malaria. Unfortunately, there is a low availability of health care workers in the nation with an estimated 29 physicians, 32 nurses, and 2 dentists for every 100,000 people. Most rural communities are also poor and have no means of transportation to obtain these health care services. Although most diseases that affect the country are preventable, Madagascar has only 20 community health workers per 100,000 residents.

References 

Paternostro, S., Razafindravonona, J., and Stifel, D. (2001) Changes in Poverty in Madagascar: 1993-1999. Cornell Food and Nutrition Policy Program Working Paper No. 120: DOI: 10.2139/ssrn.430423.

WHO. (2006) Country Health System Factsheet: Madagascar, 2006.  Retrieved November 18, 2007 from: http://www.afro.who.int/home/countries/fact_sheets/madagascar.pdf.