Ensuring that quality and business training opportunities continue in Madagascar

Since 2018, SHOPS Plus, with local partner organizations, has trained doctors, midwives, and nurses from over 900 private health facilities in Madagascar on quality assurance/continuing quality improvement and business and financial management. The trainings sought to increase clinical knowledge and improve the quality of service delivery in priority health areas such as family planning, malaria, and COVID-19. The business and financial management trainings aimed to help providers mobilize capital and allow them to manage their health facilities more efficiently and sustainably.

Group of people wearing masks.
Facilitators and new trainers at the SHOPS Plus business and financial management training of trainers.


The facilities trained represent about 30 percent of all private health facilities identified in the private sector census. As SHOPS Plus prepares to conclude its activities, ensuring that the training on these two topics continues is critical ensure sustainable high quality services in the private sector.

Preparing local partners to conduct SHOPS Plus trainings

A woman presenting with two other women on the side
New trainers lead a module during a SHOPS Plus business and financial management training.

SHOPS Plus has been working with 13 Madagascar-based organizations with the interest and skill to conduct the training program for the private health sector. These include the Association of Private Hospitals in Madagascar, the National Order of Midwives, the National Institute of Accounting Sciences and Business Administration, and the Federation of Mutuelles. The trainers followed a standard training-of-trainers protocol that included instruction on adult learning techniques, coaching on content areas, and co-leading provider trainings. Staff from SHOPS Plus partner banks, AccèsBanque Madagascar and Baobab Banque Madagascar, also participated in training-of-trainers activities so they could offer business and financial management support to their health provider clients. Some of the training will be implemented in partnership with the Malagasy Vocational Training Fund, (read the story in French on the Fund’s website)

This organization uses contributions from member organizations—including private health facilities—to provide trainings. SHOPS Plus held two pilot trainings on quality assurance/continuing quality improvement for COVID-19 to introduce Fund members to training opportunities for the private health sector. The SHOPS Plus trainers will work with the Fund to continue offering the trainings on quality. This creates another avenue for private providers to access SHOPS Plus trainings.

“This training will enrich our list of Executive Management and Business Administration programs for attendees willing to improve their professional skills.” - Minouche Rakotomalala, a new trainer from a local private business school

At the same time, SHOPS Plus is working closely with the School of Medicine at the University of Antananarivo to incorporate these courses into the curriculum for eighth year medical students. In addition to covering quality and business and financial management, the project is developing curricula for health entrepreneurship and personal development. SHOPS Plus trained 12 faculty members at the School of Medicine to deliver these courses.

A group of medical students wearing masks
Associate professors and medical specialists from the School of Medicine at the University of Antananarivo at a SHOPS Plus training session.



Health Area



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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