Policy changes to help the private health sector better serve patients in Madagascar

In Madagascar, SHOPS Plus works with the Ministry of Health and private sector champions to strengthen the legal and regulatory environment for the private health sector, leading to improved access and quality of health services to the Malagasy population. Here are two activities the team undertook to improve the policy environment.

A woman speaking to two women at a booth

Representatives from Vahatra, a member of the Federation of Mutuelles, speak to an interested stakeholder about insurance at the SHOPS Plus trade fair in 2019. SHOPS Plus is currently supporting the Federation to develop a mutuelles law.

Identifying legal and regulatory bottlenecks hampering the private sector

In some cases, laws and regulations can impede the private health sector from opening a health facility or providing medicines to patients. SHOPS Plus launched a review of laws and regulations related to service delivery, facility authorization, and the import, sale, and distribution of health products to identify bottlenecks private providers face. The project will share its findings and recommendations with the Ministry of Health and USAID, and will help develop an action plan to implement key recommendations.

Creating a strong regulatory framework for mutuelles

SHOPS Plus is addressing the need for clear regulation for community-based insurance schemes, or mutuelles. Historically, mutuelles were not formally organized, leaving them without a way to seek technical or advocacy support. In 2018, SHOPS Plus completed an analysis that found that mutuelles were interested in forming a federation. With support from the project, the mutuelles finalized organizational statutes and elected a leadership committee to create Miara-Miahy, a federation of mutuelles. SHOPS Plus is now supporting the federation to develop a mutuelles law, which will provide a strong regulatory framework for the community-based schemes across the country. Check back soon to learn about the law and the legal and regulatory review findings. 

People talking at a booth

Tsihàrôfy, a member of the Federation of Mutuelles, participates in the SHOPS Plus trade fair in 2019. Federation members look forward to the establishment of a strong regulatory framework to guide their activities. 

Read how SHOPS Plus increased access to health services through mutuelles in Senegal.

Technical 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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