In Madagascar, use of public health services is low, particularly among poor women and their families. The public health sector has struggled to serve the health needs of all citizens due to budget constraints and ongoing economic and health crises. Households, including the poor, increasingly rely on the private health sector to meet their health needs, particularly for family planning and child health products and services. SHOPS Plus is working to tap the potential of the private sector to address these needs.

The private health sector is an important source of health services in Madagascar. The SHOPS Plus 2017 private sector assessment found that private providers account for one third of total service provision in the country. A SHOPS Plus DHS analysis found that 32% of caregivers who seek sick child care outside the home-and more than one quarter of the poorest of caregivers-go to the private sector.

To strengthen the private sector’s ability to respond to critical health needs, SHOPS Plus trains private providers in family planning, WASH, and child health. The trainings aim to improve clinical knowledge and practices among private providers based on the latest healthcare protocols. In addition, SHOPS Plus trains and coaches private providers in business and financial management, and supports increased lending to providers to expand and improve their service offerings.

SHOPS Plus also seeks to improve the enabling environment for private sector service provision by strengthening dialogue between the public and the private sectors, supporting private providers to better organize, encouraging entrepreneurs to develop innovative health solutions, and carrying out research to better understand the private health sector in Madagascar.

During the first two years of the project, SHOPS Plus implemented social and behavior change campaigns and distributed key health commodities.

    Highlights from program activities from December 2016 through April 2020:

    Icon of a person training others
    Private providers trained in priority technical areas
    Icon of a hand holding out a dollar symbol, representing a loan
    Loans/investments to health and WASH sector recipients totaling $2,695,210
    Icon of a house with a medical cross, representing a clinic
    Private health facilities identified and surveyed in Analamanga region

    Program Components

    Program Components

    Supporting providers' access to finance

    SHOPS Plus is working with AccèsBanque Madagascar and Baobab Bank Madagascar (formerly Microcred Banque Madagascar) whose core target groups are micro-, small- and medium-sized enterprises.

    Publications about Madagascar



    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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