Madagascar

Introduction

Malaria transmission in Madagascar occurs all year round in the north of the country; 75% of the population lives in low-transmission areas which are prone to epidemics and 25% live in areas of high risk. The annual reported number of malaria cases in 2010 was 202,450 with 122 deaths.

Progress

Madagascar has made significant progress in scaling-up and sustaining malaria control interventions and has, in particular, been successful in attracting resources through the Global Fund. Additionally, the country has made policy changes including the banning of oral artemisinin-based combination therapy and introduction of Community Case Management of malaria and pneumonia. Case management and vector control has been scaled-up resulting in a significant reduction in malaria burden.

Impact

Madagascar has made significant progress in malaria control interventions resulting in reduced cases and deaths. The reported outpatient malaria cases decreased from 1,600,000 in 2000–2004 to 202,450 in 2010, and inpatient malaria cases decreased by 8514 in 2000 to 6,514 in 2010 and deaths from 591 in 2000 to 122 in 2010. A WHO-sponsored rapid impact assessment in 2010 in 45 of 111 randomly selected district hospitals found a decrease of 34% for inpatient malaria cases and 66% for inpatient malaria deaths in 2009 compared to 2001–2004.

Key Challenges

• Problem of reliability, completeness and timeliness of data as a result of a weak monitoring and evaluation system.
• Late release of funds from some partners delaying activities.
• Stock management weaknesses.
• Resource gaps to sustain universal coverage of key interventions.
• Delays in AMFm implementation and the uncertainty of the future of the AMFm program.