Geographical Locations - Madagascar

• (Statistical) Number of Inhabitants per Doctor: 8,120
• CIA World Factbook : Madagascar

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Madagascar
  - WHO - Tobacco Control: Country Profile - Madagascar
  - WHO - Environmental Burden of Disease: Country Profile – Madagascar
  - WHO - Malaria Country Profile - Madagascar
• WHO - Regional Office AFRO in Brazzaville, Congo

Government

• Assemble Populaire Nationale
  Algerian National Assembly - site in French and Arabic.

Non-Government

• CARE Madagascar
• Institut de recherche pour le developpement Madagascar
• Marie Stopes International: Madagascar
• MSF - Médecins Sans Frontières - MSF in Madagascar

Academic Institutions

• L’Institut National de Santé Publique et Communautaire (INSPC)

National Policy and Related Documents

Reports, Guidelines, and Projects

• Determinants of Condom Use Among Youth in Madagascar
  Objectives: To identify the key determinants of condom use with regular and casual partners among youth in Madagascar. Data and Methods: Data stem from a reproductive health survey conducted in October–December 2000 among a representative sample of 2,440 youth aged 15–24 living Toamasina province. Following theoretical models of behavior change, we use logistic regression to assess the effect of AIDS awareness, personal risk perception, condom access, perceived condom effectiveness, self-efficacy, and social support on condom use. Results: Among sexually experienced youth, only about four in 10 males and two in 10 females have ever used condoms. Fewer than 15% of youth used a condom in last intercourse with their regular partner. Whether youth will try condoms appears to depend largely on condoms’ perceived effectiveness for family planning, access to a nearby condom source, parental support for condom use, and patterns of risky sexual behavior. Young males’ likelihood of using a condom with a regular partner increases significantly if they perceive condoms to be effective for family planning (odds ratio [OR] = 11.4; p= .019). For females, it increases with level of self-efficacy (OR =2.1; p=.042) and having discussed HIV prevention with someone in the last year (OR=2.8; p=.022). Among males, condom use with casual partners is significantly higher among those who perceive themselves to be at high risk of sexually transmitted infections (OR=2.3; p=.014), who believe condoms are effective for family planning (OR=2.8;p=.048), who have good access to condoms (OR=2.9; p=.002), and who perceive their parents support condom use (OR=1.7; p=.048). Conclusions: Very few youth in Toamasina are using condoms, highlighting the need to continue and expand adolescent reproductive health interventions. Because the determinants of condom use vary by gender and partner type, reproductive health programs for youth need to develop campaign activities and messages that are sensitive to these differences. The results also emphasize the significance of condom use for family planning among youth. Thus, in this low HIV prevalence setting, it is important for youth reproductive health programs to emphasize that condoms are effective for both pregnancy prevention and STI/HIV prevention. [author abstract] [Population Services International (PSI) Research Division, Working Paper No.55, 2003]
• Drug-resistant malaria parasites introduced into Madagascar from Comoros Islands
  To determine risk for drug-resistant malaria parasites entering Madagascar from Comoros Islands, we screened travelers. For the 141 Plasmodium falciparum isolates detected by real-time PCR, frequency of mutant alleles of genes associated with resistance to chloroquine and pyrimethamine was high. International-level antimalarial policy and a regional antimalarial forum are needed. [author abstract] [Emerging Infectious Diseases, Vol. 13, No. 11, November 2007, pp.1759-1762]
• High-Risk Sexual Behavior at Social Venues in Madagascar
  Background: Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention. Methods: Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention. Results: Community informants identified numerous venues (range: 67–211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives. Conclusions: Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations. [author abstract] [Sexually Transmitted Diseases: August 2008 - Volume 35 - Issue 8 - pp 738-745]
• Madagascar: Demographic and Health Survey, 2003-04
  Comprehensive survey results are published in the DHS Final Reports approximately 8-12 months after the completion of fieldwork. Standard reports are approximately 200 pages in length and include, but are not limited to, topics such as: household and respondent characteristics, fertility and family planning, maternal and child health, nutrition, and HIV/AIDS. In French. Key findings available in English. [Measure DHS, February 2005]
• Norovirus Infection in Children with Acute Gastroenteritis, Madagascar, 2004–2005
  Of 237 children with acute gastroenteritis in Antananarivo, Madagascar, during May 2004–May 2005, 14 (≈6%) were infected with norovirus. Seasonality (November–December peak) was detected. Reverse transcription–PCR identified GII as the most common genogroup. GIs belonged to GI.1, GI.3, and GI.4. Noroviruses in Madagascar show extensive genetic diversity. [publication abstract] [Emerging Infectious Diseases, Vol. 13, No. 6, June 2007, pp.908-911]
• Prevalence and Chloroquine Sensitivity of Plasmodium malariae in Madagascar
  We report the results of clinical studies carried out at six sites in Madagascar, between January and October 2006. The aims were (i) to update our knowledge of the burden of Plasmodium malariae infection and (ii) to assess the therapeutic efficacy of chloroquine for uncomplicated quartan malaria. Our findings confirm that P. malariae is the third leading cause of malaria, accounting for 1.1% of all malarial infections. They also demonstrate that chloroquine — currently recommended for the home management of presumed malaria in children under the age of five years and commonly used by adults — remains highly effective in patients with uncomplicated P. malariae infection. [author abstract] [American Journal of Tropical Medicine and Hygiene, 77(6), 2007, pp. 1039–1042]
• Sanitation and hygiene in developing countries: identifying and responding to barriers – A case study from Madagascar
  "This report offers a snapshot of the sector as it is perceived by key decision-makers and experts at national level and by users and practitioners in one locality." [Overseas Development Institute (ODI), February 2007]

Educational Resources

• CDC - Travel Information : East Africa
• Demographic and Health Surveys Madagascar
• Library of Congress, Country Study: Madagascar