title: A Way Forward for Healthcare in Madagascar?
abstract: A healthcare utilization survey was conducted as a component of the Typhoid Fever Surveillance in Africa Program (TSAP). The findings of this survey in Madagascar contrasted with those in other sites of the program; namely, only 30% of the population sought healthcare at the government-provided healthcare facilities for fever. These findings promoted us to determine the drivers and barriers in accessing and utilizing healthcare in Madagascar. Here we review the results of the TSAP healthcare utilization initiative and place them in the context of the current organization of the Madagascan healthcare system. Our work highlights the demands of the population for access to appropriate healthcare and the need for novel solutions that can quickly provide an affordable and sustainable basic healthcare infrastructure until a government-funded scheme is in place.
authors.affiliation: Department of Epidemiology, International Vaccine Institute, Seoul, Republic of Korea.
authors.forename: Florian
authors.initials: F
authors.lastname: Marks
authors.affiliation: University of Antananarivo, Madagascar.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rabehanta
authors.affiliation: Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
authors.forename: Stephen
authors.initials: S
authors.lastname: Baker
authors.affiliation: Department of Epidemiology, International Vaccine Institute, Seoul, Republic of Korea.
authors.forename: Ursula
authors.initials: U
authors.lastname: Panzner
authors.affiliation: Department of Epidemiology, International Vaccine Institute, Seoul, Republic of Korea.
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Legon.
authors.forename: Julius N
authors.initials: JN
authors.lastname: Fobil
authors.affiliation: Institute of Tropical Medicine, Eberhard-Karls University Tübingen, Germany.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Meyer
authors.affiliation: University of Antananarivo, Madagascar.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Rakotozandrindrainy
mesh_terms: D003141:Communicable Diseases / Q000453:epidemiology / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D008270:Madagascar / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011203:Poverty
keywords: Madagascar; healthcare; insurance