LHSS is working with the government of Madagascar to increase domestic resources for health and financial protection for health for its population, by strengthening the technical and organizational capacity of three key Ministry of Public Health teams: the Universal Health Coverage (UHC) Support Unit, the Administrative and Financing Department, and Research and Planning Department. LHSS is collaborating with these three teams to:

• Promote, and help to increase, domestic resource mobilization (DRM) to make faster progress towards UHC.
• Help the Government of Madagascar promote health financial protection mechanisms.
• Improve availability and use of health budget and expenditure data.

Our work will strengthen the capacity of the Ministry of Public Health to identify ways to increase the resources available for health, and to plan out a feasible pathway to provide financial protection of health for the population. Ultimately, all citizens of Madagascar will benefit from a strengthened health system that offers accessible, affordable, high-quality essential health services without fear of financial hardship. 

Progress Highlights

• LHSS supported the UHC Support Unit to facilitate a meeting across all central level ministry directorates, aimed at strengthening collaboration on domestic resource mobilization and mutuelles implementation. The meeting led to greater awareness among the directorates about the need to collaborate on UHC reforms. The discussion also stressed the importance of strengthening the quality of health services as a prerequisite to the establishment of mutuelles.
• LHSS supported the UHC Support Unit in conducting a feasibility study of health mutuelles in five communes of Fénérive-Est. Study findings and recommendations will inform the design of a health mutuelles demonstration phase.
• LHSS provided technical and financial support for a study tour to Senegal to learn about their experience designing and implementing a mutuelles scheme. A team of 15 government policy makers and UHC Support Unit staff participated in this visit from September 17-25, 2023. Key recommendations from the study tour included establishing a dedicated national agency to coordinate and oversee UHC reforms in Madagascar, creating a purchasing agency to respect the separation of demand-supply functions, and advocating for a national budget line to support UHC risk pooling, including the inclusion of the extreme poor.