LHSS is working with the government of Madagascar to promote domestic resource mobilization for health, strengthen financial protection mechanisms for the Malagasy population, and improve the availability and use of budget and expenditure data for decision-making. LHSS Madagascar’s interventions focus on collaborating with and strengthening the technical and organizational capacity of the Ministry of Public Health, including the Universal Health Coverage (UHC) Support Unit, the Finance Directorate, and the Planning, Research, and Information System Directorate. LHSS is collaborating with these three teams to: 

• Promote DRM to make faster progress towards UHC. 
• Help the GOM promote financial protection mechanisms.  
• Improve availability and use of health budget and expenditure data.  

Our work strengthens 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

• In the spring of 2024, LHSS supported the Ministry in developing an implementation plan for the National Health Financing Strategy, a crucial step towards increasing domestic health resources. The Ministry successfully validated the plan by convening stakeholders and partners, including USAID, UNICEF, and the World Bank.  
• In the summer of 2024, LHSS collaborated with the Ministry’s Directorate of Administrative and Financial Affairs to conduct an in-depth assessment of the government's planning, programming, budgeting, and monitoring and evaluation processes. The assessment concluded with an agreed action plan to enhance planning and budgeting practices, aiming to better utilize available resources and negotiate for increased health funding from the Ministry of Economy and Finance.  
• To support the government's priority of developing a community-based health insurance model, LHSS assisted the Ministry’s UHC Support Unit with a feasibility study in five communes in Madagascar in 2023. LHSS also helped the Unit to design a roadmap and prepare for the insurance model’s pilot launch in Fall 2024. The pilot aims to assess the feasibility of expanding the insurance model nationwide. Community-based health insurance allows community members to pool contributions, providing financial protection by reducing out-of-pocket health care expenses.  
• LHSS provided financial and technical assistance to the Ministry’s Directorate of Studies, Planning, and Information Systems to produce health accounts data for the first time in over a decade. The 2022 health accounts offered critical insights into the health financing landscape, improving accountability and strategic planning for resource allocation and financial protection.  

Updated December 2024