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Madagascar

Madagascar is the country where ATIA is most active, whether in terms of beneficiaries supported, programmes or partners supported. All of ATIA’s areas of intervention are present there: health, education, social and economic.

Madagascar
RAITRATIA, Madagascar (2026) © RIJASOLO

Where our partners work

Carte de MadagascarAntsohihyMahajangaVatomandryAntananarivoAntsirabeFianarantsoaManakaraRAITRATIAMISSONGAMAMPITAAFAFITOHANAKETRIK’ASAKOLOAINARAITRATIAKOZAMASAHI
  • RAITRATIA — Health professionals capacity building, Antananarivo, Antsirabe, Vatomandry and Mahajanga
  • MISSONGA — Capacity building, Antananarivo
  • MAMPITA — Social microfinance, Mahajanga and Antsohihy
  • AFAFI — Health insurance, Antananarivo and Fianarantsoa
  • TOHANA and KETRIK’ASA — Training and job placement, Antananarivo
  • KOLOAINA — Family support, Antananarivo and Antsirabe
  • RAITRATIA — Community health and tuberculosis control, Antananarivo, Antsirabe, Vatomandry and Mahajanga
  • KOZAMA — Education, Antananarivo and Antsirabe
  • SAHI — Social microfinance, Manakara

History of ATIA’s work in Madagascar

In 2008, ATIA took over the oversight and support of urban programmes launched by Inter Aide in 1995 and has since created many other programmes and associations in Madagascar. These partners, each specialised in one area of intervention and gradually extending to other regions of the country, are supported and coordinated by ATIA, work together and share good practices:

In Antananarivo, KOLOAINA has provided psychosocial support to the most vulnerable families in the city’s deprived neighbourhoods since 1995, and extended its activities to Antsirabe in 2025.

KOZAMA, founded in 2009, works to strengthen the public education system (preschool, school tutoring, teacher training), and was also extended to Antsirabe in 2023 and to the Itasy region in 2025.

MAMPITA, created in 2008, and SAHI, created in 2015, run integrated social microfinance programmes, in the Mahajanga and Manakara regions respectively.

RAITRATIA has run a tuberculosis control programme in Antananarivo since 2020, which expanded in 2026 into a broader community health and health system strengthening programme in the Analamanga, Atsinanana, Vakinankaratra and Boeny regions, drawing on a network of partners already present in the field.

Also in Antananarivo, the MISSONGA initiative, launched in 2023, aims to improve the quality of care by strengthening doctors’ practices through continuing training and peer-to-peer sharing of experience.

TOHANA, created in 2019 in partnership with the French textile company JACADI, trains vulnerable young women from very precarious neighbourhoods of Antananarivo through a first work experience in sewing.

Finally, in 2026, the association ECFORME was re-established as KETRIK’ASA, which works to strengthen job placement for vulnerable women and young people living in the deprived neighbourhoods of Antananarivo.

ATIA supports each of these partners in strengthening their governance, technical skills and operational capacity, with a view to gradual autonomy. Some long-standing partners have thus reached an advanced level of autonomy after several years of support: CEFOR (microfinance in Antananarivo) became autonomous in 2019, VAHATRA (integrated social microfinance in Antsirabe) in 2024, and AFAFI (health insurance and social protection scheme) will do so by the end of 2027.

Socio-economic context in Madagascar

Madagascar is one of the least developed countries in the world. Its Human Development Index ranks it 183rd out of 193 countries in 2023 (1), compared with 173rd out of 191 in 2021. According to the World Bank, 69.17% of the Malagasy population lives in extreme poverty, that is, on less than 3 US dollars per person per day (2). The number of poor people has risen by around 50% in ten years, reaching 21.1 million in 2022. The deterioration is particularly marked in urban areas, where the poverty rate rose from 42.2% to 55.5% over the same period (World Bank, Madagascar Poverty and Equity Assessment, February 2024).

Madagascar also has a fragile health system that faces recurrent crises. In 2021, life expectancy at birth was 62.9 years on average (World Health Organization, 2024) (3), and maternal mortality (426 per 100,000 live births) (4) and infant mortality (47 per 1,000 live births) remain high (Madagascar Demographic and Health Survey, 2021) (5).

Sources:

  1. UNDP (2025). Human Development Report 2025: A matter of choice: People and possibilities in the age of AI. New York.
  2. World Bank (2026). Poverty and Inequality Platform (version 20250930_2021_01_02_PROD) [data set]. pip.worldbank.org. Accessed on 2026-02-17.
  3. World Health Organization (2024). Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-birth-(years)
  4. UNICEF (2023). Available at: https://www.unicef.org/madagascar/communiqu%C3%A9s-de-presse/en-2021-un-d%C3%A9c%C3%A8s-denfant-ou-de-jeune-%C3%A9t%C3%A9-enregistr%C3%A9-toutes-les-44-secondes (in French)
  5. Madagascar Demographic and Health Survey (EDSMD-V) (2021). Available at: https://dhsprogram.com/pubs/pdf/FR376/FR376.pdf (in French)

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