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Women's health innovation, Madagascar

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Madagascar

Madagascar's women's health landscape is driven overwhelmingly by government, UN, and NGO maternal and reproductive health programs rather than a commercial femtech startup scene. The country has one of the world's highest maternal mortality ratios and heavy unmet need for family planning, addressed largely through a network of over 20,000 community health volunteers, UNFPA-supported midwifery and contraceptive supply, and mHealth tools like CommCare. A small local digital health sector exists (e.g. MEDDoC), but 2025 US foreign aid cuts sharply disrupted contraceptive supply and mobile clinics, making donor dependence the defining feature of the ecosystem.

Maternal healthFamily planning & reproductive healthCommunity health workers & mHealthMenstrual healthDigital health / telemedicine
445 per 100,000

Maternal mortality ratio, among the world's highest globalcitizen.org

~10 deaths/day

Women and teenagers dying from pregnancy and childbirth complications unfpa.org

1 in 3

Women with an unmet need for family planning globalcitizen.org

50,000+

Women and girls living with untreated obstetric fistula unfpa.org

01 of 07

Latest major news

Recent developments are dominated by the fallout of 2025 aid cuts and continued maternal health campaigns.

02 of 07

Policy & strategy

National strategies frame community health, family planning, and digital health, with ambitious 2030 targets.

03 of 07

Latest ecosystem moves

Activity centers on incubated digital health startups, community mHealth tools, and menstrual health social enterprise.

04 of 07

Notable funding rounds

There is little venture funding; capital flows are donor grants and public innovation subsidies rather than equity rounds.

05 of 07

Key players & hubs

The ecosystem is anchored by government programs, UN agencies, NGOs, and a few local digital health ventures and incubators.

06 of 07

Active investors

Funding is dominated by development donors and public innovation programs; private gender-lens venture capital is largely absent locally.

07 of 07

White papers & reports

Key reference documents span national strategy and evidence on maternal, community, and menstrual health.

Latest major news

2025-01
US foreign aid freeze ends UNFPA support for MSI Madagascar, which had received 100% of its family planning commodities (implants, IUDs, injectables) plus outreach funding from UNFPA.
globalcitizen.org
2025-03
USAID clawed back approved funding across seven countries including Madagascar; Madagascar received a rescission of termination notice allowing some projects to continue.
unfpa.org
2025-08
Free obstetric fistula screening and repair campaign runs at the Regional Referral Hospital in Antsohihy (18-22 August), delivered by Freedom From Fistula Madagascar.
freedomfromfistula.org
2025-11
Report on training midwives to bridge Madagascar's maternal health gap: students lack computers and connectivity, and funding cuts mean graduates must now find jobs themselves rather than being recruited directly into public service.
unfpa.org

Policy & strategy

2023-01
Strategie Nationale de Sante Digitale de Madagascar 2023-2027 sets the framework for digital health, including mHealth for community agents.
msanp.gov.mg
2023-01
Plan Strategique National de la Sante Communautaire 2023-2027 structures the community health worker system that delivers maternal, neonatal, and family planning services.
feddai.com
2021-01
Plan d'Action National Budgetise en Planification Familiale targets raising modern contraceptive prevalence to 60% and cutting unmet need to 8% by 2030.
fp2030.org
2025-01
UNFPA global Start with Her strategy for reproductive, maternal and newborn health 2025-2030 frames its country-level support including Madagascar.
unfpa.org

Latest ecosystem moves

â–¸MEDDoC, a Malagasy startup digitizing the health system with online appointment booking and telemedicine (including a planned platform for rural populations), incubated by Zafy Tody and selected for Miary Digital. orangefab.mg
â–¸USAID Mikolo / Ministry of Health developed a CommCare mHealth app enabling community health agents to manage childhood illness, give family planning advice, and refer severe cases. msh.org
â–¸SEED Madagascar, with UNICEF, runs a menstrual hygiene management program in the Anosy region, training seamstresses to make and sell reusable sanitary pads as a livelihood. unicef.org
â–¸Sante Sud installs self-employed community midwives in rural fokontany delivery clinics in the Analamanga region to extend care to women and children. santesud.org
â–¸Miary Digital second cohort (launched Jan 2025) drew 320 applications; 26 startups selected, each eligible for USD 15,000 on completing incubation. pic.mg

Notable funding rounds

Disclosed round size (USD)

Miary Digital startups (incl. MEDDoC) USD 15,000 each
Grant · 2025-01 · Miary Digital / World Bank (PIC) pic.mg
MSI Madagascar undisclosed emergency bridge
Grant · 2025-05 · Short-term emergency donor funding globalcitizen.org

Rounds by type

2 rounds
Grant2

Key players & hubs

Ecosystem by organisation type

10 orgs
NGO6
Hub2
Startup1
Govt1
MEDDoC
Startup

Malagasy digital health startup: appointment booking, telemedicine, medical community management, based in Antananarivo meddoc.mg

Zafy Tody
Hub

Antananarivo tech startup incubator and business angel; incubated MEDDoC and delivers Miary Digital zafytody.mg

Orange Fab Madagascar
Hub

Orange accelerator that has incubated 39+ startups; lists MEDDoC among health ventures orangefab.mg

UNFPA Madagascar
NGO

Finances the majority of reproductive health commodities; midwifery, family planning, and fistula campaigns since 1978 madagascar.unfpa.org

MSI Madagascar (MSI Reproductive Choices)
NGO

Family planning and mobile outreach provider; hit hard by 2025 commodity funding loss globalcitizen.org

Management Sciences for Health (USAID Mikolo/ACCESS)
NGO

Implemented mHealth/CommCare and supports 20,000+ community health volunteers across 14 regions msh.org

SEED Madagascar
NGO

Menstrual hygiene management program with UNICEF; reusable pad production in the Anosy region unicef.org

Sante Sud Madagascar
NGO

Installs rural community midwives in delivery clinics; office in Antananarivo santesud.org

Freedom From Fistula Madagascar
NGO

Free obstetric fistula screening and repair surgery campaigns freedomfromfistula.org

Ministere de la Sante Publique
Govt

Sets national digital health, community health, and family planning strategies msanp.gov.mg

Active investors

Active investors by headquarters

Global 2
USA 2
Japan 1
UNFPA
Primary financier of reproductive health commodities, midwifery, and family planning in Madagascar unfpa.org
Global
USAID
Funded Mikolo/ACCESS mHealth and community health programs; 2025 cuts disrupted family planning supply msh.org
USA
UNICEF
Backs menstrual hygiene management and community health volunteer programs unicef.org
Global
World Bank (via PIC / Miary Digital)
Funds the Miary Digital startup incubation program that supports digital health ventures pic.mg
USA
Government of Japan
Funded UNFPA-supported emergency obstetric and fistula repair facility in the Androy region unfpa.org
Japan

White papers & reports

â–¸Strategie Nationale de Sante Digitale de Madagascar 2023-2027, Ministere de la Sante Publique msanp.gov.mg
â–¸Plan Strategique National de la Sante Communautaire 2023-2027, Ministere de la Sante Publique feddai.com
â–¸Effects of reductions in US foreign assistance on HIV, TB, family planning, and maternal and child health (modelling study), The Lancet Global Health, 2025 thelancet.com

Sources and references

Every figure and claim above links back to a public source. 14 references, updated 2026-08.