Building a healthcare network dedicated to pregnant women in Madagascar

Andzaha Santé is a Franco-Madagascan association whose aim is to establish a network of « Health and Solidarity Centers » in Madagascar. It was on Nosy Boraha, an island north-east of the mainland, that the association opened its first Health and Solidarity Center in 2013. In doing so, it wanted to improve existing healthcare infrastructures and provide better quality healthcare to mothers and their children.

One of the highest maternal and infant mortality levels in the world

Upon retracing his family’s footsteps during a trip to Nosy Boraha, Gérard Hoareau, now the president of Andzaha Santé, was struck by the poor state of the local medical infrastructure, which he describes as a « health disaster. » Madagascar is one of the poorest countries in the world: « according to the Human Development Index*, Madagascar is ranked 156th out of 186 countries, » he adds. « So we decided to launch a program with the Madagascan Ministry of Health and the World Health Organization to identify health priorities in Nosy Boraha. As there was absolutely nothing for monitoring pregnancy and childbirth, the creation of a mother and infant center soon appeared to be the obvious solution. »

Acting by integrating existing organization

The first Health and Solidarity Center was opened in Ambotifotatra, the administrative capital of Nosy Boraha. It now works in synergy with other medical centers: public hospitals, clinics, and a healthcare center run by nuns. This desire to favor the overall development of the island’s health system earned him the full support of the Madagascan government, which has signed a partnership agreement with the association. « We are also working with Gynécologie Sans Frontières, which brings its expertise. » The center provides as much care as possible before hospitalization is required: a trained medical team (doctors, mid-wives, and nurse’s aides) monitor the patients at every step of their pregnancy, with over 250 consultations every month.

A grant from the Air Liquide Foundation to support home care services

The team also provides home healthcare for patients who cannot travel. As Nosy Boraha has no road infrastructures, the team used to visit patients by motorcycle, which limited the amount of medical equipment they could carry. The Foundation’s grant financed the acquisition of an all-terrain medicalized vehicle fitted with a portable ultrasound scanner. The vehicle arrived on the island in September of 2015 and now allows the association to carry out consultation campaigns and to help patients in emergency situations.

A long-term ambition

To finance the health center and provide practically free healthcare to the poorest patients, the Health and Solidarity Center relies on an innovative development model, based on social entrepreneurship. It will create several micro-companies (water conveyance, laundry, taxi services, etc.), which will donate part of their profits to the center. Recognized as being in the general interest, Andzaha Santé’s aim has always been to replicate this model in other regions around the country, but the president of the association urges patience: « We first want to consolidate our actions with the 26,000 inhabitants of Nosy Boraha, where there is growing demand, indeed, we have just recruited a second doctor. »


To find out more

Andzaha Santé Association’s Website:


* An index defined by the United Nations Development Program



The demand of support to the Air Liquide Foundation is appropriate. Women die due to the lack of suitable follow up during the pregnancy. The all-terrain medicalized vehicle enables the transport of all the Health and Solidarity Center team with a portable ultrasound scanner to provide free care to villagers.

Arnelle VAVA
Head of agency