Facilities and Health Information:
Standards of healthcare throughout Madagascar are well below U.S. standards. There are small hospitals and clinics in Antananarivo that provide basic but acceptable care for emergencies. Outside of Antananarivo, the quality of care is very questionable and should only be used when other options are not available. Caution and good judgment should be exercised when seeking hospital and medical services. The U.S. Embassy maintains a list of hospitals and specialists, which can be provided on demand.
Most medications, generally of French or South African origin, are available in Antananarivo. If you need to refill a prescription from outside of Madagascar, it is important to carry a prescription from your health care provider listing the medicine's generic name, but it is best not to rely on re-filling medications in Madagascar as the availability varies. Travelers are advised to carry a supply of anti-malarial medication if traveling outside Antananarivo. U.S. citizens who will be carrying medications with them to Madagascar may wish to contact the Malagasy Embassy in Washington, D.C., regarding any restrictions on imports.
Ambulance services are available in Antananarivo with Assistance Plus at 032 07 801 10 or 22 487 47; Polyclinique d’Ilafy at 22 425 73 or 033 11 458 48; Espace Medical at 22 625 66 or 22 481 73 or 034 05 625 66; and CDU (Centre de Diagnostic Medical d’Urgences) at 22 329 56. However, due to traffic jams, response times are often dangerously slow. Assistance Plus has air ambulance capacity for remote and less accessible regions of the country.
Malaria is prevalent, particularly in the coastal regions. Using preventive measures and malaria prophylaxis is strongly recommended. Rabies is endemic, and there are many street dogs. It is recommended that travelers have the pre-exposure vaccination series prior to arrival in Madagascar. If bitten by an animal, wash the affected area immediately with soap and running water for ten minutes. Seek medical care immediately at the Institute Pasteur in Antananarivo. Plague is also endemic to Madagascar, but casual tourists are unlikely to be infected. While the reported HIV prevalence rate is low, particularly by African standards, Madagascar suffers from a very high reported incidence of sexually transmitted infections and tuberculosis.
The East African Indian Ocean islands have seen a rise in cases of chikungunya, a viral dengue-like ailment, and dengue itself. As with malaria, chikungunya and dengue are transmitted by mosquitoes. Every effort should be made to use bed nets, repellants, proper clothing, and barriers that discourage/prevent mosquito bites. The CDC has further information on chikungunya and dengue on their website.
Travelers should drink bottled water or carbonated beverages. Local water is not potable. Water purification tablets may be used as necessary. Bottled water is readily available.
Drinking Water Source - % of rural population improved"
Drinking Water Source - % of total population unimproved:
Drinking Water Source - % of urban population improved:
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Sanitation Facility Access - % of total population unimproved:
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Infectious Diseases - degree of risk:
Animal Contact Disease (s):
Food or Waterborne Disease (s):
bacterial diarrhea, hepatitis A, and typhoid fever
Vectorborne Disease (s):
malaria and dengue fever
Water contact disease (s):