Madagascar Demographics

What is the population of Madagascar?

Population	26,955,737
Population Growth Rate	2.65%
Urban Population	32.600000
Population in Major Urban Areas	ANTANANARIVO (capital) 1.987 million
Nationality Noun	Malagasy (singular and plural)
Ethnic Groups	Malayo-Indonesian (Merina and related Betsileo), Cotiers (mixed African, Malayo-Indonesian, and Arab ancestry - Betsimisaraka, Tsimihety, Antaisaka, Sakalava), French, Indian, Creole, Comoran

What are the health conditions in Madagascar?

Life Expectancy at Birth	64.850000
Death Rate - deaths/1,000 population	7.1
Infant Mortality Rate - total deaths/1,000 live births	46.130000
Health Expenditures - percent of GDP	4.1%
Physicians Density - physicians/1,000 population	.16
Hospital Bed Density - beds/1,000 population	.2
Major Infectious Diseases - degree of risk	very high
Drinking Water Source - percent of urban population improved	78.200000
Maternal Mortality Rate - deaths/100,000 live births	240
Mean Age for Mother's First Birth (age 25-49)	19.5
Contraceptive Prevalence Rate - female 12-49	39.9%
Total Fertility Rate - children born/woman	4.36
Obesity - adult prevalence rate	1.6%
Sanitation Facility Access - percent of urban population improved	19.200000
Underweight - percent of children under five years	36.8%

How long do people live in Madagascar?

Life Expectancy at Birth	64.850000
Median Age	19.000000
Contraceptive Prevalance Rate - female 12-49	39.9%
Infant Mortality Rate	46.130000
Maternal Mortality Rate - deaths/100,000 live births	240
Total Fertility Rate - children born/woman	4.36

Birth Rate - births/1,000 population	34
Median Age	19.000000
Population Growth Rate	2.65%
Sex Ratio at Birth - male/female	1.030000
Age Structure	40.170000
Contraceptive Prevalance Rate - female 12-49	39.9%
Infant Mortality Rate	46.130000
Maternal Mortality Rate - deaths/100,000 live births	240
Mother's mean age at first birth	19.5
Total Fertility Rate - children born/woman	4.36

What are the health conditions in Madagascar?

Medical 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.

Health Expenditures - percent of GDP

4.1%

Hospital Bed Density - beds/1,000 population

.2

Physicians Density - physicians/1,000 population

.16

What is school like in Madagascar?

Education Expenditures - percent of GDP	2.7%
Literacy - female	62.5%
Literacy - male	75.5%
Literacy - total population	68.9%
Literacy Definition	age 15 and over can read and write
Total School Life Expectancy - (primary to tertiary)	10.000000

Can people in Madagascar read?

Literacy - female	62.5%
Literacy - male	75.5%
Literacy - total population	68.9%
Literacy Definition	age 15 and over can read and write

Is Madagascar a safe place to visit?

Crime Information

Madagascar has experienced a dramatic spike not only in the number of crimes, but also in their severity and type. To put this into perspective, Madagascar remains, by and large, safer than many other African countries and even certain U.S. cities.

Over the last three years, there has been a surge in armed attacks. The number of reported incidents has increased steadily since 2009, and by mid-2013, the U.S. Embassy noted reports of more home invasions. The majority of reported crimes targeted Malagasies and did not involve foreigners.

Carjackings, though infrequent in cities, are known to occur. There have been many reports of thieves reaching into stopped vehicles, opening unlocked doors, or sometimes breaking the windows to steal cell phones, purses, and even jewelry from their victims. Keeping windows rolled up and doors locked will minimize these types of situations.

In addition, armed bandit attacks on vehicles carrying goods and people—specifically taxi-bes (which operate within urban centers) and taxi-brousses (which travel to outlying regions) —have increased drastically since 2009 and now occur regularly. Groups of armed bandits often position themselves on the national routes after dark to ambush vehicles. Others have involved armed criminals who stage a “breakdown” that blocks the roadway, forcing the victimized driver to slow down, and hence become more vulnerable. Additionally, sometimes local villagers design a “trap” of sand, a tree log, or some other substance or condition that makes the only viable road impassible. Local villagers then “assist” the stranded vehicle and expect monetary compensation. Although the interim government has taken steps to increase checkpoints to deter banditry, the U.S. Embassy prohibits personnel from traveling at night outside of Antananarivo or the other major cities, due to these attacks and the lack of security force coverage outside of city limits. All U.S. citizens are advised to avoid unknown taxis, especially if alone or at night.

Another major concerns for visitors, especially those in Antananarivo, are crimes of opportunity, such as pick-pocketing, purse snatching, and residential and vehicular theft. Although some of these crimes are non-confrontational, incidents involving violence by assailants do occur and are rising, particularly when the victim resists and when several persons confront the victim. The U.S. Embassy has received reports of physical attacks against foreigners, including U.S. citizens, particularly in coastal tourist areas. A number of these attacks resulted in serious injuries and, in rare cases, fatalities. Criminal elements in Antananarivo and throughout Madagascar are becoming bolder when selecting their victims, and are also committing more crimes in areas that are considered to be “safe:” those that are generally well-lit and well-traveled by pedestrians and vehicles.

Criminal gangs comprised of felons, ex-military, and police are known to commit home invasions and kidnappings, sometimes targeting foreigners. In April 2013, a Western businessman working in Antananarivo was kidnapped at gunpoint and held for four days before being released for ransom. Organized gangs of bandits are known to patrol areas where foreigners, who are perceived to be wealthy, tend to congregate. Crimes such as burglary and robbery also occur in areas outside the capital, and the threat of confrontational and violent crime in rural and isolated areas continues to rise. Coastal cities like Toamasina and Mahajunga have experienced a particularly significant rise in crime over the last year, and violent assaults on foreign travelers in high-traffic tourist areas, like Nosy Be, the Ankerana and Montagne d’Ambre National Parks adjacent to Diego, and the area surrounding Tolagnaro (Ft. Dauphin), have also been reported.

To reduce the risk of being victimized, travel in groups and avoid wearing expensive jewelry or carrying costly electronic items (iPods, digital cameras, or high-end cell phones) with you in public. Valuable items should never be left in an unattended vehicle or at a hotel (unless locked in the hotel safe). Walking at night, whether alone or in a group, is not considered safe in urban areas, including in the vicinity of Western-standard hotels, restaurants, and night clubs in Antananarivo. Visitors are strongly discouraged from traveling outside of cities after dark, due to banditry, lack of lighting, poor road conditions, and lack of security assets. While traveling in vehicles, remember to lock your doors and keep your windows rolled up at all times.

In major cities, the National Police are charged with maintaining peace and security. Outside of major cities, the Gendarmerie is primarily responsible for these duties. Due to a lack of resources and equipment, police and gendarmerie responses to victims of crime are often limited, slow, or nonexistent. Though not exclusively targeted at foreigners, popular discontent with the ability of authorities to maintain law and order has resulted in a number of incidents of violent vigilantism and summary mob justice. As recently as October 2013, two French nationals accused of being pedophiles or organ traffickers in Nosy Be were burned alive by an angry crowd. A third suspect, a Malagasy national held by police, was seized and also killed. Similar incidents of mob justice have occurred throughout the country, including Diego, Toamasina, and Tolagnaro (Ft. Dauphin).

U.S. citizens visiting Madagascar should not expect to experience any hostility or aggression solely because of their citizenship.

Don’t buy counterfeit and pirated goods, even if they are widely available. Bootlegs are illegal in the United States, and their purchase may also violate local Malagasy laws.

Criminal Penalties

While you are traveling in another country, you are subject to its laws even if you are a U.S. citizen. Foreign laws and legal systems can be vastly different than our own. In some places you may be taken in for questioning if you don’t have your passport with you. In some places, driving under the influence could land you immediately in jail. These criminal penalties will vary from country to country. There are also some things that might be legal in the country you visit, but still illegal in the United States, and you can be prosecuted under U.S. law if you buy pirated goods. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States. If you break local laws in your host country, your U.S. passport won’t help you avoid arrest or prosecution. It's very important to know what’s legal and what’s not where you are going.

Persons violating Malagasy laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking of illegal drugs, as well as child prostitution, are severe. Convicted offenders can expect long jail sentences and heavy fines in Madagascar.

Arrest notifications in host country:

While some countries will automatically notify the U.S. Embassy if a U.S. citizen is detained or arrested in a foreign country, that might not always be the case. To ensure that the United States is aware of your circumstances, request that the police and prison officials notify the U.S. Embassy as soon as you are arrested or detained overseas.