Public health challenges in Madagascar: Trends in the 25 most common diseases across 22 regions from 2015 to 2024

Common diseases; District hospitals; Health information system; Madagascar; Malaria; Social Sciences (miscellaneous); Psychology (miscellaneous); Decision Sciences (miscellaneous)

Abstract :

[en] This study aims to provide an overview of the 25 most commonly encountered diseases in district reference hospitals (CHRD) across Madagascar's 22 regions from 2015 to 2024, with the goal of better guiding public health policies and improving healthcare delivery. The originality of this study lies in the use of aggregated clinical data from the Health Information System (HIS), centralized through the DHIS2 platform, and validated by data committees at multiple levels (services, hospitals, districts). The methodology relies on the analysis of data collected from CHRDs, gathered both manually and digitally, and validated at different hierarchical levels before being centralized in DHIS2. The geographic and socio-demographic profile of Madagascar, the health pyramid, and the data collection and validation mechanisms are also considered to contextualize the results. Preliminary analyses reveal that the most recurrent diseases include malaria, acute respiratory infections, diarrheal diseases, tuberculosis, and severe malnutrition, with significant regional disparities. For instance, the fatality rate for severe malaria remains high (6%), while neonatal mortality stands at 26‰. Consultation rates remain low (37.2% in 2022), especially in rural areas. This study highlights the weaknesses of the Malagasy healthcare system, particularly in terms of prevention and healthcare coverage. It suggests the need for better resource allocation, strengthening regional health infrastructure, and rigorous data monitoring to support Universal Health Coverage (UHC).

Disciplines :

Public health, health care sciences & services

Author, co-author :

Kameni Nematchoua, Modeste ; Université de Liège - ULiège > Département ArGEnCo > Urbanisme et aménagement du territoire

Ratsiambakaina, Diana; National Institute of Public and Community Health, Ministry of Public Health, Madagascar ; Institute of Tropical Odonto-Stomatology of Madagascar (IOSTM), University of Mahajanga, Madagascar and CHU Mahavoky Atsimo Mahajanga, Madagascar

Rasoariseheno, Faratiana Jenny; Institute of Tropical Odonto-Stomatology of Madagascar (IOSTM), University of Mahajanga, Madagascar and CHU Mahavoky Atsimo Mahajanga, Madagascar

Andriamasinoro, Rija Onintsoa; Institute of Tropical Odonto-Stomatology of Madagascar (IOSTM), University of Mahajanga, Madagascar and CHU Mahavoky Atsimo Mahajanga, Madagascar

Rakotomalala, Nivoarimelina Zoly; Faculty of Medicine of Mahajanga, Madagascar and CHU PZAGA Androva Mahajanga, Madagascar

Raveloharimino, Nirina Henintsoa; Faculty of Medicine of Mahajanga, Madagascar and CHU PZAGA Androva Mahajanga, Madagascar

Raotoson, Herisitraka; Faculty of Medicine of Mahajanga, Madagascar and CHU PZAGA Androva Mahajanga, Madagascar

Rakotovazaha, Harimbola Fiononantsoa Razaiarilala; Faculty of EGS Antananarivo, Department of Sociology, Madagascar

Reziky, Alphonsine Mboty; Nutrition-Environment-Health Doctoral School of the University of Mahajanga, Madagascar

Mariette, Rakotoson; Nutrition-Environment-Health Doctoral School of the University of Mahajanga, Madagascar

More authors (15 more)

Language :

English

Title :

Public health challenges in Madagascar: Trends in the 25 most common diseases across 22 regions from 2015 to 2024

Publication date :

December 2026

Journal title :

Social Sciences and Humanities Open

eISSN :

2590-2911

Publisher :

Elsevier Ltd

Volume :

Pages :

103349

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S2590291126009149?httpAccept=text/xml

Available on ORBi :

since 27 August 2026

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