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Madagascar (9th)*
Population: 27.69m (2020)
Area: 587,041 sqkm
Diarrhoea deaths: 10,970 (2019)
ORS coverage: 19% (2019)
ORS + Zinc coverage: 6% (2019)
* Madagascar has the ninth highest number of diarrhoea deaths in the World
National EML download: [not yet found]
National policy
✅ ORS+Zinc in National Clinical Guidelines
✅ National Essential Medicines List last updated in 2020 or 2019 [needs verification]
✅ ORS included in the National Essential Medicines List
✅ Zinc included in the National Essential Medicines List
✅ Co-packaged ORS & Zinc included in the National Essential Medicines List (since the 2019 edition)
Zinc availability
✅ Zinc available “over the counter”
❓ Any retailer can sell Zinc without the need for a licence
Outlets for Zinc tablets:
✅ Pharmacies
✅ Drug stores/shops [needs verification]
❌ Supermarkets
✅ General retail outlets [needs verification]
✅ Community Health Workers
❌ Door-to-door sales people
✅ Government hospitals/clinics
✅ Private hospitals/clinics
✅ Campaigns and outreach
Co-pack availability
✅ Co-packaged ORS and Zinc available [Currently, the co-packaged form is not available everywhere except in some health facilities supplied by UNICEF as part of the drought emergency in the south of the country. Jun-2022.]
❓ Discussions underway about introducing co-packaged ORS and Zinc
Outlets for co-packaged ORS and Zinc tablets:
❌ Pharmacies
❌ Drug stores/shops
❌ Supermarkets
❌ General retail outlets
❌ Community Health Workers
❌ Door-to-door sales people
❌ Government hospitals/clinics
❌ Private hospitals/clinics
❌ Campaigns and outreach
✅ Other: Currently, the co-packaged form is not available everywhere except in some health facilities supplied by UNICEF as part of the drought emergency in the south of the country.
Co-packaged ORS and Zinc brands (may not be exhaustive)
Renata Limited (2022 UNICEF delivery as part of the drought emergency response).
Co-packaged ORS and Zinc manufacturers (may not be exhaustive)
None
Co-pack costs
Typical cost of a ORS/Zinc co-pack in the PUBLIC sector
500 Ariary (0.12 USD): as part of social marketing supported by NGOs.
Typical cost of a ORS/Zinc co-pack in the PRIVATE sector
2 000to 2 600 Ariary (0.50 to 0.60 USD)
✅ Diarrhoea programmes currently on-going
| Name | Organisation | Funder | Diarrhoea specific | Target area |
| Projet PARN (Projet d’Amelioration des Resultats Nutritionnels) | Ministere de la Sante Publique | World Bank | No | 8 regions |
| Community IMCI through the child health service of the Ministry of Health, NGOs, United Nations system agencies | Ministere de la Sante Publique and PSI (NGO) |
USAID and UNICEF | No | National |
Additional information
Comment from one correspondent:
The combined ORS+Zinc kit form is certainly included in the list of essential medicines [since 2019] but currently the availability of this form in the country is very low. The central medical stores is in the process of launching a call for tenders this year for the combined form. (Jun-2022)
Information based on 2 questionnaire and 1 comment