WHO · UNICEF · UN IGME 2024← All Countries

🇲🇬

Maternal & Child Mortality
in Madagascar

Southern Africa · #27 of 30 worst globally

Child Deaths Since Jan 1, 2026

0

52.5 per 1,000 live births · Madagascar

Deaths at Birth Today

0

est. newborns today

Infant Mortality Rate

52.5

per 1,000 · 1.9× world avg

Maternal Mortality Rate

335

per 100,000 · 1.7× world avg

Southern Africa

Birth Mortality Crisis

Mothers & Newborns
Dying in Madagascar
During Childbirth

335 maternal deaths per 100,000 — heavily driven by malnutrition and anaemia in pregnancy, and a critical shortage of health professionals (0.18 doctors per 1,000).

Newborn & Infant Mortality

52.5deaths per 1,000 live births

1.9× the world average

Maternal Mortality During Birth

335deaths per 100,000 live births

1.7× the world average

👶

Newborn & Child Deaths During Birth in Madagascar

Madagascar has the world's highest stunting rate (~50%). The 2009 political crisis caused years of aid suspension. Cyclone seasons cause regular humanitarian emergencies. The Grand Sud region regularly experiences famine.

Modest overall improvement but deeply uneven — the Grand Sud faces periodic famine conditions.

Leading Causes of Child Death at Birth

Neonatal causes28%

Diarrhoea20%

Pneumonia16%

Malaria10%

Other26%

* Neonatal deaths (first 28 days) represent the largest share of under-5 mortality.

What Happens in the Delivery Room

🏥

Births in a health facility~83%

estimated — lower in conflict/rural areas

👩‍⚕️

Skilled birth attendant present~53%

doctor, midwife or trained nurse

⚠️

Neonatal deaths (first 28 days)48%

of all under-5 deaths occur at birth

🩸

Most preventable with skilled care~75%

of child and maternal deaths

🤱

Maternal Mortality During Birth in Madagascar

The 2009 coup led to suspension of international aid for years. Annual cyclone seasons destroy infrastructure. Southern region Grand Sud regularly faces drought-driven famine.

Limited progress. Political instability and climate vulnerability create persistent setbacks.

Causes of Death During Labour & Delivery

Haemorrhage28%

Anaemia / malnutrition22%

Eclampsia18%

Sepsis16%

Obstructed labour10%

Other6%

* Haemorrhage and eclampsia together cause over 50% of deaths — both are treatable with basic skilled care.

Why Mothers Die at Birth Here

🩺

Emergency obstetric care availableLimited

few facilities can manage haemorrhage

🩸

Blood transfusion accessCritical gap

haemorrhage kills within 2 hours

💊

Magnesium sulphate (eclampsia)Often absent

costs $1 — saves lives instantly

✅

If skilled care were universal~75% fewer deaths

WHO estimate for this mortality level

⚠️

Why Is This Still Happening?

Structural Barriers to Safe Birth in Madagascar

World's highest stunting rate — 50% of children chronically malnourished

Grand Sud region recurring famine

2009 political crisis causing prolonged aid suspension

Annual cyclone seasons destroying infrastructure

0.18 doctors per 1,000 people

🎯

SDG 3 Progress Assessment

Madagascar requires sustained political stability and climate resilience investment alongside health system strengthening.

💡

Prevention & Solutions

How Can We Prevent This in Madagascar?

📍 The Situation

Madagascar is an island with extreme regional variation — the capital Antananarivo has reasonable healthcare, but coastal and remote central highland communities are severely underserved. Cyclones regularly damage infrastructure in the south. The country has high rates of malnutrition that compound pregnancy risk.

🔬 How Ultrasound Helps

Madagascar's island geography makes mobile health solutions particularly attractive. Battery-powered, handheld POCUS devices that do not require infrastructure represent a leap in what is achievable during community outreach visits. Training through GUSI's online platform is accessible in urban areas; cascading that training to rural health workers through in-person workshops at district hospitals builds the capacity needed for national impact.

🎓 The Training Gap

Madagascar's district hospital network provides natural training hubs for a cascade model. GUSI's train-the-trainer approach — certifying district-level trainers who then train community health workers — is the right architecture for Madagascar's geography.

What a trained provider can detect with a portable ultrasound device

🩸Placenta previa

🔄Malpresentation

👥Twin pregnancy

📉Fetal growth restriction

⚡Pre-eclampsia markers

🫁Childhood pneumonia

💉Internal bleeding

🧠Hydrocephalus

🧮

Interactive Model

POCUS Impact Calculator — Madagascar

Model based on: 600 scans/provider/year · 15% high-risk detection rate · 47% mortality reduction for detected cases (Swanson et al. 2014 · WHO POCUS in LMICs review)

Number of POCUS-trained providers deployed in Madagascar50

1 provider250500 providers

Scans per Year

30,000

pregnant women screened

High-Risk Detected

4,500

flagged for referral / intervention

Maternal Deaths Prevented

23

mothers saved per year

Newborn Deaths Prevented

42

babies saved per year

Total Lives Saved Per Year

65deaths prevented

1.3

lives per provider

$381

est. cost per life saved

$24,750

total training investment

* This calculator uses a conservative evidence-based model. Actual impact varies by deployment context, provider experience, and health system capacity. Training cost based on GUSI OB POCUS Essentials (~$495/provider). Mortality reduction from peer-reviewed POCUS implementation studies in low-resource settings.

�

Technology & Education

A Practical Plan to Bring POCUS to Madagascar

🗺️ Deployment Roadmap for Madagascar

Baseline assessment — map existing facilities, referral pathways, blood supply, and available midwives, nurses, and physicians who could be trained.
Provider training — enrol local champions in GUSI's OB POCUS Essentials + Pediatric POCUS courses. Certify a core group to train others.
Device procurement — select appropriate portable handheld devices based on power infrastructure, connectivity, and budget (see brands below).
Protocols & referral integration — define what to scan, what findings trigger referral, and how to document scans at the point of care.
Quality assurance — regular image review sessions, outcomes tracking, and refresher training to maintain competency.

📡 Recommended Portable Ultrasound Devices

🦋 Butterfly iQ+

Website →

Single-probe whole-body device covering OB, cardiac, lung, and FAST exams. App-based platform with built-in AI guidance. Designed for low-resource environments — charges via USB and works with any smartphone.

🔵 Philips Lumify

Website →

App-based probe that plugs into Android phones. Multiple transducer heads available for OB and point-of-care use. Widely used in GUSI-supported training programs globally.

🟢 GE Vscan Air

Website →

Wireless, pocket-sized dual-probe handheld. Streams live images to a smartphone app. Excellent battery life — purpose-built for rapid bedside OB and FAST-style assessments.

🔷 Clarius HD3

Website →

High-resolution wireless handheld. Multiple probe configurations available. Strong image quality in a compact form factor — suitable for OB, lung, and neonatal scanning.

Global Ultrasound Institute · GUSI

The training that closes the gap — built for providers in settings like Madagascar

GUSI trains physicians, nurses, midwives, and community health workers in Point-of-Care Ultrasound. Courses are designed from the ground up for providers in resource-limited settings — short, practical, competency-based, and available online or in person. Every course maps directly to the conditions killing mothers and babies during childbirth.