Age takes its toll. After serving the population for nearly a century and a half (135 years), the Cenhosoa—formerly the Military Hospital, Soavinandriana Hospital, and Girard and Robic Hospital—is clearly showing the scars of its longevity. The building has gone years without any significant renovation, and services have failed to improve. Worse, patients are forced to bring their own buckets and basins and fill them with water at night. The hospital also suffers from power outages due to a lack of backup generators.
The Cenhosoa perfectly illustrates the situation in public hospitals and basic health centers. This is because health has not been a priority for successive regimes. The 2026 Finance Law allocates 856.1 billion ariary, down from 920.9 billion in 2025—a 7% cut.
Globally, Madagascar ranks 164th out of 192 countries in this sector. This reduction will have negative impacts on the health situation. Health spending accounts for 6% of GDP, while the Abuja Declaration, which Madagascar signed, sets a minimum of 15%. Public health expenditure per capita is even more alarming at 5 dollars (25,000 ariary), compared to 538 dollars in Seychelles, 273 dollars in Mauritius, and 13 dollars in Comoros. The WHO sets a minimum threshold of 249 dollars.
Due to the lack of a real social security or insurance system, 35% to 40% of health costs remain the responsibility of households. The universal health coverage index stands at only 28%, compared to 44% in sub-Saharan Africa. Many households have no access to care or medicine, the cost of which can be five to ten times the daily individual income, estimated at 2 dollars. Exhausted, they prefer to rely on providence or turn to devotion, where they are at least sure to receive consideration and attention from the State.
Captured & Published at: 2026-08-21 05:39:10 (Madagascar Local Time EAT)
Original Source: https://www.lexpress.mg/2026/08/hopitaux-de-mortalite.html