Health Indicators
Programs
Summary: Phase 3. Scale-up delivery at the national or sub-national level
Madagascar is currently in Phase III of Multiple Micronutrient Supplementation (MMS) implementation, reflecting significant progress toward national integration. MMS has been incorporated into the country’s national guidelines, Essential Medicines List (EML), and antenatal care (ANC) protocols. However, it has not yet been included in recurring budget allocations or procurement plans at the federal or local government levels. At present, MMS is distributed free of charge in intervention districts, with UNICEF serving as the sole supplier. Discussions are ongoing to expand supply through the World Bank Project in 13 regions. Delivery systems are being developed, and MMS has already been integrated into Social and Behavior Change Communication (SBCC) strategies and Health and Logistics Management Information Systems. Despite this progress, supply chain strengthening and capacity building for healthcare providers remain key priorities. The program faces challenges such as insufficient funding for full national scale-up and the lack of government coverage for duties and taxes on MMS imports. Lessons learned include the positive impact of the IMPROVING project on maternal nutrition, the role of traditional birth attendants in enhancing ANC and MMS uptake, and the effectiveness of free MMS distribution in improving adherence. Key stakeholders include various government bodies, PIVOT, PARN, UNICEF, the National Institute of Public and Community Health, GRET, the Bill & Melinda Gates Foundation (BMGF), and other partners. The next steps involve initiating MMS distribution in emergency-affected areas and advocating for broader funding and operational support to sustain and expand the program.
Sources: 2nd Regional Africa Meeting, HMHB Survey 2021-2023
Dashboard
Implementation Status
Key Program Actors and Partners
Challenges and Next Steps
Tools and Resources
Summary: Phase 1. Evidence-Informed Engagement
Madagascar has incorporated BEP supplementation into a five-year resilience strategy, with scale-up of Blanket Supplementary Feeding Programme (BSFP) activities taking place since at least 2021.
Source: HMHB Survey 2025