Doctors Bring Affordable Health Care to Madagascar Neighborhood

The Health Center for All is just a starting point, as Dr. Tafangy has other dreams, including starting a health insurance progr
The Health Center for All is just a starting point, as Dr. Landisoa Tafangy has other dreams, including starting a health insurance program.
A.G. Klei, USAID
New clinic offers one-stop shop for wide range of health needs
“Here, the premises are clean and welcoming, and there is always a doctor available to receive you at any time of day.”

January 2017—The crowd had swelled to about 30 people. All of them were young girls and mothers. Some already carried a baby in their arms. They were intently listening to the community health educator explain the different methods of family planning available at the health center.

All of these women were there because they were interested in taking charge of their futures. And they had this opportunity, at a brand new health center, thanks to an exceptional young Malagasy woman.

Dr. Landisoa Tafangy and her husband, Dr. Yoland Rakotondraibe, saw many vulnerable people in the neighborhood of Ankadindravola-Ivato, a suburban area in northern Antananarivo, struggling to access affordable, effective health care. Tafangy knew the region because of her other career—as an air traffic controller at the nearby Ivato International Airport.

Most of the community members earned their living from small-scale farming and fishing. With low incomes, they had difficulty paying for adequate health care to keep them and their children healthy.

The circumstances of the community moved Tafangy and her husband. So two years ago, without any business background or available funding, but driven by a strong will to help, they started the Health Center for All, or Tobim-pahasalamana ho an’ny Rehetra in Malagasy. The name represents their central mission—to provide a clinic that is accessible and affordable for local people. The goal is to improve the health of the community so its members can improve their productivity and living conditions.

The doctors designed the Health Center for All as a one-stop shop providing low-cost general and specialized health care for poor families, including ear, nose and throat treatment; ophthalmology; pediatrics; gynecology; obstetrics; ultrasound scanning; and dentistry. The center offers flexible payment options and free health care to those in dire need. Tafangy calls these “our social medical activities,” which include special days with free screenings, consultations and medication two to three times a year.

Nearly 6,500 people were treated at the center in 2015, and over 6,800 families can now access the facility.

The health center works in partnership with Marie Stopes International for family planning activities under the USAID-funded Support for International Family Planning Organizations program, and is a member of the BlueStar network of private clinics providing family planning methods.

Partly due to her achievement in establishing the health center, Tafangy was selected as one of Madagascar’s 2016 Young African Leaders Initiative Mandela Washington Fellows. She traveled to the United States for a six-week course in business and entrepreneurship, won a business plan competition, and received a grant from the United States African Development Foundation.

The grant is helping to support the health center as well as Tafangy’s new plan—to start a health insurance program that will provide members with free health care and medication in return for quarterly payments of Ar 10,000 Malagaryariary, or $3.

Ranaivo Bakoliharivonjy, 63, and her husband, Germain Rabemanantsoa, 65, are both retired school teachers living on limited incomes. They have been regular users of the Health Center for All for a year and a half and say that the quality of their health care access has improved tremendously since the clinic opened.

“Once I was down with high blood pressure and my husband and I went to see the doctor at her office,” says Bakoliharivonjy about her experience prior to using the clinic. “She was not there and I had to go back home with my sickness, without seeing any doctor.”

“[Here] the premises are clean and welcoming, and there is always a doctor available to receive you at any time of day. During a consultation, the doctor takes all his time to check the patient, and then they provide almost all needed medicines at affordable prices,” added Rabemanantsoa.

After overcoming significant challenges at the beginning, Tafangy now says the health center is thriving, but successfully establishing the health center is just the first of many goals. “I feel proud of myself and my staff for all that we have achieved. But when I consider the extent of the work that lies ahead of us, we still have a very long way to go.”


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