Madagascar, an island off the eastern coast of Africa, has a population of 27.7 million people, 70.7% live below the poverty line. The vast majority have little to no access to health care. Eye disease is one of the 10 most prevalent medical conditions in the country and an estimated 60,000 people are blind and 379,490 people live with moderate and severe visual impairment.

Seva and the Kilimanjaro Centre for Community Ophthalmology (KCCO) have been working with local Malagasy partners since 2009. Together, we are developing comprehensive eye care programs within this island nation off the southeast coast of Africa.

Seva supports direct eye care service delivery, training, equipment and supplies through programming at four hospitals: Ambohibao (near the capital city of Antananarivo), Tomatave/ Toamasina (on the central east coast), Antsirabe (in the central highlands) and Sambava (in the northeast). Seva funds are also targeted to support community outreach activities to rural and remote populations, so that people most in need of eye care have access to treatment.

The Malagasy ophthalmologists at each of the four hospitals we work with have provided exceptional leadership. This has resulted in effective government partnerships, strong teamwork, supportive management, and engagement with the community.

Seva also supports a nationwide pediatric program in Madagascar by funding clinical services, supplies and transportation, as well as training a network of community workers, called Key Informants, to find and refer children who need eye care.

To assist with the financial sustainability of the Malagasy programs, Seva Canada funded a cost revenue assessment by the Madagascar programs. The purpose of this assessment was for the hospitals to determine where costs could be reduced, without compromising care, and where revenues could be increased while still ensuring free or subsidized services for those too poor to pay. Following the assessment, Seva Canada provided training in both cost recovery and revenue generating strategies.

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