Africa > Madagascar > Health

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Access to sanitation	37%		[112nd of 129]
Birth rate, crude > per 1,000 people	37.99 per 1,000 people		[28th of 195]
DEFINITION: Crude birth rate indicates the number of live births occurring during the year, per 1,000 population estimated at midyear. Subtracting the crude death rate from the crude birth rate provides the rate of natural increase, which is equal to the population growth rate in the absence of migration.		View time series
SOURCE: CIA World Factbook, December 2003
Children Underweight Rate	11%		[13th of 95]
DEFINITION: Children under 5 severely underweight, according to UNICEF estimates.
SOURCE: World Development Indicators database
Contraception	19%		[75th of 89]
DEFINITION: % contraceptive prevalence 1995 - 2000. Data refer to married women aged 15-49, but the actual age range covered may vary across countries.
SOURCE: UNICEF
Dependency ratio per 100	91		[16th of 166]
DEFINITION: Dependency ratio (per 100), 2003
SOURCE: UN (United Nations). 2002. United Nations Population Division Database on Contraceptive Use. Department of Economic and Social Affairs, Population Division. January. New York
Drug access	50%		[121st of 163]
DEFINITION: Population with access to essential drugs 2000. The data on access to essential drugs are based on statistical estimates received from World Health Organization (WHO) country and regional offices and regional advisers and through the World Drug Situation Survey carried out in 1998-99. These estimates represent the best information available to the WHO Department of Essential Drugs and Medicines Policy to date and are currently being validated by WHO member states. The department assigns the estimates to four groupings: very low access (0-49%), low access (50-79%), medium access (80-94%) and good access (95-100%). These groupings, used here in presenting the data, are often employed by the WHO in interpreting the data, as the actual estimates may suggest a higher level of accuracy than the data afford. b.
SOURCE: World Health Organization
expenditure per capita > current US$	7.3 $		[180th of 186]
DEFINITION: Total health expenditure is the sum of public and private health expenditures as a ratio of total population. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation. Data are in current U.S. dollars.		View time series
SOURCE: WHO (World Health Organization). 2001. Correspondence on access to essential drugs. Department of Essential Drugs and Medecines Policy. February. Geneva
Fertility rate, total > births per woman	5.04 births per woman		[28th of 194]
DEFINITION: Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current age-specific fertility rates.		View time series
SOURCE: World Development Indicators database
Hospital beds > per 1,000 people	0.42 per 1,000 people		[54th of 149]
DEFINITION: Hospital beds include inpatient beds available in public, private, general, and specialized hospitals and rehabilitation centers. In most cases beds for both acute and chronic care are included.		View time series
SOURCE: World Development Indicators database
Infant mortality rate	78.52		[25th of 179]
DEFINITION: The number of deaths of infants under one year old in a given year per 1,000 live births in the same year. This rate is often used as an indicator of the level of health in a country
SOURCE: World Development Indicators database
Life expectancy at birth, total > years	55.82 years		[143rd of 194]
DEFINITION: Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.		View time series
SOURCE: CIA World Factbook, 28 July 2005
Major infectious diseases > Food or waterborne diseases bacterial and protozoal diarrhea, hepatitis A, and typhoid fever
DEFINITION: This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population. The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines. Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note - The sequence of exposure categories listed in individual country entries may vary according to local conditions. food or waterborne diseases acquired through eating or drinking on the local economy: Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6-9 months; vaccine available. Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine. Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%. vectorborne diseases acquired through the bite of an infected arthropod: Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 1.5-2.5 million estimated annual deaths occurring in sub-Saharan Africa. Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases. Yellow fever - mosquito-borne viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%. Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%. African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites. Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection. Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%. Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%. Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases. Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3-7 days, some cases result in persistent arthritis. water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers: Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months. Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite. aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine: Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks. respiratory disease acquired through close contact with an infectious person: Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5-15% of cases, typically within 24-48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia. animal contact disease acquired through direct contact with local animals: Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.		View time series
SOURCE: World Development Indicators database
Maternal mortality	490 per 100,000		[26th of 136]
DEFINITION: Maternal mortality reported per 100,000 births 1985-1999. The maternal mortality data are those reported by national authorities. UNICEF and the World Health Organization periodically evaluate these data and make adjustments to account for the well-documented problems of under-reporting and misclassification of maternal deaths and to develop estimates for countries with no data (for details on the most recent estimates see Hill, AbouZahr and Wardlaw 2001). Data refer to the most recent year available during the period specified.
SOURCE: All CIA World Factbooks 18 December 2003 to 18 December 2008
Physicians > per 1,000 people	0.29 per 1,000 people		[31st of 148]
DEFINITION: Physicians are defined as graduates of any facility or school of medicine who are working in the country in any medical field (practice, teaching, research).		View time series
SOURCE: UNICEF (United Nations Children?s Fund). 2002. Official Summary: The State of the World's Children 2002. New York: Oxford University Press.
Probability of not reaching 40	31.6%		[36th of 111]
DEFINITION: Probability at birth of not reaching the age of 40.
SOURCE: World Development Indicators database
Probability of reaching 65 > Male	43.8%		[123rd of 159]
DEFINITION: Probability at birth of reaching the age of 65.
SOURCE: UN 2001 via backone.pdf
Spending > Per person	5		[132nd of 133]
DEFINITION: Spending per capita (PPP) in $US 1998.
SOURCE: UN (United Nations). 2001. World Population Prospects 1950-2050: The 2000 Revision. Database. Department of Economic and Social Affairs, Population Division. New York
Tobacco > Cigarette consumption	315		[86th of 106]
DEFINITION: Approximate average number of cigarettes smoked per adult per year
SOURCE: World Bank. 2002. World Development Indicators 2002. CD-ROM. Washington, DC
Total expenditure on health as % of GDP	2.1%		[184th of 185]
DEFINITION: Total expenditure on health as % of GDP, 2002
SOURCE: World Health Organization
Water availability	21,102 cubic meters		[43rd of 169]
DEFINITION: Water resources: total renewable per capita (m3/capita year)
SOURCE: World Health Organization

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