Madagascar

Madagascar, formerly known as the Malagasy Republic, is the fourth largest island in the world. It was a French colony until it gained independence in 1960, and has remained desperately poor. With a population of 20 million (2008 estimate), it has a birth rate of 41.4 per 1,000 and an infant mortality rate of 75.2 per 1,000 live births. The maternal mortality rate is 550 deaths per 100,000 live births.

Abortion is available in Madagascar only to save the woman's life, but illegal and self-induced abortions are believed to be widespread, and hospitals treat many women suffering from incomplete abortion. In 2001, 27.1 percent of women aged 15–49 reporting using contraceptives, including 18.3 percent using modern methods. The legal age of consent to marriage was raised to 18 for both men and women in 2007; at that time, 39 percent of children younger than 18 were already married (42 percent in rural areas, 29 percent in urban areas). Most people (52 percent) in Madagascar follow traditional indigenous religious practices; second most common is Christian (41 percent) followed by Muslim (7 percent).

Total fertility is high at 5.7 (although down from 6.2 in 1993), and only 46 percent of births are attended by skilled personnel. The maternal mortality ratio in 2000 was 550 per 100,000 live births and the neonatal mortality rate was 33 per 1,000 live births.

Traditionally, women in Madagascar held a higher role in society than in mainland Africa; Many tribal chiefs were also women; from 1828 until 1896, Madagascar was ruled continuously by four queens. In recent times, many prominent politicians have also been women, including Gisèle Rabesahala, the leading Marxist in the country. Society, however, especially in villages, remains patriarchal, in spite of the fact that women have had legal equality in property ownership and marriage since the 1890s. Of note is that women make up 45 percent of the workforce, and 18 percent of households in Madagascar are headed by women. In the northwest of the island, more traditional practices exist compared with the rest of the country.

Under colonial rule, the medical services in Antananarivo, the capital, and the major towns were traditionally reserved for foreigners and the local elite. However, after independence, there was a significant increase in health services in rural areas with the provision of clinics and midwives. This has coincided with a rise in the number of associations designed to advance women and women's rights. However, 55 percent of the population still do not have access to clean drinking water, and two-thirds of the population cannot access sanitary facilities. In addition, approximately two-thirds of the population are believed to be malnourished, due to recent crop failures, as soil erosion has limited the country's agricultural land use to only 5 percent. To financially assist their families, approximately 20 percent of children work in industries including [Page 675]mining. These reasons, and the prevalence of many diseases, has meant that approximately 160 children in Madagascar die every day from preventable causes, according to figures published by the United Nations Children's Fund (UNICEF).

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