A young Malagasy woman brings health care to a poor community

The crowd had swelled to about thirty 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. Dr. 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 Dr. Tafangy and her husband.  So two years ago, without any business background or available funding, but driven by a strong will to help, they decided to start the health center, naming it “Tobim-pahasalamana ho an’ny Rehetra”, or “Health Center for All” in Malagasy. The name represented their central mission – to provide a clinic that is accessible and affordable for local people. The goal was to improve the health of the local community so that its members could increase their productivity and improve their living conditions.

Dr. Tafangy and her husband started the Health Center for All after seeing many vulnerable people in their neighborhood struggling to access affordable, effective health care

USAID / A.G. Klei

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

The health center works in partnership with Marie Stopes International for family planning activities under the USAID-funded SIFPO (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, Dr. Tafangy was selected as one of Madagascar’s 2016 Young African Leaders Initiative (YALI) Mandela Washington Fellows, traveling to the United States for a 6-week course in Business and Entrepreneurship. As usual, Dr. Tafangy excelled. She won the YALI Business & Entrepreneurship business plan competition and received a grant from the United States African Development Foundation. The grant is helping to support the health center and also Dr. 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 Malagary ariary, or $3 USD.

The Health Center for All is just a starting point, as Dr. Tafangy has other dreams, including starting a health insurance program

USAID / A.G. Klei

63-year-old Ms. Ranaivo Bakoliharivonjy and her husband, 65-year-old Mr. Germain Rabemanantsoa are both retired school teachers living on limited incomes. They have been regular users of the Health Center for All for the last 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 Ms. Bakoliharivonjy. “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 Mr. Rabemanantsoa.

After overcoming significant challenges at the beginning, Dr. 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.”