The Sustaining Health Outcomes through the Private Sector (SHOPS) Plus project in Madagascar supported the goals of the United States Agency for International Development (USAID) and the government of Madagascar in the areas of family planning, reproductive health, and malaria. The strategic objective of SHOPS Plus Madagascar were to increase access to and use of priority health products through strategic expansion of private sector approaches in the health system. Banyan Global led the access to finance component, working to stimulate health and water, sanitation, and hygiene (WASH) sector lending and strengthen the business and financial skills of private health providers and WASH enterprises. The project supported AccèsBanque Madagascar and Baobab Banque Madagascar in the use of their USAID/Development Finance Corporation guarantees. The guarantees served to stimulate commercial investment in private health care to improve access to and quality of services. Banyan Global worked directly with the banks, providing support in developing loan products tailored to private health and WASH businesses, building relationships with stakeholders such as equipment suppliers, and generating leads on new potential bank clients. Banyan Global also worked with private health networks in Madagascar to strengthen their members’ business management capacity through training and individual consultations.