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