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SHOPS Plus Supports Access to Women’s Surgical Care for Low- and Middle-Income Households in Madagascar

Dr. Edith Masinjanahary is a gynecologist with a private health practice that offers general consultations, prenatal consultations, ultrasounds, and family planning services in Madagascar. In October 2018, she attended a United States Agency for International Development (USAID)-funded Sustaining Health Outcomes through the Private Sector (SHOPS) Plus business and financial management training implemented by Banyan Global team members, which inspired her to open a clinic specialized in women’s health care.

“The SHOPS Plus training was the spark for me to expand my activities. The module on setting goals [Setting and Planning your Objectives] really helped me to start a surgical service for middle- and low-income households. I followed step by step the different phases you taught during the training. The health center has now become a well-known clinic. We invite you to come and see the result here in Toamasina!” Dr. Masinjanahary said proudly over the phone.

Dr. Edith Masinjanahary (second from right) and her team at Hugney Clinic in Toamasina, Madagascar.

Operational since March 2019, Dr. Masinjanahary’s self-financed Hugney Clinic specializes in women’s health services requiring surgical intervention such as caesarian deliveries, ovarian cysts, and uterine fibroids. In a typical month, the clinic employs 11 people and serves 150 patients; from March 2019 to September 2020, the surgical service treated 213 cases. Most of the clinic’s patients are from low- and middle-income households, and the service fees are 40 to 50 percent lower than standard prices in Toamasina. During the pandemic, SHOPS Plus contacted Dr. Masinjanahary to discuss risk mitigation strategies. Although the COVID-19 pandemic impacted general consultation services, the family planning and surgical services have provided sufficient income to allow Dr. Masinjanahary to keep her staff employed.

“We collaborate with midwives in rural areas surrounding Toamisina who refer emergency cases, especially caesarians, to us. What matters for us is the life of the baby and the mother, so we provide health care regardless of any payment guarantee as we know that families from rural areas are poor and not prepared for such emergencies. We let them set up the payment terms that they can afford when the patient is out of danger. We are happy to say that so far we have always been paid less than 30 days after the patient returns home,” Dr. Masinjanahary explained. Feeling confident in the future of Hugney Clinic, and with the support of her team, Dr. Masinjanahary is considering launching a new laboratory service as part of her recovery plan following the COVID-19 crisis.