Santé (Montrouge, France)
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Malaria remains one of the major public health problems in Madagascar. For malaria, most of the eco-epidemiological facies of the African continent are found on this large island because of its geo-climatic diversity. These include the subequatorial facies on the east coast, the tropical facies on the west coast, the high-altitude tropical facies in the center and the subdesert facies in the south. ⋯ The current reorganization of the health service in Madagascar constitutes a favorable opportunity to establish a new approach for the fight against malaria. This is geared towards the participation of the decentralized health structures and the contribution of the community in the conception and the achievement of their respective strategies for the fight, supported by the central Service of the Fight Against Malaria. This new decentralized approach seems more appropriate to respond to the demands of the specific and selective strategies of the fight, better adapted to the different facies described above, and to render the National Program of the Fight Against Malaria more efficacious.