Madagascar’s economic growth has beenslow at 1 percent annually in the last five years and farinferior to sub-Saharan region’s average. Income per capitain 2014 fell to around USD 400 (2005 constant USD), losingabout 20 percent from 1970 when per capita income reachedthe highest point since independence. The economic andsocial effects of the 2009 political crisis were intensifiedby the suspension of many donor activities which, in acountry where international aid represented 40 percent ofthe government budget, led to significant cuts ininvestments and a sharp decline in the delivery of services.Macroeconomic stability was maintained during the crisis, asboth fiscal and monetary authorities maintained prudentpolicies. A low public debt to GDP ratio (37.3 percent in2014) and a low tax revenue (9.7 percent of GDP in 2014)contributed to hindering public investments necessary fordevelopment and adequate provision of public services. In acontext of high poverty rates, low overall public resourcesto finance public services delivery, and continuousfragility, economic and political instability, how canpublic spending promote better outcomes in education andhealth? How can the Government of Madagascar and itspartners support better access to improved quality ofservices, in particular for the most vulnerable? The Reviewof Public Spending in Social Sectors in Madagascarsystematically analyses how education, health and nutritionhave been financed over the past five years. It examines theamounts, distribution and impact of public spending, andformulates recommendations on how best to allocate futurepublic spending with a focus on incremental resources.
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