The SHOPS Plus project conducted a market shaping assessment of pregnancy tests in the Antanavario region in Madagascar. The assessment shows that pregnancy tests are widely available in the private sector, but only available in the public sector through donor-supported community health agents. The majority of providers interviewed said that they never experienced stockouts.
When pregnancy cannot be ruled out using the World Health Organization (WHO) pregnancy checklist, potential family planning clients are asked to return later or are sent to a private pharmacy to purchase pregnancy tests. Redirecting family planning clients to the private sector to purchase a pregnancy test can result in a delay in starting contraception, unforeseen cost to the public clinic client, and ultimately the possibility of client drop-off.
There are opportunities to increase the availability of pregnancy tests in Madagascar. The Ministry of Public Health (MOPH) can emphasize the reliability of the WHO checklist in conjunction with pregnancy tests and revise guidelines accordingly. Training could reinforce this practice in the public sector. In the private sector, franchises can reinforce this through either guideline revisions, refresher trainings, or both.