Madagascar's current political instability has severely affected industry and other livelihood sources, including the tourism sector. As a result, losses in income have hit many households. With more than two out of three people living in poverty, and alomst half of those in extreme poverty, the impact of these losses is acute. In urban areas particularly, the ability of families to afford food, clean water and access to basic social services - including health services and medicines - has diminished.
The economic difficulties caused by the crisis have also left the state's health sector infrastructure weakened. As budgets have been cut the national capacity to meet commitments to provide mothers and children with basic health services has been curtailed.
The country’s health service is no longer able to meet basic funding requirements for providing routine vaccinations for children and pregnant mothers. As a result, UNICEF Madagascar is increasing expenditure on vaccines by 50 percent in 2010 in order to provide children with essential vaccinations.
Thousands of people who should have seen improvements in water and sanitation facilities since the beginning of 2009 are not being reached, making UNICEF's work in this area even more urgent to reduce unnecessary childhood deaths caused by waterborne illnesses.