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However, these measures and support systems tend to break down with the process of modernization, population growth, urbanization, and migration and the opening of new markets. Transitional Authority HAT to mitigate the impact of the political crisis on the urban poor, who were acutely affected. Drugs are not covered, but Inter Aide has negotiated price reductions with local pharmacies. Since , they have consisted almost exclusively of payments to public pension schemes while all other social protection expenditures, including those in the areas of health and education, have been dramatically cut.
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Madagascar remains a highly centralized state where communes have very limited resources and the few public services provided at the local level are carried out by the devolved offices of the line ministries. Bachelard, Jerome; Marcus, Richard
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- Nutrition-related transfers in kind.
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