Health emergencies represent major challenges requiring effective and coordinated responses. The World Health Organization (WHO) plays a central role supporting countries to enhance their resilience to public health crises, in accordance with the International Health Regulations. The objective of this work is to identify implemented interventions, challenges encountered, best practices to leverage, and recommendations to strengthen preparedness and responses to future crises. The study is based on a qualitative analysis of evaluation reports from WHO interventions and its partners. Data were organized into thematic categories (coordination, communication, surveillance, case management, logistics) and supplemented by verbatim excerpts from the reports. A comparative approach highlighted commonalities and specificities across the different crises.
Three case studies in different periods were selected: pneumonic plague outbreaks (2017–2018), the COVID-19 pandemic (2020–2021), and nutritional crisis in the Grand South (2023). This study illustrated the effectiveness of management and responses led by the WHO in Madagascar and the necessity to reduce socio-economic burden of health emergencies. WHO has been at the forefront of supporting the government and partners in enhancing health emergency responses in Madagascar. Recommendations from the After-Action Reviews and Intra-Action Reviews provide a foundation to strengthen resilience to future crises, while also helping local health systems respond quickly and effectively and improving coordination between national and international organizations”. Recommendations from the AAR and IAR have laid the baseline for increased resilience to future crises while strengthening local health systems for rapid and effective responses and enhancing coordination between national and international actors.