Madagascar’s education system exhibits severe weaknesses that leave a large number of children without the basic skills required to function in the labor market. Since the start of the political and economic crisis in 2009, progress made on key health indicators has stagnated or is being reversed with Madagascar falling off track to achieve the MDGs. The prevalence of chronic malnutrition among children under five is one of the highest in the world. Maternal mortality ratios also have remained relatively high and stagnant over the last ten years and the country.