This Selected Issues paper takes stock of developments in education, health, and social assistance and offers policy options in the Republic of Madagascar. The quality of education in Madagascar is falling with low school completion rates, a high share of untrained teachers, and declining test scores. Finding fiscal space to allocate more public resources to the education, health, and social protection sectors should be a key government priority. The resources currently budgeted for these sectors remain much lower than in other Sub-Saharan African countries and insufficient to improve development outcomes. Madagascar made some progress in improving access to primary education and basic health services, but the quality of the education system has deteriorated, significant human resource gaps remain in the health sector, and the poverty rate has increased. The paper recommends that in the area of social protection, identify clear and predictable funding sources with a view to gradually scale up existing social programs, while developing a national social registry to harmonize the social response among different interventions and actors and set a strong basis to gradually increase social assistance coverage of the vulnerable population.