Surprisingly, however, mosque attendance is very low. Mixed with their Islamic practices, there is a strong involvement in occultism and spirit possession. Local Megalasy folk religions have also had a strong influence on the people. The physical needs of the Comorians are numerous. Major problems in Madagascar include poverty, inadequate housing, disease, and poor roads.
Educational levels are low and very few children attend school.
There is a shortage of hospitals and doctors, and many suffer from illnesses and malnutrition. Moral decline has led to a large number of sexually active teenagers, resulting in the transmitting of venereal diseases. Such problems contribute to a high death rate. The spiritual needs of the Comorians are even greater. Though there is freedom of religion in Madagascar, evangelism is not well received by the Shafiite Muslims.