性工作者
Sex worker organisations, such as "Fikambanaina Vehivavy Miavotena Toamasina" (FIVEMITO) and "Femmes Interessee au Development de Antalaha" (FIDA) (which is partially funded by the World Bank), have reached agreements with local governments to issue sex workers over the age of 18 identity cards. These identity cards allow access to free healthcare.