One factor that has helped to mitigate the human impact of the squeeze on the state finances has been donors' willingness to adjust their strategy to provide extra support for key social sectors. Aid to Madagascar has been falling, owing to the near total freeze on general budgetary support.

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Aid to social sectors has, however, actually increased substantially, reaching US$256m in 2010, compared with just US$180m in 2008, according to World Bank figures (which exclude aid from China, India and Arab states, for which comprehensive data are not available). Aid for health has risen by 75% over the past two years, while funding for social protection is up by 42%. The extra social spending comes despite a drop of about US$200m per year in total donor support, compared with pre-crisis levels. As is normally the case in countries whose governments are not recognised as legitimate by donors, aid is mainly channelled through non-governmental organisations, rather than central government structures. Last year less than 10% of aid for social sectors was delivered through the central government ministries of health and education.