Tsara Tsiky

The first 100% locally produced toothpaste makes Malgasy people smile

Many people suffer of poor oral health and hygiene. Most residents brush their teeth with leaves or with poor quality, affordable toothpaste. This leads to the insurgence of cavities and abscesses, usually by the third decade of life.

To address the challenge, H4O conducted a feasibility study in 2015 which pointed out the opportunity of supplying a toothpaste 100% made in Madagascar. Therefore, H4O has created a social enterprise entirely managed by a team of local women to produce Tsara Tsiky – a medicated toothpaste with fluoride. Tsara Tsiky is the cheapest toothpaste on the Malgasy market. Revenues generated by the sale of the toothpaste cover both the costs of raw materials and salaries for women employed, guaranteeing profit that is entirely reinvested in H4O’s WASH projects.

Ultimately, this project is contributing to increased women’s economic empowerment and financial resilience of H4O.

Tsara Tsiky

The first 100% locally produced toothpaste makes Malgasy people smile


About the Hygiene products laboratory project

Key info

  • Project location: Nosy Be
  • Sector of intervention: Women’s entrepreneurship
  • Dates: 2016 – ongoing
  • Target: toothpaste consumers and Tsara Tsiky employees
  • Skills development: supply chain management

For who


The project has active beneficiaries, who are mainly the female workers employed at Tsara Tsiky, and a wider pool of beneficiaries, namely, those who purchase the toothpaste. More specifically, the main active beneficiaries are:

  • 6 female workers employed at Tsara Tsiky



  • 6 local women trained and empowered
  • More than 25,000 units of toothpaste sold in in 2016-2019
  • 1 production lab fully powered by a photovoltaic stand-alone kit
  • Scalability of H4O’s interventions thanks to the reinvestment of profit of Tsara Tsiky into cross-cutting interventions of the Organization

How the project impact in our Area

The aim of the project is to provide all Nosy Komba families with a private bathroom in order to:

Health improvements

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  • Reduce the number of oral cavities and gastrointestinal diseases
  • Ensure that at least 70% of the raw materials for the toothpaste are sourced locally

Women's empowerment

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  • Provide a stable source of income and economic independence
  • Create new job positions for women in the community

Skills development

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  • Provide skills training, competences and tools to a local team that produces, packages and sells the products of Tsara Tsikyì
  • Train young female students through apprenticeship programmes offered at Tsara Tsiky

Financial sustainability

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  • Set up a local and sustainable social enterprise that provides xxx for all the communities where the project is implemented
  • Switch to a quality product, locally made, at a competitive price
  • Establish a local sustainable business
  • Facilitate expansion of the business

Description of the project

Why? For whom and through which interventions?

About the context

In Madagascar, most rural population lacks access to clean water (63.77%) improved sanitation facilities (83.39%) and access to products for appropriate personal hygiene (49.46%).
The inability to access quality personal hygiene products leads most Malgasy residents to brush their teeth with leaves or to purchase the most affordable and often low-quality toothpaste. This leads to the insurgence of different mouth-related diseases.

How our research and evidence-based approach shapes our interventions

To shape our interventions, the project takes stock of the results of a feasibility study conducted by A.P.P.A. (Aid Progress Pharmacist Agreement ONLUS), within the Faculty of Pharmacy of the University of Turin and H4O in 2015 has shed light on the lower quality of the toothpastes purchased by the wider share of the local population and to initiate the production of a medicated toothpaste with fluoride that could be produced and sold locally.

Core activities

  • Training of local women in the scientific basis of communicable diseasesby an Italian pharmacist
  • Training of women employed about the whole supply chain as well as management of Tsara Tsiky social enterprise
  • Purchasing of raw materials and production, distribution and sale of toothpaste in nearby islands
  • Involvement of Tsara Tsiky’s employees in Hygiene Promotion campaigns in schools and for school age children’s mothers with toothpaste donation (see Hygiene Promotion interventions)
  • Training of young female students through apprenticeship programmes offered at Tsara Tsiky

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