Traffic in Antananarivo, many visitors’ and residents foremost experience with road transit, is abominable and worsens each year, with too many vehicles, mostly in very bad repair and condition, and simple transits of 5-20km taking 1-2 hours in all daylight hours.
Rains worsen the plight of the capitals and cities’ roads in the rainy season, and potholes and lack of any traffic law and order, with deluges of motorcycles make Tana a gridlock in perpetuity. If you can stay within walking distance of points of interest, such as the Avenue de L’Independence, you will have a superior stay and less stress. At night, always take a taxi for safety and because after dark it is much faster and traffic is eased or gone.
The National Route 7 south, and most of the road north, west, and all the way east to Tamatave has good pavement, with the northeast and southeast still stuck with horrid roads, and the west coast, east cost, and the northern connector from Vohemar to Ambilobe being rough and unpaved dirt that can pound your car for days for little distance as well.
4×4’s can survive all routes in Madagascar, while sedans may have trouble as soon as they leave the main axis NSEW. The tradeoff for better pavement is much higher accident rates, with drivers flying fast around corners and down smooth tarmac. The road to Tamatave from Tananarive has daily wrecks for example, while the northern rural roads out of SAVA don’t allow you to drive fast enough to have even an intentional fatal collision if you tried.
Car rental and car and driver hire is possible in almost any city of the country, and self-drive is possible with an international drivers license or American or European license. Note that accidents with a foreigner behind the wheel will always be blamed on the foreigner, and quietly all embassies advise to avoid such situations or immediately leave, as mobs gather fast and it can be highly dangerous and even deadly for foreigners to stay in such scenes.
Overlanding Madagascar is a fantastic adventure, and most of the treasures of the island live far outside the capital and into the interior.