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It is important to know that the road infrastructure in Madagascar has been improved since the last past 18 months. You can travel on paved road quite easily from Antananarivo to Tuléar via Ranomafana using normal vehicle. Many other roads have been repaired. During the dry season you can make Antananarivo - Diego in one day when it took 3 days in the past.
Madagascar is probably one of the least well develloped countries on the planet when it comes to road infrastucture. so if you have less than 2 or 3 weeks on this vast island, you might consider hiring your own wheels. Highways do no exist and distances are not measured in kilometers but in duration. On paved road, an average speed of 50km/h is considered very high given the road conditions.
Your first option is to rent a car. If you stick to the "route nationale 7" (Tana-Toliara), you will be fine with a small car or vehicule which does not have off road capabilities. If you plan to venture out of the paved roads and see more out off the beaten track sites, you would need a 4x4. Given the poor state of the roads and the bewildering driving habits of other road user, it's quite unwise to venture out on your own. It's almost impossible to hire a car without a driver but if you are able to do so, you would have to pay a large refundable deposit as a guarantee to rental companies.
Renting a car with a driver is very cheap compared to what you would pay in a developped country and and it is very advisable: The driver can function as your local guide. This is where a driver-guide differs from a simple driver ( who doesn't necessarly speak french or english nor provide you explanation about sights, ect...) .
For the more adventurous there is also a very interesting second option: renting a motorcycle. it's cheaper, and you're much more mobile : you'll be able to go where cars can't. but of course for such a solution, you need to have at least a basic knowledge of maintenance and reparations.
Of course you can skip the luxury of having your own wheels and move about the malagasy way. you'll need time on your hands, but
taxibrousses and small cargo boats can bring you (almost) anywhere. it's much cheaper of course and you'll come closer to seeing the country from a locals' perspective. for practical information on this, there are - as usual - only 2 sources : other travellers you meet and the lonely planet guidebook.
But even if you've rented your own vehicule, there's one place where you should realy stop and get out of it. in Fianarantsoa rails seek their way trough verdant rainforest and rice paddies to Manakara. here the 3rd steepest railway line in the world slowly descents from the highlands to the east coast. it's a trip high on "couleur local", since it's the lifeline for locals bringing their produce to the market. You should note that the old train is not reliable and scheduled departure may not happen at all so you need to plan for a back up plan.