The growth is due in part to an indigenous revival movement, known as Fifohazana, that has worked through the church since the early twentieth century.

SALFA, as it is known, is a community-based primary health project with special initiatives that cover child survival, family planning, and HIV/AIDS prevention.

[3] Fifohazana is a revival movement, focused on the Word of God,[4] that has been incorporated into the Malagasy Lutheran Church.

[4] Throughout Madagascar, the movement has established compounds, called toby, where church activities, exorcism, counseling, and medical care are carried out.

[8] The church was admitted at the International Lutheran Council as a full member at their World Conference, held in Antwerp, Belgium, on 25–26 September 2018.