Medical centers, dispensaries and hospitals are found throughout the island, although they are concentrated in urban areas and particularly in Antananarivo. Access to medical care remains beyond the reach of many Malagasy, especially in the rural areas, and many recourse to traditional healers. In addition to the high expense of medical care relative to the average Malagasy income, the prevalence of trained medical professionals remains extremely low. In 2010, Madagascar had an average of three hospital beds per 10,000 people and a total of 3,150 doctors, 5,661 nurses, 385 community health workers, 175 pharmacists, and 57 dentists for a population of 22 million. Fifteen percent of government spending in 2008 was directed toward the health sector. Approximately 70 percent of spending on health was contributed by the government, while 30 percent originated with international donors and other private sources. The government provides at least one basic health center per commune. Private health centers are concentrated within urban areas and particularly those of the central highlands.