Famadihana coexists, sometimes uneasily, with Christianity across the highland communities that keep it, since a large majority of Madagascar's population identifies as Christian following centuries of missionary activity, and church positions on the custom have ranged from outright discouragement to accommodation that treats famadihana as compatible cultural practice alongside Christian belief, a live and ongoing negotiation rather than a settled doctrine on either side. Economic pressure has also reshaped the custom in recent decades: the ceremony is expensive, requiring new shrouds, feasting for often hundreds of guests, and sometimes tomb repair or construction, costs that have led some families to hold famadihana less frequently than earlier generations did, and public health authorities have at times discouraged the practice during disease outbreaks, since handling of remains carries genuine infection risk that Malagasy health officials and, at points, the practice's own defenders have had to weigh against its social and religious importance.
Anthropologists who have studied famadihana closely, notably Maurice Bloch's influential fieldwork among the Merina, read the custom as expressing a distinctive Malagasy relationship to time, ancestry and land, in which the durable, unchanging tomb and its ancestors ground the identity of an otherwise mobile and changing family across generations, a reading that treats the practice as a serious subject of religious and social anthropology rather than as spectacle.