Making the connections, sustaining real change

We recognise the inextricable links between poor health, unmet family planning needs, food insecurity, environmental degradation and vulnerability to climate change.

In response to these interconnected challenges, we have developed a holistic approach integrating reproductive health services with marine conservation and coastal livelihood initiatives.

Our distinctive style of working has emerged through conversations with our partner communities, who have challenged us to appreciate the ways in which human and ecosystem health are intertwined.

Our unconventional journey in conservation began through listening. We learned that people in Velondriake, Madagascar’s first locally managed marine area, thought that fish stocks would collapse without improved access to family planning. We also saw that, as a field-based organisation working in these isolated communities, we were ideally positioned to address this critical unmet need.

We started incorporating reproductive health services into our fisheries management initiatives in 2007. Since then, we have expanded this programme to serve over 25,000 people across more than 60 communities along Madagascar’s west coast. From seaweed aquaculture to maternal and child health, our interdisciplinary teams now work closely together to coordinate their activities and identify opportunities for cost-sharing between all of our programmes.

We engage communities in a variety of environmental and health topics through small group discussions, interactive theatre and school workshops. Exploring the connections between different themes enables us to broaden our reach, for example, getting men talking about family planning and involving women in fisheries management.


Our holistic way of working is often referred to as “Population-Health-Environment” (PHE) because of the way that such an integrated portfolio of programmes reflects the relationships between people, their health and the environment.

The PHE approach empowers people to make their own reproductive health choices, while equipping them with the skills they need to manage their resources sustainably. It has been shown to produce greater impacts than single-sector interventions, and to generate additional benefits such as the increased engagement of women in alternative livelihood activities.

We have presented the results of our holistic model worldwide, including at the Woodrow Wilson Center, the World Conservation Congress and the International Conference on Family Planning. It won the St Andrews Prize for the Environment in 2014, the Excellence in Leadership for Family Planning (EXCELL) Award in 2013, and the Buckminster Fuller Challenge in 2011.

Our impact

Couples are empowered to plan and better provide for their families; improving food security, allowing women to play a more active role in fisheries management, and boosting the sustainability of local conservation efforts. Coastal communities are able to live more healthily and sustainably with their marine environment, building social and ecological resilience to climate change.


people reached by BV’s integrated conservation and community health programmes


unintended pregnancies averted to date

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Supporting partners to work holistically

We developed a PHE programme in the Velondriake area of southwest Madagascar from 2007, and replicated this approach further north along the coast in Belo sur Mer from 2013 and in the Barren Isles from 2015.

Having experienced the immense value of integrating reproductive health services with our marine conservation initiatives, we are now supporting partners in Madagascar, Mozambique and beyond to adopt this approach.

We are advancing the development of a national PHE network in Madagascar, bringing together health and conservation NGOs to facilitate cross-sector partnerships. We are offering technical advice and mentoring to various marine conservation partners starting to implement PHE programmes with health agencies including Marie Stopes Madagascar, proposing learning exchanges and training courses, convening meetings to share experiences, and collating impact data to communicate to a variety of stakeholders.


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