In direct response to the unmet family planning and health needs of Madagascar’s semi-nomadic Vezo fishing communities, we have developed a community health programme which upholds their reproductive rights to choose freely the number and spacing of their births. This initiative is known locally as Safidy, meaning “the freedom to choose”.
In close collaboration with health partners including USAID Mikolo and Mahefa Miaraka, we train and support local women to offer community-based family planning and other basic health services within the Madagascar Ministry of Public Health’s national health system.
These networks of voluntary community health workers offer counselling and products including condoms, contraceptive pills and injections as well as mosquito nets, water purifying solution and oral rehydration salts. They are also trained in the management of childhood illnesses and the promotion of simple health-enhancing behaviours (exclusive breastfeeding, handwashing with soap, etc).
They are provided with short-acting contraceptives at cost price from Population Services International, which they sell in their villages for a small income. We are currently piloting the use of smart phones to monitor and assure the quality of these services. We also partner with Marie Stopes Madagascar, whose mobile outreach teams visit our remote sites to offer long-acting reversible contraceptives (implants and intra-uterine devices) on a regular basis.
We facilitate a diverse range of peer-led community outreach activities to support critical thinking about health-related behaviours and the sustained adoption of health-enabling social norms. Interactive theatre workshops, storytelling sessions and small group discussions engage men, women and youth in topics ranging from maternal health to seaweed farming and fisheries management.
Our holistic approach fosters broad community participation, for example, opening up discussions about family planning with men by relating food security concerns to reproductive rights.
We enable people to make their own family planning choices, upholding their reproductive rights while equipping them with the skills they need to manage their natural resources sustainably.
Gaining access to family planning services improves maternal and child health outcomes, allows girls to delay their first pregnancy until after they have completed their education, and affords women more opportunities to become economically active.
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 bolstering 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.
This community health programme is a key component of Blue Ventures’ critically acclaimed Population-Health-Environment (PHE) approach, which addresses the interconnected challenges of unmet family planning needs, food insecurity, environmental degradation and vulnerability to climate change in a holistic way.
Having experienced the immense value of integrating community health services with our marine conservation initiatives, we are now supporting partners in Madagascar, Comoros, Mozambique, Tanzania, Kenya, Indonesia and beyond to adopt this approach.
We are advancing the development of a national PHE network in Madagascar, bringing together health and environmental organisations to facilitate cross-sector partnerships. We are offering technical advice and mentoring to various environmental organisations starting to implement collaborative PHE initiatives with health organisations including Marie Stopes Madagascar, proposing learning exchanges and training workshops, convening meetings to share experiences, producing technical resources, and collating both quantitative and qualitative results data to communicate to a variety of stakeholders.
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