In direct response to the unmet family planning needs of Madagascar’s semi-nomadic Vezo fishing communities, we have developed a community health programme which upholds their reproductive rights to freely choose the number and spacing of their births. This initiative is known locally as Safidy, meaning “the freedom to choose”.
We started providing health services by running outreach clinics in remote villages, and these still continue in a few areas. We also train and support local women to offer community-based family planning services. We provide them with 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.
Our network of community-based distributors offers counselling and products including condoms, hormonal pills and injections as well as mosquito nets, water purifying solution, oral rehydration salts and antenatal medication. We also collaborate with Marie Stopes Madagascar to offer long-acting reversible contraceptives (hormonal implants and intra-uterine devices) on a regular basis.
We facilitate a diverse range of peer-led behaviour change communication activities to enable the sustained adoption of healthier practices by all community members. Radio shows, interactive theatre and small group discussions engage men, women and youth in topics ranging from sexual health to fisheries management.
Our integrated approach fosters broad community participation, for example, opening up discussions about family planning with men by relating food security concerns to reproductive health.
We enable people to make their own reproductive health choices, while equipping them with the skills they need to manage their 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, and boosting 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 reproductive health services with marine conservation initiatives, we are now assisting other organisations to adopt this approach. We are supporting the development of a national PHE network in Madagascar in collaboration with Voahary Salama, bringing together health and conservation NGOs, donors and policy makers to facilitate cross-sector partnerships.
We are offering technical advice and mentoring to conservation organisations starting to implement PHE with health partners such as 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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Our holistic approach to marine conservation is featured in the article "How to save oceans with contraceptives - a radical approach" by Astrid Zweynert of the Thomson Reuters Foundation.
Antananarivo, Madagascar – Health and conservation sectors unite to establish a broad network of policy makers, funders and practitioners committed to reinforcing an integrated approach to sustainable development in Madagascar
St Andrews, Scotland - An innovative project integrating community-based health services with locally-led marine conservation initiatives has won this year’s St Andrews Prize for the Environment
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