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”.
We train and support local women to offer community-based family planning and other health services, integrated closely with Madagascar’s Ministry of Health system as much as possible. 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 health agents offers counselling and products including condoms, contraceptive pills and hormonal injections as well as mosquito nets, water purifying solution and oral rehydration salts. They are also trained in the management of childhood illnesses. We 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 holistic 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, 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.
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 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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