Blue Ventures’ community health programme delivers health education and services in order to enable couples to make their own reproductive health choices, as part of our integrated Population-Health-Environment (PHE) approach. Safidy, meaning “freedom to choose” in Malagasy, has been operating in the Velondriake locally managed marine area on Madagascar’s southwest coast since August 2007. This report provides a summary of community health activities carried out during the third year of the programme (2009-2010).