The freedom to choose: integrating communitybased reproductive health services with locally led marine conservation initiatives in southwest Madagascar

Abstract

Madagascar's diverse marine ecosystems serve as critical biodiversity habitats and are also essential to the livelihoods, food security and culture of coastal people, including semi-nomadic Vezo fishers based along the southwest coast. Commercialisation of their traditional fisheries, rapid coastal population growth related to unmet family planning needs, and lack of alternatives to fishing in this arid region are resulting in the unsustainable exploitation of coastal resources. In response to these challenges, marine conservation organisation Blue Ventures has developed an approach to community-based conservation and development that reflects the inextricable links between humans, their health and the environment. We describe how this model has evolved in the Velondriake locally managed marine area, home to approximately 1 0,000 people, over the last decade through strong cross-sector partnerships. It has entailed the integration of community-based reproductive health services with locally led marine conservation initiatives including temporary octopus fishery closures, permanent marine reserves and alternative coastal livelihood activities such as aquaculture. All of these programmes are underpinned by community education that engages men, women, youth and children in both health and conservation topics. The provision of voluntary family planning services in the Velondriake area is estimated to have averted more than 800 unintended pregnancies since 2007, and the temporary octopus fishery closure model has been implemented over 1 50 times along the southwest coast since 2004. Preliminary, anecdotal reports from community members and programme staff indicate that this integrated Population-Health-Environment approach enables couples to plan and better provide for their families, empowers women, improves food security and directly supports the sustainability of local conservation efforts. It is proving to be an easily replicable model for addressing community health needs and advancing biodiversity conservation efforts in some of Madagascar's most remote and under-served areas. RÉSUMÉNon seulement les écosystèmes marins de Madagascar abritentils une biodiversité exceptionnelle mais ils sont également intrinsèquement liés au mode de vie et à la sécurité alimentaire des populations côtières, notamment des pêcheurs seminomades qui vivent le long de la côte sud-ouest. La commercialisation des produits de la pêche traditionnelle, la croissance rapide de la population qui est en partie liée à des défauts en matière de planification familiale et l'absence d'alternatives à la pêche dans cette région aride se traduisent par une exploitation non durable des ressources côtières. Pour trouver une solution à cette situation, l'organisation de conservation marine Blue Ventures a élaboré une approche holistique qui considère les liens obligés entre les Hommes, leur santé et l'environnement. L'évolution du modèle élaboré pour l'aire marine de Velondriake est décrite ici ; elle concerne environ 1 0 000 personnes au cours...

Integrating Community‐Based Family Planning Services with Local Marine Conservation Initiatives in Southwest Madagascar: Changes in Contraceptive Use and Fertility

“…Blue Ventures has supported the provision of voluntary family planning services to communities in and around the Velondriake locally managed marine area since 2007, through outreach clinics and a network of 30 local women trained as community‐based distributors of contraceptives .…”

“…The Velondriake locally managed marine area is located in the Morombe district of the Atsimo‐Andrefana region in southwest Madagascar. Velondriake covers more than 750 km 2 and has a population of approximately 10,000 people living in 25 villages .…”

“…Blue Ventures links health promotion and family planning information with environmental topics, facilitated through peer‐led community outreach and behavior change communication activities such as cultural and sporting events, interactive village presentations, radio shows, women's group meetings, and young people's clubs . These initiatives engage men, women, and youth in health and environmental discussions, particularly by linking concerns related to food security and fish stocks to reproductive rights and family planning.…”

“…Fertility rates are relatively high, with women in Atsimo‐Andrefana giving birth to an average of 6.2 children compared to the national average of 4.8 . Combined with significant levels of migration from arid inland zones, this level of fertility results in the coastal population doubling every 10 to 15 years, placing increasing pressure on the region's marine ecosystems and the traditional fishing livelihoods that they support .…”

“…As a holistic response to the interconnected challenges of unmet reproductive health needs and environmental degradation in this region, Blue Ventures has developed a program combining the provision of voluntary family planning services with local marine resource management initiatives . This program upholds the reproductive rights of all individuals to choose freely the number and spacing of their births, while also upholding the management rights of coastal communities with regard to their marine resources.…”