Blue Ventures’ Integrated PHE Initiative in Madagascar

Beat on the Ground // Guest Contributor

Blue Ventures’ Integrated PHE Initiative in Madagascar

November 8, 2010 By Matthew Erdman

In the small coastal village of Andavadoaka, Madagascar, the village elders offer a bottle of rum and two cigarettes to their ancestors before the men and their sons launch their wooden dugout canoes into the sea. Leaning over the side, their masked faces scour the water for their prey.

Meanwhile, the women – with babies on back and spears in hand – set out on foot into the shallow waters. One probes a small hole with her spear, and a tentacle reaches out to grapple with it. After careful coaxing, she pulls out an octopus, kills it, and adds it to her collection, which she tows on a string behind her.

In total, more than 1,850 pounds of octopus are collected on the opening day of the octopus harvest, a seasonal occurrence in Velondriake, the Indian Ocean’s first locally managed marine area.

Velondriake, which means “to live with the sea,” stretches along more than 40 km of southwestern Madagascar’s coast. The region encompasses 25 villages and is home to more than 8,000 people of the Vezo ethnic group, who are almost entirely dependent on marine resources, such as octopus, fish, and mangrove forests, for subsistence and income. But these resources are quickly disappearing due in large part to over-harvesting.

Blue Ventures Conservation – the London-based NGO I work for – has been working in the area since 2003 to protect the region’s coral reefs and mangroves, as well as their biological diversity, sustainability, and productivity, while also improving the quality of life of the local community.

To this end, Blue Ventures helped the community create a series of coastal marine reserves. Several permanent reserves protect the biodiversity of the coral reefs and mangroves, and help fish populations recover; while nearly 50 temporary reserves have increased the productivity of the octopus and crab fisheries. Octopuses reproduce quickly and juveniles grow at a nearly exponential rate, so a brief harvesting hiatus can lead to significant increases in yield. Increased yields translate to increased profits – something greatly welcomed by the people of this impoverished region.

The people of the region are also reproducing quickly: the average total fertility rate in Velondriake is 6.7 children per woman, according to our data. On average women are only 15 years old when they first conceive. To compound this problem, a majority of the population is under the age of 15 – at or approaching reproductive age. At the current growth rate, the local population will double in only 10 to 15 years. The local food sources, already heavily depleted, barely feed the current population, let alone twice that amount. Without enabling these coastal communities to stabilize their population growth, efforts to improve the state of marine resources and the community’s food security are considerably hindered.

In August 2007, Blue Ventures launched its Population, Health, & Environment (PHE) program as a weekly family planning clinic in Andavadoaka, which provided access to ingestible and injectable birth control options, as well as condoms. The clinic increased the village’s contraceptive prevalence rate (CPR) from 9.4 percent to 36.3 percent, and the Velondriake region’s CPR from 11.0 percent to 15.1 percent, in its first two years. (CPR data for the third year is not yet available, but should be notably higher, especially at the regional level.)

In 2009, Blue Ventures opened two more clinics and began holding quarterly outreach clinics in all Velondriake villages. We started offering long-acting, reversible contraceptive options, including Implanon and IUDs. Most recently, we have implemented a community-based distributor (CBD) program to provide wider access to contraceptives around the region, particularly for villagers that could not easily reach one of the clinic sites. These expansions paid dividends: the number of patients increased almost four-fold between the second and third years, with a cumulative total for all three years of just under 1,700 patients.

Recently, the PHE program began a partnership with the UN Population Fund (UNFPA), becoming the first PHE project to receive support from the UNFPA within Madagascar. The UNFPA funds will allow us to add new regional clinics; launch a behavior change campaign, including a regional theater tour and educational events; and further develop the CBD program.

UNFPA’s support of this initiative represents an important endorsement of Blue Ventures’ integrated approach to the challenges of marine sustainability, food security, reproductive health, and population growth. Funding applications to focus on improving maternal and infant health and to conduct a full health-needs assessment of the Velondriake region are pending.

In taking a population, health, and environment approach, Blue Ventures creates synergies that allow for the more effective achievement of health and conservation outcomes. Through providing family planning and health options – services the community really wants – Blue Ventures generates more support for all of its other initiatives, such as conservation and aquaculture programs.

This integrated multi-pronged approach also helps speed up the move towards a more sustainable future. By empowering and enabling couples to take control of their fertility, couples are able to have the size family they want. The use of family planning helps lower the population growth rate, and lower growth rates decrease pressures on natural resources. Decreased pressures on natural resources lead to healthier ecosystems; healthier ecosystems mean more natural resources available; and more resources lead to healthier families.

Through recognizing this inextricable link between communities, their health, and the environment they live in, Blue Ventures hopes to preserve not just the local coral reefs and mangroves, but the Vezo seafaring lifestyle. This way, the sons on the boats and the babies on the women’s backs may still have enough octopus and fish to harvest when they take their own children out to sea.

Matthew Erdman is the PHE coordinator for Blue Ventures. For more information about Blue Ventures’ PHE activities, please contact phe@blueventures.org, or visit their website at www.blueventures.org.

Photo Credit: Adapted from “07,” courtesy of Blue Ventures.

Topics: Africa, Beat on the Ground, biodiversity, community-based, conservation, consumption, environment, environmental health, global health, Guest Contributor, oceans, PHE, population
- http://www.blogger.com/profile/03843352081471719134 Carolyn
  
  I'm a student at Rhodes College in a population and national security class– I've really enjoyed reading this blog and seeing the relevance of the topics I've been discussing in class. This post mentions that the use of contraceptives allows women to "have the size family they want." Is there any data about what size that is? It seems like the subsistence fishing practiced in this region is pretty labor intensive. Though couples may not want to have 6 or 7 children, is it possible that they need them to support themselves?
- Natalie
  
  I too am a student in the same class as Carolyn at Rhodes, and I also found this article to be quite pertinent. I think this article gives a hopeful viewpoint on the future of health and the environment. Given the success that Blue Ventures' PHE program has had in the last two to three years, my question is, has this program or could this program be used to address similar problems of other African countries, especially those on the coast? Also, this article mentions that funds from the UNFPA might allow Blue Ventures to "launch a behavioral change campaign." Would this campaign address simply behavioral changes towards the use of contraception, or also one that educates natives about sustainable resource management?
- Virginia
  
  I have also been taking the Population and National security class at Rhodes, and have learned a lot about the problems that population and environment issues such as those cited above can cause in terms of national security. The writings we have read in class have given us the background knowledge to understand these issues and general solutions that could be implemented. I was very heartened to read this blog because it gives an example of solutions being implemented effectively. It is all too easy as a young student to become overwhelmed by the future, and this shows one way that knowledge can be used for change.
- Andrew Millis
  
  Carolyn is onto an important point, motive. Blue Ventures is definitely making the best out of the cards they are given. The organization is providing access to contraceptives, stopping not just at condoms, but using oral and injectible contraceptives, the latter of which, as Nicholas Kristof’s book “Half the Sky” testifies, is shown to have greater effects in reducing fertility rates in underdeveloped countries than other methods. That being said, how effective can these efforts be if the motive is not present? Matthew explicitly states in his post that their approach empowers couples “to have the size family they want”, but a reduction may very well not be in their best interests when the economy relies heavily upon fishing, agricultural production, and mining.
  
  In order for Blue Ventures’ efforts to be fully utilized, there must be a motivation to reduce family size. Restructuring of Madagascar’s economic system likely will catalyze this. Increased foreign investment will likely create both more specialized jobs and more demand for jobs. As the demand for jobs and the need for education in order to secure these more specialized jobs increases, both the need for children decreases and the competition to secure a future for children increases (look at Eastern Europe). This may very well catalyze a marked decrease in fertility rates, as families will begin to see the benefit in reducing family size. Blue Ventures is off to a good step, but I can definitely see other factors influencing their success.
- Anonymous
  
  It will be difficult to reduce family in Madagascar as well as in many places in Africa as long as Africans carry the mindset that children are their social safety-net for their older years. Until viable pension systems are established for private sector employees (and aren't tampered with by corruption) and wages are driven up so that the average Malagasy or citizen of an African country can be taxed and contribute to such a system, population won't be driven down. Eventually the population bubble will burst in specific countries, but only when those nations mature economically. In the meantime, it appears as if Blue Ventures is doing some great work to try and educate people on what larger family actually does to a cripple a family's self-determination at the household level. Thank you Blue Ventures team!
- http://www.blueventures.org Rebecca Hill
  
  Dear Carolyn and Natalie and to all above respondents
  
  Thank you so very much for your interest in our work and for taking the time to ask us such interesting questions. I hope that the following provides you with further insight into the communities that we work with.
  
  With no other appreciable source of income, the communities of the southwest of Madagascar are wholly dependent on fishing for their livelihoods and survival. With rapidly depleting fish stocks, chronic food insecurity is a stark reality facing the region, with most families living on well under $1/day.
  
  With regards to desired family size, information has been gathered from focus group discussions and meetings held in villages. Overwhelmingly, responses have been that those with larger families have categorically stated that this has not been their family choice (for example to support themselves) but rather due to the lack of access to family planning services. This need has been expressed by both men and women of the region.
  
  With regards to addressing similar problems facing other African countries, we believe our progamme to be important in its field and wholly replicable in other parts of the world where natural-resource dependent communities face similar social and environmental challenges.
  
  Regarding your question about our behaviour change campaign, as an integrated Population, Health and Environment initiative, our interventions are approached in an integrated holistic manner. Our educational messages are developed with the communities to address these multiple needs in a collaborative fashion, as opposed to tackling issues in isolation. We believe that this approach results in better health and conservation outcomes simultaneously.
  
  Thank you again for your interest in our work. Do not hesitate to contact us for further information.
  
  All the Best
  
  Rebecca Hill
  
  Project Manager
- Katie M
  
  the people of southwest Madagascar depend on fishing for their livelihoods and fish stocks are depleting as the population is increasing, would the creation of an education system to teach the people skills other than fishing be a viable option? If people have other skills, then they will not be reliant on fishing as a source of income. However, this does not address the potential food shortage resulting from decreasing supplies and an increasing population. Blue Ventures operation in Madagascar seems to be actively fighting this problem. Octopus conservation efforts sound as if they are helping to increase the food supply, and the distribution of birth control is projected to decrease the total fertility rate. The combination of population control and environmental “policies” looks to have a great impact on health and quality of life for these people. This population, health, environment approach enables people to have the family size they want and enough food to feed them. If a trade skill education was added, Madagascar may be a lucrative location for foreign investment because it would boast a healthy, stable, skilled population.

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