Six years after beginning a marine conservation program focused on octopus fishery management in southwest Madagascar, “we can proudly say that we have made a real impact as an organization providing health care,” said Dr. Vik Mohan, medical director of Blue Ventures and a practicing doctor in the United Kingdom.

“What drew me to Madagascar was Blue Ventures,” said Mohan, “I was really impressed with the quality of work they were doing, their commitment to the region, and just their ethos for working.” After working for some time solely on marine conservation in a number of villages in Velondriake, the eco-tourism NGO saw rapid population growth putting pressure on natural resources, leading to malnutrition and maternal health problems. In response, the group adopted a more comprehensive approach to conservation and added a clinic to meet demand for reproductive health services and empower women.

“When we first started we were offering services in one village, one clinic, once a week,” Mohan said. The demand for health services encountered was so great, however, Blue Ventures now offers services, including contraception, in 40 villages through outreach clinics and community-based distributors. Fifty-five percent of women of reproductive age in the area are using contraception, and total fertility rate – number of births per woman per year – has declined by 40 percent.

Mohan explains that the rapid uptake in contraceptive use stemmed in part from Blue Ventures’ good relationships with communities, via their prior marine conservation efforts, but also a culturally-sensitive, rights-based approach to providing care. “People have come to us because we offer them a service that they need, and because they trust us to do that,” he said.

“Going beyond the data…what I see is that women are healthier. What I see is that children are healthier. What I feel is that women are more empowered,” he said. More women are involved in octopus fishing, biodiversity conservation, and sustainable livelihoods initiatives “because they’ve got the capacity, the energy, and the empowerment to do so.”

“What we hope, and what we think, is happening, is that this sense of empowerment, this sense of agency and self-efficacy that they experience as a result of having control over their fertility, spills over into other parts of their lives.”