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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 10,000 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 150 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. RESUME Non seulement les ecosystemes marins de Madagascar abritent-ils une biodiversite exceptionnelle mais ils sont egalement intrinsequement lies au mode de vie et a la securite alimentaire des populations cotieres, notamment des pecheurs semi-nomades qui vivent le long de la cote sud-ouest. La commercialisation des produits de la peche traditionnelle, la croissance rapide de la population qui est en partie liee a des defauts en matiere de planification familiale et l’absence d’alternatives a la peche dans cette region aride se traduisent par une exploitation non durable des ressources cotieres. Pour trouver une solution a cette situation, l'organisation de conservation marine Blue Ventures a elabore une approche holistique qui considere les liens obliges entre les Hommes, leur sante et l'environnement. L’evolution du modele elabore pour l’aire marine de Velondriake est decrite ici ; elle concerne environ 10 000 personnes au cours de cette derniere decennie et des partenariats multisectoriels. Le modele a integre des services de sante reproductive avec des initiatives de conservation marine gerees localement, comme des fermetures temporaires de la peche aux poulpes, des reserves marines permanentes et des activites generatrices de revenus telles que l'aquaculture. L’ensemble de ces programmes est soutenu par des actions d’education en mobilisant les hommes, femmes, jeunes et enfants sur des themes aussi varies que la sante ou la protection de l’environnement. Ainsi, on estime que la prestation des services de planification familiale volontaire dans la region de Velondriake a pu eviter plus de 800 grossesses non desirees depuis 2007, et des fermetures temporaires de la peche aux poulpes plus de 150 fois le long de la cote sud-ouest depuis 2004. Des rapports preliminaires et anecdotiques de membres des communautes et des personnels du programmes indiquent que cette approche integree « Sante – Population – Environnement » permet aux couples de planifier et de mieux subvenir aux besoins de leurs familles, aux femmes de s’emanciper et aux familles d’ameliorer leur securite alimentaire tout en soutenant directement la durabilite des activites de conservation marine gerees localement. Ce modele s’est revele etre facilement reproductible pour repondre aux besoins de sante communautaire et pour faire avancer les efforts de conservation de la biodiversite dans les regions les plus reculees et les plus isolees de Madagascar.

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