Madagascar: Ambitious family planning goals

ANDAVADOAKA, 23 July 2008 (IRIN) - "I often get women in the clinic who have had eight or more children and are desperate to stop," said nurse Rebecca Hill, who has been running a family planning clinic in Andavadoaka, a remote village in southwest Madagascar, for the past six months. "They are all too pleased to have a break, and family planning can allow that to happen. But there is a huge unmet need for these facilities here, and that needs to change."

Madagascar, an island renowned for its unique biodiversity, is struggling to balance the demands of conservation with the needs of a rapidly growing population that has doubled in the last 25 years, reaching 19.6 million in 2007, according to UN figures. It is expected to hit 43.5 million by 2050.

Family planning initiatives in the cities have met with some success, but there is still a significant lack of contraceptive services in rural areas. "Reaching isolated communities is the real issue," Andre Damiba, country director for Marie Stopes International (MSI), a reproductive health agency, told IRIN.

According to the government, in some parts of the country 70 percent of 16-year-old girls have already given birth to their first child. In recognition of the problem, the Ministry of Health has taken the unusual step of changing its name to include family planning.

The government has also made family planning one of the eight pillars of the Madagascar Action Plan (MAP), an ambitious economic and social development strategy recently launched by President Marc Ravalomanana.

The MAP sets two ambitious goals for family planning: reducing the average size of the Malagasy family "to improve the wellbeing of each family member, the community and the nation"; and comprehensively meeting the demand for contraceptives and family planning. It plans to do this by making contraceptives more widely available, providing educational programmes and reducing unwanted teenage pregnancies.

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