Providing family planning services to remote communities in areas of high biodiversity through a Population-Health-Environment programme in Madagascar.

Population-Health-Environment (PHE) is an interdisciplinary model of programme design which recognises the complex interconnections between people, their health and their environment. PHE responds holistically to the challenges faced by ecosystems and the communities dependent on them, with thematically distinct but interconnected work strands sharing the same infrastructure, resources and goals. This has been shown to achieve better outcomes than tackling health and environmental issues in isolation. This paper shows how PHE programme design has been used by Blue Ventures for providing family planning services in a remote, biodiverse coastal region in southwest Madagascar. The PHE programme has integrated family planning services into a pre-existing, community-based conservation programme, aided by the established infrastructure and good community relations developed by the conservation workers. Implementation of the programme has led to a strong uptake of family planning services, and couples in the region are now able to make their own family planning choices. Successes and challenges of the programme are discussed.