Integrating community health services with local marine management efforts

Garth Cripps for Blue Ventures
Published: 04 January 2016
Last edited: 24 February 2022
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This solution integrates community health services with local marine management and coastal livelihood initiatives.


This holistic health-environment model enables previously under-served communities to access family planning services so that they can choose freely the number and timing of their births. It improves their health while equipping them with the skills and opportunities they need to manage their natural resources sustainably. 


It's being implemented through cross-sector partnerships between health and environmental organisations in a variety of contexts. Programmes are designed to respond to priority community unmet needs and remove barriers to participation in local marine management. 


East and South Africa
Scale of implementation
Coral reef
Marine and coastal ecosystems
Fisheries and aquaculture
Food security
Gender mainstreaming
Health and human wellbeing
Local actors
Outreach & communications
Sustainable livelihoods
Other theme
Reproductive health
Loss of Biodiversity
Ecosystem loss
Unsustainable harvesting incl. Overfishing
Lack of alternative income opportunities
Changes in socio-cultural context
Lack of technical capacity
Lack of food security
Sustainable development goals
SDG 1 – No poverty
SDG 2 – Zero hunger
SDG 3 – Good health and well-being
SDG 4 – Quality education
SDG 5 – Gender equality
SDG 6 – Clean water and sanitation
SDG 8 – Decent work and economic growth
SDG 10 – Reduced inequalities
SDG 14 – Life below water
SDG 17 – Partnerships for the goals
Aichi targets
Target 1: Awareness of biodiversity increased
Target 3: Incentives reformed
Target 4: Sustainable production and consumption
Target 6: Sustainable management of aquatic living resources
Target 10: Ecosystems vulnerable to climate change
Target 11: Protected and conserved areas
Target 18: Traditional knowledge


Madagascar | Comoros, Mozambique, Kenya, Indonesia


This solution responds to the interconnected challenges of poor community health, unmet family planning needs, food insecurity, environmental degradation and vulnerability to climate change. 


Women of reproductive age, their partners and their families

How do the building blocks interact?

Blue Ventures’ health-environment model is an holistic approach with several components vital for its success:


- The provision of voluntary family planning and other basic health services enables people to choose freely the number and timing of their births, and removes a barrier to community engagement in local marine management. 


- LMMAs are the core of Blue Ventures’ locally led approach to marine conservation, and integrate closely with the other components. As explained by Mr Roger SAMBA, president of the Velondriake LMMA Association: “Family planning lets couples choose how many children they have, while marine reserves help to increase fish catches. If the population isn’t growing so rapidly and the fish catches are increasing, then we can have a better balance between fish stocks and our population. This means that people and the environment can live together, and we all benefit from this.”


- Seaweed and sea cucumber farming provides communities with new sources of income so that they can diversify their livelihoods, thereby improving community well-being and enhancing the sustainability of local marine management efforts.


  • Contraception use among sexually active women of reproductive age in the Velondriake LMMA (Blue Ventures' first site in Madagascar) has increased more than fivefold from less than 10% in 2007 to over 50% in 2016.
  • More than 4,000 unintended pregnancies are estimated to have been averted among a population of 45,000 to date (all of Blue Ventures' sites in Madagascar).
  • Family planning users report having better physical and mental health, being able to work more, earn more money and better provide for their children.
  • Women and youth now make up 85% of the Velondriake LMMA’s management association.
  • Blue Ventures is assisting other organisations to adopt this approach by supporting the development of a national learning network in Madagascar, bringing together health and environmental groups, funders and policy makers to facilitate cross-sector partnerships.


Irene was in her final year of secondary school when she had her son, now four years old. She didn’t manage to take her school leaving certificate then, and was left feeling like her efforts in primary school had been quite futile. She decided to start using family planning after the birth of her son, choosing three-monthly depo-provera injections offered by the community-based distributor of contraceptives in her village. Once Irine took control of her reproductive health, she found that her business ideas thrived, her confidence grew, and she became able to provide for her son. To earn money, Irene grows seaweed and sea cucumbers through an initiative supported by marine conservation organisation Blue Ventures. She describes how their private sector partner, a company called Indian Ocean Trepang, provides juvenile sea cucumbers for local farming teams to grow out to adult size in community-managed pens. Irene also has a small business selling products that she sources from outside of the village, with her mother looking after her son while she’s away. Thanks to these efforts, she’s been able to build a large house with four rooms, buy several goats and pay for her son’s school fees. Irene isn’t yet married but she’s very clear about one condition before she gets engaged; that she can continue to use contraception until she’s ready to have another child. She even approached a lady in her community with limited resources and many children to support, as she felt sorry for her and wanted to speak to her about family planning. The lady was wary: “According to the rumours here in this village, using contraception will destroy your body so I’m fearful about it.” Irene explained that this is only a rumour: “I’m using the contraception that you’re scared of and you can see that I’m healthy, there hasn’t been a change in my body and I’m able to do many activities!” The lady agreed on the condition that she would speak to her husband first, who accepted willingly, saying that he didn’t want his wife to suffer anymore. This lady is still happily using family planning today, and Irene continues to help by reminding her of the follow-up appointments noted in her medical book as she’s unable to read. Having experienced the benefits of using family planning herself, Irene is dedicated to encouraging other women in her village to think about their options and realise their reproductive rights. (Photo-illustrated story:

Contributed by's picture

Laura Robson Blue Ventures

Other contributors

Blue Ventures
Madagascar PHE Network