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In Madagascar, despite slow economic growth, the population is growing rapidly by about 600,000 people each year.
Madagascar’s population is projected to nearly double by 2050. While the total fertility rate is steadily declining, the average remains at 4.8 births per woman. This is largely due to Madagascar's high unmet need for contraception.
According to a Demographic Health Survey from 2009, 19% of married women of reproductive age wanted to space or limit their births but were not using any form of contraception. Although this level has since improved, the overall level of contraceptive use needs additional attention and investment, particularly as the population continues to grow.
Since 1992, Marie Stopes Madagascar has been working with national government and non-governmental partners to provide a full range of sexual and reproductive health services including contraception, maternal health, post-abortion care, and screening for sexually transmitted infections and HIV.
Madagascar’s population is projected to nearly double by 2050.
Our outreach teams - consisting of a doctor, nurse, co-ordinator, and driver - travel through rural and hard-to-reach parts of the country offering long-acting and permanent contraceptive methods. In addition to the short-acting methods available at community and primary health centres, these outreach teams ensure that people have access to the full range of voluntary contraceptive information and services.
In 2012, Marie Stopes Madagascar began using light-weight inflatable tents that are easy to transport and quick to assemble for use in hard-to-reach areas. The tents enable outreach teams to serve rural areas where a suitable building is not always available. The washable tents have three rooms that can be used for counselling, procedures, and recuperation, and are an innovative way to ensure that high-quality contraceptive services can be offered even in the most remote locations.
In Madagascar, our team identified a need to reach young people and provide them with sexual and reproductive health services. Almost two thirds of the population is aged under 25, and rates of maternal mortality remains high. 32% of girls aged 15-19 already had children or were currently pregnant, according to a survey conducted by DHS. The same survey showed that the number was significantly higher for the poorest quantile, where 51% had started childbearing.
In 2013, Marie Stopes Madagascar piloted a highly successful youth voucher programme. Between July 2013 and December 2014, 58,417 vouchers were distributed to young people: