JSI RESOURCES: Publications

Madagascar Technical Brief – Engaging Youth to Improve Health and Reduce Gender-Based Violence


The health needs of adolescents and youth remain consistently high in Madagascar because many young people cannot access complete and accurate health information, health education, or modern forms of contraception and preventive care. The country has a high adolescent fertility rate with 108 births per 1,000 women aged 15–19 compared to the global average of 42 per 1,000. Madagascar also has the 13th highest rate of child marriage in the world with 41 percent of girls married by age 18. The Government of Madagascar (GOM) recognizes early marriage as a form of gender-based violence (GBV) and promulgated a law in 2007 setting the minimum legal age for marriage at 18 years.

Despite this law, child marriage remains widespread. Because young people aged 10–24 account for 32 percent of Madagascar’s population, addressing their health needs can have broad lasting impacts. The GOM has adopted family planning as an important strategy to improve adolescent and youth health and reduce maternal mortality. The USAID Community Capacity for Health Program placed adolescents and youth at the center of efforts to improve access to health promotion and reproductive health services by locating interventions at places where youth spend time, such as schools and the community, and by leveraging youths’ networks to share information. These efforts focused on preventing early or unwanted pregnancies, engaging boys and young men in health activities, and raising awareness and empowering youth in the fight against GBV. 

With a clear focus on youth across its community interventions, the Program contributed to progress toward the GOM family planning 2020 goals, which included: 1) increasing the contraceptive prevalence rate from 33 percent in 2013 to 50 percent in 2020, and 2) reducing the rate of unmet need for FP from 17.8 percent in 2013 to 9 percent in 2020.

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