Healthy people in a healthy environment : impact of an integrated population, health, and environment program in Madagascar : final report

This report summarizes a five-year program in the integration of population, health, and environment (PHE) in three environmental corridors in Madagascar, with little access to health services and poor access to improved water sources and sanitation. The purpose of the program was to determine if activities implemented in an integrated manner achieved better results than if the activities were implemented separately. Integrated PHE activities target sector-specific projects to foster greater collaboration and increase the integration of the respective activities in such a way as to increase the efficiency of each. This synergy is produced through a better understanding of how the interaction between human health and the environment affects communities located near regions that depend heavily on natural resource use, and through the design and implementation of activities that address this interaction. In this concept, the environment is broadly defined to encompass the use of natural resources and natural processes, including agriculture, forestry, and biodiversity conservation.Unsustainable population growth is an important threat to ecosystems. Offering reproductive choices as a critical program element not only reduces this threat, but also improves women’s and children’s health.

The “Household Food Security and Livelihood Concept” served as a roadmap for guiding the design and program implementation of PHE integration. It provided the analytic framework for the baseline and impact surveys and program monitoring. This concept implies that people’s choices and actions related to PHE are based on economic forces and can be influenced by various programmatic interventions on different levels in the framework.