Celebrating 10 Years of Project Safidy
Project Safidy is based on an evaluation of a previous community health project, which highlighted a lack of understanding of sexual and reproductive health options and limited access to family planning services in Fort Dauphin
– Dr. Mamy Andriatsihosena, Head of Community Health
In Madagascar, sexual and reproductive health and rights information is challenging for young people to access. Long-standing cultural taboos associated with talking openly about sex, sexuality, and contraception, combined with under-resourced healthcare and education systems, makes accessing accurate, rights-based information difficult. As a result, Malagasy youth lack the knowledge and guidance to make safe sexual decisions, increasing their vulnerability to unintended pregnancies and sexually transmitted infections, which remain high across the country.12 For example, in 2021, only 8.5% of young women and 7.3% of young men aged 15-19 used a condom during their last sexual encounter.3 With nearly half of the Malagasy population under the age of 15, young people across Madagascar must be equipped with the skills, knowledge, and attitudes to navigate their sexual encounters and exercise their sexual and reproductive health and rights (SRHR).4
What does 10 years of project Safidy look like?
Founded in 2012, SEED’s project Safidy is rooted in the premise that young people across Madagascar have the right to make an informed decision about when to engage in sexual activities. Preliminary research ahead of project Safidy found that knowledge uptake and behaviour change were most effective when sexual health education was delivered within schools. As a result, Safidy I partnered with the public high school in Fort Dauphin to reinvigorate the existing but largely dormant, ‘Anti-Aids club.’ Through this model, passionate students were trained as educators to teach their peers about risk-taking sexual behaviour and host extracurricular activities such as sexual health quizzes and mass mobilisation events that promoted safe sex practices. The students really enjoyed the sexual health activities and requested for the workshops and sports events to continue on an ongoing basis.
“In Malagasy, Safidy means choice or informed decisions. Safidy equips school youth with the capacity to choose what they want in relation to their sexuality and exercise their sexual and reproductive health and rights”
– Dr. Mamy Andriatsihosena, Head of Community Health
Based on the success of Safidy I, in 2015, Safidy II partnered with the middle school in Fort Dauphin to introduce ‘bitesize’ sexual health sessions, which were delivered by the SEED team, and continued to work in high schools through the Anti’Aids club. These sessions were highly effective in improving students’ sexual health knowledge and motivated the Safidy team to advocate for the inclusion of SRHR messages within the national high school curriculum. As a result, in 2018, Safidy III partnered with the National Ministry of Education (MEN) to conduct a regional pilot and deliver sexual health lessons on puberty, consent, contraception, and STIs to 12 southeast middle and high schools. Of the 430 students who attended the sexual health sessions, 84% reported an increased ability to use contraception and recognise sexual and reproductive rights. This success led to a national pilot, which delivered an expanded 12-lesson national curriculum to 25 high schools across Madagascar.
As both pilots effectively improved students’ sexual health knowledge, Safidy IV supported the MEN to integrate SRHR messages into the national high school curriculum. From late 2018- 2020, the integrated curriculum was rolled out in high schools across Madagascar, enabling students to access rights-based sexual health information as they reach the critical age of sexual debut. The curriculum encompasses 12 context appropriate topics of puberty, menstrual hygiene management, early pregnancy, STIs and HIV, communication, consent, vaginal fistula, cervical cancer, early marriage, sexual abuse, gender equality, and advocacy. Overall, the integration of rights-based SRHR education in the national high school curriculum was a significant achievement for the Safidy team and will support Malagasy youth to obtain the skills and knowledge to make informed sexual decisions for generations to come.
However, after successfully integrating SRHR topics into the national curriculum, SEED’s 2019 research found that many teachers lacked the confidence and capacity to deliver comprehensive sexuality education to Malagasy youth. As a result, Safidy IV adopted a ‘train the trainer’ approach to provide intensive SRHR training to 355 high school teachers across Madagascar. Following the training, 95.5% of teachers agreed that they were equipped with the skills and knowledge to deliver rights-based SRHR education to their students, marking significant progress toward the sustainability of the curriculum.
To further enhance the sustainability of SRHR education, in 2020, Safidy IV partnered with Madagascar’s largest teacher training university in Antananarivo, Ecole Normale Supérieure (ENS), to integrate SRHR modules consistent with the new curriculum taught in high schools across the country. This partnership equipped ENS professors with the skills and knowledge to teach SRHR education delivery to the next generation of Malagasy teachers, subsequently improving access to SRHR education for high school students across Madagascar. Additionally, in late 2019, Safidy IV launched the national SRHR Network Initiative to unite civil society organisations working in the field of SRHR across the country. The network now has 37 member organisations, reaching 23 regions, and aims to strengthen the implementation of SRHR advocacy work by encouraging SRHR actors to share resources and work together to reinforce positive SRHR values.
“A key success of Safidy is the integration of SRHR topics into the national education program for high schools and the formalisation of the SRHR Network. Safidy is now incorporating the curriculum into the teacher training college, enabling pre-service teachers to have insight into the SRHR concepts and topics before they teach at school”
– Dr. Mamy Andriatsihosena, Head of Community Health
Now entering its 11th year of operation, Safidy V continues to work with the MEN to increase the ability of teachers to deliver rights-based SRHR education in high schools across Madagascar. By enhancing the capacity of teachers to provide SRHR education, young people across Madagascar will have access to the skills and knowledge to navigate their sexual encounters and feel empowered to exercise their rights. Safidy V also continues to expand its work with teacher-training universities across Madagascar to integrate SRHR education and build the capacity of university professors to deliver SRHR education. This partnership equips future generations of high school teachers with the necessary skills to deliver sexual health education to Malagasy youth. Lastly, Safidy V continues to support the SRHR Network to become an independent organisation and raise the profile of SRHR across Madagascar through events, advocacy, capacity building, and organizational support, which culminated recently in the Third National SRHR Conference.
By embedding SRHR in the national curriculum, Project Safidy equips young people with the necessary tools to achieve their sexual and reproductive rights, reducing their vulnerability to HIV, STIs, and unintended pregnancies now and into the future. Long-term, Safidy ensures that the SRHR of Malagasy youth is prioritised, and that progress is made towards Madagascar’s development goals. At an international level, Safidy contributes to the Sustainable Development Goals of Good Health and Well-being (SDG3), Quality Education (SDG6), and Gender Equality (SDG5). Overall, Safidy’s engagement with the Malagasy government is the start of a national movement to equip Malagasy youth with the knowledge needed to achieve improved sexual health, and to negotiate safer sexual relationships in line with their rights.
References
1. Guttmacher Institute. Madagascar 2022. Available from: https://www.guttmacher.org/regions/africa/madagascar#:~:text=In%20Madagascar%20in%202015%E2%80%932019,Abortion%20is%20prohibited%20in%20Madagascar
2. Klinger A, Asgary R. Implementation and evaluation of a curriculum to teach reproductive health to adolescents in northern Madagascar. Int Health. 2016;8(3):179-86.
3. World Health Organization. Sexual and reproductive health and rights infographic snapshot - Madagascar 2021. Available from: https://apps.who.int/iris/bitstream/handle/10665/349436/WHO-SRH-21.122-eng.pdf
4. INSTAT, UNICEF. Multiple Indicator Cluster Survey, Madagascar 2018: Le marriage des enfants. Antananarivo, Madagascar UNICEF and INSTAT; 2018. Available from: https://mics.unicef.org/surveys