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Status: Fully funded

Date: April 2019 – Present

Project partners: Regional Ministry of Health, basic health centres in the three sites, Mahatalaky middle and high school

Target Beneficiaries: Students and out-of-school youth and students (aged 15-24)

Location: Mahatalaky, Sainte Luce, and Tsagnoriha, Mahatalaky Commune, Anosy region, southeast Madagascar

Why is it important?

There are now 31,000 people living with HIV in Madagascar, a 54% increase since 2010 (UNAIDS, 2017). Of these people, only 8% are aware of their status and 5% are receiving treatment, the lowest rates in sub-Saharan Africa (UNAIDS, 2017). In Anosy, the isolated southeast region of Madagascar, poor healthcare service provision and low sexual and reproductive health knowledge exacerbate the threat of HIV and sexually transmitted infections (STIs). Under 40% of people in this region are able to identify HIV prevention methods, such as condom use, and over 90% of people have never been tested for HIV (Santé, 2010).

Mahatalaky, a rural town located four hours from Fort Dauphin, and the neighbouring communities of Sainte Luce and Tsagnoriha, are particularly at-risk due to extreme healthcare shortages. One doctor based in Mahatalaky serves 12 villages, and healthcare centres lack basic provisions, such as condoms, STI tests, and medication. Furthermore, definitive testing and treatment for HIV is only accessible by travelling to Fort Dauphin. Without these crucial resources, healthcare providers in these three sites feel ill-equipped to handle the communities’ sexual and reproductive health challenges, leading them to approach SEED for support.

‘Fort Dauphin has one of the highest [STI] prevalence rates; it might even reach up to 50%’

healthcare professional, Fort Dauphin 2019.

Teza 2010 HIV workshop MO 2-min.jpg

What we're doing

Developed in direct response to these community requests, Project Mitao (‘to protect yourself’ in Malagasy) seeks to overcome these challenges through research and capacity-building in the rural communities of Mahatalaky, Tsagnoriha, and Sainte Luce. To alleviate critical knowledge gaps, SEED will undertake collaborative research to understand the complex factors driving the spread of HIV and STIs in the three sites. This research will employ a variety of complementary methods to examine the sexual and reproductive health and rights (SRHR) knowledge, attitudes, and practices of young people and accompanying healthcare service structures in rural Anosy.

To equip young people with key SRHR skills, SEED will partner with rural healthcare providers and teachers to pilot SRHR lessons with students and out-of-school youth. Focused on the topics of consent, STIs and HIV/AIDS, contraception, and puberty, these lessons will build young people’s immediate capacity to prevent STIs and generate important findings about SRHR education.

To channel research findings into sustainable responses to STIs and HIV/AIDS, SEED will increase stakeholder engagement through the creation of a robust, participatory network of partners. SEED will conduct capacity-building with local and regional stakeholders to share emerging findings, exchange feedback and direct next steps, ensuring that this research provides the basis for long-term STI prevention and treatment in some of Madagascar’s most vulnerable communities.


The Mercury Phoenix Trust, private donors.