Linking Population, Health, and Environment in Fianarantsoa Province, Madagascar.

For more than a decade, development practitioners and communities in Fianarantsoa province, Madagascar, have been involved in community-based projects that link family planning, health, and environment efforts. Since the early 1990s, a range of approaches that combine family planning and/or health interventions with environment and rural development activities have been implemented throughout Fianarantsoa province, making it one of the richest centers of such programming in Madagascar and the world. This brief explores the evolution of crosssectoral approaches and projects in Fianarantsoa, outlines ongoing challenges to effective project implementation, and highlights opportunities for strengthening and expanding collaboration. It is based on a review of published literature and project documents, and interviews with over 20 practitioners, technical advisers, and funders in Madagascar and the United States.