Human population growth is one of the primary drivers of biodiversity loss. Throughout much of the developing world growth of human populations is occurring in part as a result of a lack of access to sexual and reproductive health services, and this is having profoundly negative impacts on biodiversity and natural resource-dependent livelihoods. We present experiences of the incorporation of sexual and reproductive health services within a pre-existing community-based marine conservation initiative in Madagascar as part of an integrated population, health and environment (PHE) programme. Our results demonstrate the considerable demand for, and lack of social barriers to, the introduction of sexual and reproductive health services in this region. These findings emphasize the mutually beneficial synergies, supporting both public health and conservation objectives, which can be created by integrating sexual and reproductive health services into more conventional biodiversity conservation activities. This PHE approach demonstrates the inextricable link between reproductive health and resource use by providing practical, immediate and lasting benefits to public health, gender equity, food security and biodiversity conservation.
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