EXECUTIVE SUMMARY

With the transition to the New Strategic Plan 2018-2021and the arrival of the new Country Representative for Madagascar and Country Director for the Comoros and Mauritius, Mr. Constant-Serge Bounda, Year 2017 was a pivotal year for the United Nations Fund for Population (UNFPA) in the Indian Ocean region. True to its mandate of «Achieving a world where every pregnancy is desired, every childbirth is safe and the potential of every young person is fulfilled», UNFPA works in Madagascar, the Comoros and Mauritius. To allow for taking into account the specificities of each country in its action, the new Representative visited different areas of Madagascar on the occasion of various celebrations, program delivery, advocacy, and launches; paid an official visit to the Chief Commissioner in Mauritius; and attended the official launch of the 2017 State of the World Population Report in the Comoros.

For each of the three countries, an intervention framework has been defined and addresses, for Madagascar and the Comoros, quality sexual and reproductive health services; empowerment of adolescents and young people; gender equality and women's empowerment; census and data management, all with a view to reducing poverty. For Mauritius, the issue of the ageing of the population and fertility decline, a problem specific to the country, has been granted special attention in addition to the issues shared with Madagascar and the Comoros (gender-based violence and youth sexual and reproductive health) and the intervention framework forms part of an effort towards
better quality of life and a more equitable society. Working on these focuses, UNFPA carried out the following flagship actions during Year 2017.

Republic of Madagascar

In the area of sexual and reproductive health, UNFPA is the prime provider of family planning commodities in Madagascar, ensuring procurement and distribution. At the national level, it also supported the adoption of a sexual and reproductive health and family planning law that aims, inter alias, to ensure universal access to contraceptive methods, through various forms of advocacy: conferences, debate with parliamentarians, etc. The Act was actually adopted by the Parliament. At a more local level, it promoted young people's access to sexual and reproductive health services by supporting the establishment and operation of 22 youth centers and 14 spaces for adolescents where they can benefit from counseling and condom distribution. For the general population, 15 model family planning centers and 10 mobile FP/STI integrated service centers have been established.

In the area of maternal and neonatal health, UNFPA has contributed to equipping health facilities with materials, equipment and additional midwives, and training staff. Thus, 26% of health facilities can now provide basic emergency obstetric and neonatal care (EONC), 3 training sites and 1 skills laboratory have been equipped for pre-service midwifery training. The management of obstetric fistula, a problem affecting some 50,000 women in Madagascar, is another area in which UNFPA is working, particularly through the training of six new surgical teams in cooperation with Senegal. The repair campaigns carried out with partners including Madagascar’s First Lady, the World Food Program, and national and international NGOs have allowed for treating 1 098 women. In the fight against gender-based violence (GBV), UNFPA supported the launch of discussions on GBV legislation, the establishment of an economic reintegration program and the setting up of listening and legal counsel centers. These initiatives benefited to 5,581 victims of GBV. In addition, law enforcement officials benefited from an international exchange to build their awareness and their training as well as from the provision of tools for the care of GBV victims in a workshop organized by UNFPA and funded by the Peace Building Fund. An innovative partnership was launched with the armed forces to further involve them in fighting GBV. Further to this action, the Government made the decision to set up a Feminine Proximity Brigade, with the support of UNFPA.

Working on the issue of the demographic dividend, UNFPA carried out awareness-raising activities, including a round table for all stakeholders and a day of reflection for female Members of the Parliament, and supported the launch of the national road map under the patronage of the Prime Minister. In support to the development of reliable population data, and specifically the census, UNFPA advocated with technical and financial partners for census support and provided IT equipment and mobilized international expertise for training. The final phase of the national census is expected to be completed by mid-2018. 

As regards humanitarian response, the drought in the South, Cyclone Enawo and the plague epidemics, UNFPA activatedthe Minimum Emergency Facility to ensure access to and availability of quality services for mothers, infants and girls, pregnant women with a focus on reproductive health. This involved mobilizing and paying for additional midwives and distributing emergency kits to maintain the level of maternal and neonatal care in the aftermath of cyclone Enawo, in the drought-stricken southern Madagascar, and during the plague epidemics as well as contracting NGOs to relay health and psychosocial support in remote areas.

Union of the Comoros
In the field of sexual and reproductive health, UNFPA initially intervened at the national level in support of the development of a plan for implementing the national sexual and reproductive health strategy. With regard to young
people specifically, the agency has supported several associations, including the Comorian Association for the Welfare of the Family (ASCOBEF) and Collaboration, Action, Sustainability (CAP) in their awareness-raising
activities, screening activities and distribution of condoms.
With regard to women, UNFPA provided technical and material support on the one hand to increase the use of contraceptive products and on the other hand to improve access to emergency obstetrical and neonatal care. As a
result, midwives were trained, the maternity ward of the Oichili health district received new medical equipment and supplies as well as two additional midwives, thanks to the support of Australia AID. The maternity of Ouizini
continues to receive support by UNFPA for supplies and midwives, in continuation of the provision of an ambulance in the past. These actions have resulted in zero maternal death in this facility.
As part of its work for youth, UNFPA, together with the United Nations system, supported the development of the National Youth Policy, which aims to fully involve young people in their own development and focuses on Education, Health, Education and Skills Development, Well-being, Employment and Entrepreneurship, Rights, Governance and Empowerment of Youth.
In the area of GBV, UNFPA has contributed to strengthening institutional capacity to implement the gender-based violence policy, including through the establishment of a national platform, the development of a roadmap, the
updating of the National Policy on Equality and Equity (PNEE), and support for civil society organizations such as the HIFADHU for listening and legal aid services for victims.

As part of its support to the population census, UNFPA, as the technical lead, supported the development of the project document, mapping, training of demographers, the management of the census implementation unit, and the
assistance by a permanent technical advisor.

Republic of Mauritius (including Rodrigues)
In terms of action for young people and in particular their sexual and reproductive health, activities have focused on the Rodrigues Island, where early pregnancy is a major problem. UNFPA supported the training of 40 young peer educators on the topics of sexuality and HIV/AIDS as well as illicit substances, on the initiative of the Youth Commission.
This awareness-raising action was amplified by UNFPA's support for a mass youth awareness campaign in schools entitled “Zen pa pressé” (or “Young people are in no hurry”) on early pregnancies, reaching 740 schoolchildren. UNFPA also maintains its longstanding support to the Youth Counseling Center where, in addition to receiving counseling on sexual and reproductive health from a nurse, young people can also broaden their horizons by connecting to the world in the computer room.
In the fight against GBV, an awareness campaign titled "Men as partners" was carried out with the support of UNFPA, involving some 500 men, as part of a male engagement strategy to reduce violence against partners. Prenuptial counseling is another strategy to combat violence, namely domestic violence, and as such UNFPA supported the Young Couples Training Program run by the Family Support Offices and the Mauritius’ Alliance for Women to the benefit of a hundred couples. In addition, UNFPA supported the preparation of the report on “Intimate partner violence”.
The ageing of the population being a specific problem in Mauritius, with projections showing that 32.5% of the population would fall in the over-60 age bracket in 2056, UNFPA supports the Ministry of Health and Quality of Life in conducting an assessment of demographic trends. This support extends to the revision of the national population policy.

Advocacy, awareness-raising, mobilization and partnership For UNFPA in the Indian Ocean region, World or International Thematic Days, among other events, provide opportunities to spread its messages, raise public and
policy-makers’ awareness, and ultimately contribute to the fulfillment of its mandate. As such, the agency participated in the following events during year 2017:
• International Condom Day in February in Madagascar, with the aim of promoting youth’s sexual and reproductive health;
• International Day against Obstetric Fistula in May in Madagascar, which saw a ceremony of commitment of governmental authorities, a training for medical students, and a working session to advocate with service clubs such
as Lions Club and Soroptimist International;
• International Midwives’ Day, in May in Madagascar and the Comoros, with a twofold objective: to raise midwives’ profile with communities and to promote access to quality sexual and reproductive health services;
• International Population Day in July in Madagascar and the Comoros, focusing this year on the concept of family planning;
• International Youth Day in August in Madagascar: this day was an opportunity to enhance the visibility of youth centers at the decentralized level and to promote the demographic dividend agenda;
• Launch of the 2017 State of the World Population Report in October in Madagascar in the Comoros, entitled Worlds Apart: Reproductive health and rights in an age of inequality.

 
Prospects
With many achievements for UNFPA in the Indian Ocean region, Year 2017 also marks a milestone in its programming and introduces, with Year 2018, the New Strategic Plan that  aims to achieve three transformative results, namely (i) zero preventable maternal deaths, (ii) zero unmet family planning needs and (iii) zero gender-based violence.
Building on its past achievements by ensuring program continuity and operational excellence, UNFPA intends to strengthen three approaches to fulfill its mandate. On the one hand, it strives to strengthen partnerships with
countries, political parties, civil society and the private sector and in the same vein to strengthen regional cooperation to share best practices and optimize the use of resources. On the other hand, the agency wants to get closer to its beneficiaries in its action as evidenced by the strengthening of offices in Toliara, Madagascar.
The new strategic plan, the change in management, the building on of past achievements and the strengthening of partnerships will instill a renewed ambition at UNFPA, this year and over the coming years