(28) State-run health clinics in the region suffered chronic staff and supply shortages, and three out of the four state-run clinics in the Velondriake LMMA were staffed solely by male health workers, a major barrier to access reported by many women in the region.
In 2007, 56% of girls living within the Velondriake LMMA aged 15-19 already had children or were pregnant--placing them at highest risk of maternal and infant mortality.
In regular, informal discussions with community representatives, including representatives from women's groups, and in discussions at Velondriake LMMA meetings, communities expressed a strong desire for improved access to family planning services.
In 2007, with the approval of community leaders and government health bodies, Blue Ventures opened the Velondriake LMMA's first family planning clinic in the village of Andavadoaka, staffed initially by an expatriate health care professional employed by Blue Ventures (whose primary role had been to provide health care to Blue Ventures staff and volunteers).
The family planning service was gradually expanded from 2009 to 2011 to include outreach clinics in nine villages within the Velondriake LMMA, with Blue Ventures staff travelling by boat or oxcart to deliver services in these villages.
The 15 villages that are not part of the Velondriake LMMA fall within areas where other conservation groups have started similar community-based conservation programmes.
Within the Velondriake LMMA, rapid economic gains resulting from temporary octopus closures fuelled community interest in more ambitious marine conservation initiatives; however, securing buy-in for the LMMA itself has proved more challenging, as the benefits of restrictions on destructive fishing practices or creating permanent marine reserves are less immediately apparent.
Conservation colleagues within Blue Ventures have said that the provision of health services is helping to strengthen support for the LMMA (Shawn Peabody, In-Country Director, personal communication, August 2012).
The Verata project is now part of the Locally-Managed Marine Area Network (LMMA) and its Fiji counterpart, FLMMA.
The Fiji LMMA is successful both in the way that it has replicated its work and lessons learned regionally, and that at the Fiji level it has, since its inception in 1999, grown to include communities in six districts and cover 10% of the inshore marine area of Fiji.
LMMAs have since proliferated in Madagascar, and they now cover more than 12,000 sq km of its coastal shelf.
The LMMAs have increased coastal communities' resilience, says Douglass, but an even better solution would be one that operated at a regional level--a network of LMMAs in the first instance, perhaps.