MSI United States
Sep 3 · 2 min read

Every day, in countries around the world, we see contraception and safe abortion access restricted by unnecessary regulations. That’s why we are working to change real policies that prevent women and girls from seeking contraceptive and safe abortion care.


Until recently, anyone under the age of 18 in Madagascar was required written consent by a parent or guardian to access contraception. Madagascar has a huge adolescent population — over 50% of the total population is under 20. Though 18 is the legal age of marriage, child marriages are still widespread– 12% of girls are married by the age of 15 and 41% by the age of 18. Because so many girls are having sex at younger ages, young people in Madagascar are exposed to early pregnancies. In fact, one third of young women have given birth by the time they reach 18.

Studies show that when girls grow up in areas where reproductive health services are readily available, they are less likely to drop out of school before they hit puberty because parents are more willing to invest in girls’ education when there is a higher likelihood of them being successful later.

Annie Ramasy, an MSI nurse in Madagascar, has seen this firsthand.

“I once had a 16-year-old client about to graduate from high school,” Annie said. “She got an implant. When I met her later, she thanked me and said that if she had not gotten the implant, she certainly wouldn’t be studying at university now.”

Restrictions on contraception use were denying adolescents of the chance Annie’s client had to finish her education. To show politicians just how crucial reproductive health is to secure the futures of young women, MSI Madagascar took three influential senators to two cities to meet young pregnant girls with no access reproductive healthcare. We knew that if the senators talked to young women one-on-one, they’d see the importance of increasing access to contraceptive service.

Nurse Annie Ramasy speaks with one of her adolescent clients, Mirana.

And they did — with the senators’ help, MSI Madagascar was able to change the law which required the written consent of a parent or guardian for anyone under the age of 18 to access contraception. Now, adolescents in Madagascar no longer need parental or guardian consent to get contraception and the health workers providing these services are protected.

We know that when girls and young women have access to judgement free, culturally appropriate sexual health education and reproductive health services, they are more likely to make informed, healthy choices and feel confident in their decisions. That’s why we will continue fighting for policy change until every woman has access to the reproductive care she wants.

Her Future

Stories from MSI about women's determination to access family planning and safe abortion care.

MSI United States

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We are part of a global organization working in 37 countries, unified by our unwavering commitment to help every woman have children by choice, not chance.

Her Future

Stories from MSI about women's determination to access family planning and safe abortion care.

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