A critical examination of the barriers and social determinants of health impacting the implementation of a national sexual and reproductive health rights curriculum in Madagascar

Abstract Despite some international and national efforts in recent decades, Madagascar continues to make poor progress towards key sexual and reproductive health rights (SRHR) indicators. There are persistent cultural, social, political and economic barriers to accessing good quality SRHR knowledge and services globally, but particularly in regions with limited international geo-political influence, such as Madagascar. The political crisis in 2009 resulted in a stagnation and regression of SRHR services, due to the cessation of international funding, leaving youth-based services inadequate and insufficient. This paper aims to critically examine the social determinants and external factors that may influence and impact the roll-out of a national SRHR educational curriculum in Madagascar over the coming years. From the perspective of two SRHR specialists working in this context, this paper serves as a call for further action from the national and international community to address the still unmet SRHR needs of youth in Madagascar.