Madagascar’s 32 million inhabitants are a predominantly young population. With an average age of 21, young people face significant sexual and reproductive health and rights (SRHR) challenges: early and unintended pregnancies, unsafe abortions, high rates of STIs/HIV, and low contraceptive use.
These barriers are even more pronounced for persons living with disabilities. For the estimated 15% of the population living with disabilities, SRHR information and services remain largely inaccessible. Girls and young women with disabilities are especially vulnerable to sexual violence and unintended pregnancies. Comprehensive sexual education is another critical gap: parents rarely discuss it with their children, and educators often avoid the subject altogether. This silence has serious consequences in cases of sexual assault, as children very rarely confide in their families, as highlighted by a 2021 study by the Nifin’Akanga movement.
In a society where sexuality remains taboo and where people with disabilities are often silenced or ignored, Autisme Madagascar, a non-profit organisation based in Madagascar, seeks to challenge stigma and exclusion by affirming that every person has the right to safety, pleasure, and autonomy over their body. With support from AmplifyChange, Austime Madagascar generate knowledge and evidence to support SRHR services and information for persons with disabilities and combat the stigma around their sexuality and sexual pleasure. Providing context-driven information and responses to the realities persons with disabilities face, their work documents lived experiences and personal narratives of persons with disabilities to amplify their voices in advocating for more inclusive SRHR.
FROM LIVED EXPERIENCE TO COLLECTIVE TRANSFORMATION
Autisme Madagascar’s M’iray project adopted a participatory and inclusive approach, recognising that lasting change must come from those most directly concerned. Persons with disabilities and their caregivers were actively involved at every stage; not as beneficiaries, but as agents of change.
The process began with a series of consultation workshops with 77 persons with disabilities and 75 caregivers, designed to collect their experiences, perceptions, and realities regarding sexuality and reproductive rights. The workshops had a particular focus on individuals with intellectual and invisible disabilities.
The project’s participatory and supportive approaches had a positive impact. Before attending a workshop, one attendee, a dedicated caregiver named Mrs. Landy, felt uncertain about discussing sexuality with the young woman she supports, who had long been told that her desires were invalid. This silence not only stifled her ward’s self-worth but also created barriers to understanding her rights.
Mrs. Landy used her training through the M’iray project to build confidence and learn how to advocate for her ward’s sexual health and rights. Back in her community, she said simply, “I can be her voice.” Similar stories emerged from other workshops. Together, these caregivers are helping change how their communities understand dignity, autonomy, and SRHR for persons with disabilities.
The insights gathered from these workshops informed capacity-building sessions for both caregivers and people with disabilities. These trainings created a cohort of 78 SRHR peer educators, including 38 persons with disabilities, which fostered peer-to-peer empowerment. An innovative educational tool was developed to make SRHR information more accessible, promote self-determination, and challenge social taboos around pleasure and bodily autonomy for persons with disabilities.
In addition, the findings and recommendations from these workshops were presented to policymakers and civil society actors, advocating for stronger inclusion of persons with disabilities, especially those with invisible disabilities, in national SRHR policies. In doing so, the project contributes to a broader movement toward freedom of choice, equality, and systemic change.
TOWARDS A MORE INCLUSIVE SOCIETY
The M’iray project achieved significant progress in breaking the silence around the sexuality of persons with disabilities, a subject rarely addressed in public discourse in Madagascar. Participants embraced the initiative with remarkable enthusiasm, expressing a strong desire to share their stories and realities. For many, it was the first time their voices were truly heard and valued as individuals with rights, choices, and emotions.
The project generated new knowledge and sensitivity among journalists on how to responsibly report on SRHR and disability, encouraging more accurate, respectful, and stigma-free media coverage. This change contributes to a broader cultural shift in how society perceives persons with disabilities; not as passive beneficiaries, but as active rights holders and change-makers. Through the project, the team additionally produced a short documentary to raise awareness about SRHR for persons with disabilities
Although the project was successful, it also faced challenges. Working with individuals with intellectual and invisible disabilities is both complex and enriching, and in many cases, the team had to rely on caregivers, whose voices sometimes reflected their own concerns rather than those of the individuals themselves. This required building trust and innovative communication methods to access genuine experiences.
Another challenge lay in addressing deep-seated prejudices among some local officials and community leaders, who still believe that persons with disabilities, particularly women, should be denied access to SRHR for fear of social repercussions. This underlines the urgent need for continued advocacy, awareness, and dialogue to transform mindsets and ensure that SRHR truly includes everyone.
FROM LESSONS LEARNED TO LASTING CHANGE
Since September 2025, Madagascar has been facing a major civic uprising led by Gen Z, denouncing inequality, corruption, and the lack of economic and political opportunities. The violent repression of peaceful protests has led to a military-led transitional regime, increasing concerns about restrictions on civic space and human rights violations.
Autisme Madagascar are launching the second phase of their M’iray project in this challenging context. Malagasy youth are calling for a new vision of society, one that values individual choice, equality, and the separation of state and religious influence. Their struggle for dignity and autonomy echoes the very principles at the heart of SRHR advocacy work.
The aim of the next phase of the M’iray initiative is to strengthen advocacy and mobilisation among stakeholders so that people with disabilities can enjoy a healthy and fulfilling sexual life, grounded in freedom of choice and respect for diversity. To ensure this can be achieved, Austisme Madagascar will:
- Lead inclusive advocacy to promote access to SRHR services and information for persons with disabilities;
- Raise awareness and deliver innovative training on sexuality, pleasure, and well-being in an open and respectful manner;
- Consolidate the “Movement for Difference” to build a strong, sustainable coalition capable of long-term advocacy.
A key lesson learned from the first phase of the project is the importance of inclusivity. Involving PWD at every stage of program design and implementation is essential for building a more effective and equitable system that can provide holistic support to all individuals, regardless of their abilities. Autisme Madagascar hope to expand the M’iray project nationally and advocate for the establishment of state-funded structures present at least at the district level. These structures should be staffed with trained personnel and experts specialising in the care of people with disabilities. This will ensure that the services provided truly meet the specific needs of this population, particularly regarding SRHR services and protection against violence.
Additionally, Autisme Madagascar aim to broaden their network by enhancing funding sources and building collaborations with organisations that have relevant experience in this field. Working hand in hand with these partners will allow us to benefit from their expertise and improve the quality of our actions.
Moving forward, Austisme Madagascar are excited to continue amplifying the voices of persons with disabilities, ensuring that the right to pleasure and safety is recognised and celebrated for all. Ultimately, the M’iray project aligns with the aspirations of an entire generation seeking greater freedom, equality, and respect for human dignity for all, without exception.
