Evaluating the impact of a community-designed health and livelihood intervention on deforestation trends in rural Madagascar: A quasi-experimental study

Tropical forests are disappearing at an alarming rate, jeopardizing livelihoods, ecosystems, and climate stability. In many tropical regions, deforestation now surpasses reforestation, resulting in a net carbon emission from some of the world's most critical natural carbon reserves. Preventing further forest loss is a crucial strategy in addressing climate change and nature conservation. The objective of this analysis is to evaluate the 5-year impact of a community-designed solution aimed at achieving climate mitigation through reductions in illegal logging and fires in rural Madagascar. While the establishment of protected areas in biodiverse, carbon-rich tropical forests contributes to biodiversity conservation and climate mitigation efforts, local communities are often excluded from such efforts, leading to social and economic disenfranchisement. This can, in turn, further exacerbate forest loss, as local communities might engage in illicit logging and unsustainable land conversion practices to maintain their livelihoods. The intervention entails expanded healthcare access and training in sustainable farming and agroforestry practices designed by communities living in and near the protected rainforest area, offsetting expenses historically met through illegal logging and providing alternatives to expanding swidden agriculture. Health In Harmony-Fahasalamana Mirindra (HIH-FAMI) is a non-governmental organization working with local rainforest communities to reverse deforestation by providing support for community-designed interventions (often involving healthcare and livelihoods) in exchange for commitments to forest conservation. Between 2021 and 2025, HIH-FAMI supported approximately 15,000 community members living in and around Manombo Special Reserve, a biodiversity-rich protected area on Madagascar’s southeastern coast, to design and implement their own solutions to improve both their own wellbeing and that of the ecosystem they lived within. The interventions were introduced after two years of conducting a Radical Listening design process with communities in Manombo between 2017 and 2020 to identify priority interventions. Communities shared that their first priorities were healthcare and sustainable food production, which they indicated are interlinked, and their second priority was school infrastructure. HIH now collaborates with community members across 31 villages in and around the Manombo Special Reserve to address healthcare access, ongoing cycles of food insecurity and poverty, sustainable resource use, education, and climate resilience.