Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar © 2023 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. 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Table of Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The key findings from this mixed-method study are: . . . . . . . . . . . . . . . . . 12 Access to education is a challenge for all in Madagascar, but girls face additional gender-specific barriers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Access to sexual, reproductive, and maternal health services remains limited, especially for adolescent girls and young unmarried women . . . . . . . 23 The continuum of barriers to finding good-quality employment and accessing productive assets disproportionately affects women and girls . . . . . 29 Women and girls face limitations to their agency and decision-making, particularly in the domain of family formation . . . . . . . . . . . . . . . . . . . . . 36 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Appendix A. Methodology of the qualitative background study . . . . . . . . . . . . . 48 Appendix B. Entry points for legal reform to expand women’s empowerment in Madagascar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Abstract This Overview presents the findings from the mixed-method study on gender inequalities in Madagascar, illustrating the key gender gaps in the country and shedding light on the unique challenges that young Malagasy women face in their educational, professional, and family trajectories. Due to the persistence of financial, social, and institutional barriers, Malagasy women and girls encounter significant disadvantages across all dimensions of well-being and are unable to access opportunities in an equal manner with men and boys in the country. They are largely constrained in their ability to accumulate human capital in education and health, and to participate in economic opportunities; and they face severe limitations in agency and decision- making, particularly with respect to family formation. Women and girls also appear to be disproportionally affected by the impacts of climate change and the COVID-19 pandemic, which further widen preexisting gender gaps and amplify vulnerability to poverty, violence, and discrimination. On the basis of the research findings, the Overview presents key gender gaps in Madagascar and proposes four strategic lines of policy recommendations to (i) assist girls and young women in completing school education, (ii) improve women’s and girls’ access to professional health care and prevent teenage pregnancy, (iii) enhance women’s economic opportunities, and (iv) improve women’s and girls’ voice and agency through the elimination of all forms of gender- based violence. Four thematic notes accompany this Overview and present detailed findings in the four key dimensions: education, health, economic opportunities, and agency. Acknowledgments This Overview report is part of a study on gender disparities in Madagascar, “Unlocking the Potential of Women and Adolescent Girls—Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar.” The study was conducted by a core team composed of Alina Kalle and Miriam Muller. The report benefited from important contributions by Tamara Bah, Joaquin Gustavo Betancourt, Ursula Casabonne, Fatoumata Dieng, Alexandra Jarotschkin, Francis Muamba Mulango, Esperance Mukeshimana, Stephanie Kuttner, Carmen de Paz, Sabrina Razafindravelo, Hiska Noemi Reyes, Paula Tavares, and David Seth Warren. The team is grateful to peer reviewers Andrew Brudevold-Newman, Tazeen Hasan, and Ana Maria Oviedo for their thoughtful inputs. Honora Mara edited the report. Karem Edwards provided excellent administrative support throughout. The team worked under the guidance of Benu Bidani, Marie-Chantal Uwanyiligira, and Pierella Pacci. A team from Ivorary Consulting collected, transcribed, translated, and coded the qualitative data. This research was funded by a grant from the Hewlett Foundation. Finally, our deepest gratitude to all key informants and to the women, girls, and parents who shared their personal stories with us. Abbreviations DHS Demographic and Health Survey ECDE early childhood development and education EPM Permanent Household Survey FP family planning FRAM Fikambanan’ny Ray Aman-drenin’ny Mpianatra (association of parents of students) GBV Gender-based violence IPV Intimate partner violence LFP labor force participation MICS Multiple Indicator Cluster Survey MMR maternal mortality rate PD Positive deviant SRH sexual and reproductive health TFR total fertility rate UNESCO United Nations Educational, Scientific and Cultural Organization WASH water, sanitation and hygiene WBL Women, Business, and the Law WDI World Development Indicators Introduction P romoting gender equality is crucial not only for women and girls themselves but also for their families, for their communities, and for society at large. Based on the global evidence, economic and social empowerment of women is associated with their increased decision-making power, reduced vulnerability to gender-based violence, and delayed early marriage and fertility (Acharya et al. 2010; Aizer 2010; Chakravarty, Das, and Vaillant 2017). Moreover, gender equality brings instrumental value for families and society, because of its positive correlations with economic growth, improved labor productivity, reduced poverty and food insecurity, and better outcomes for future generations (Aguirre et al. 2012; Allendorf 2007; Andrabi, Das, and Khwaja 2011; Dumas and Lambert 2011; Mulugeta 2021). As Madagascar undergoes a demographic transition and expects significant growth in the share of its working-age population by 2050, focusing investments to ensure the health, education, and empowerment of adolescent girls is a particularly important strategic action that will likely result in long- term gains for economic growth and sustainable development. Evidence shows that social and economic investments in adolescents protect progress made in childhood, accelerate productivity and economic growth, and safeguard the health of the future adult population (Levine et al. 2008). This Overview presents the main findings from a mixed-method study on gender inequalities in Madagascar, which intends to shed light on adolescent girls’ and young women’s empowerment with the ultimate purpose of informing the policy response to address underlying barriers. The objectives of the study were to generate knowledge and deepen understanding of gender inequalities and their drivers in Madagascar with a focus on adolescence; to explore challenges and opportunities that adolescent girls face in making decisions about family formation, education, work, and the intersection of these elements; and to identify factors and strategies that support young women in their decisions about education, work, and family formation. The quantitative analysis explored the status of gender gaps across multiple dimensions (human capital, economic opportunity, and women’s agency) by socio-demographic characteristics, identified regions with the most severe gender gaps, and assessed the country’s development in reducing gender disparities over the past two decades. (See box 1 for a list of the quantitative data sources used in this report.) The team also conducted a literature review on what works to effectively empower women and girls, based on evidence from the Sub-Saharan Africa region (World Bank 2023). In addition to the quantitative assessment, the team conducted a qualitative study with the aim of generating knowledge about the range of factors that contribute to gender inequalities in education, family formation, employment, and access to sexual and reproductive health (SRH) services, with a particular focus on adolescent girls and young women. Specific focus areas of the research included (1) factors for school inclusion or reintegration of adolescent girls; (2) determinants of adolescent girls’ marriage decisions; (3) adolescent girls’ aspirations in terms of education and professional careers; (4) causes of gender disparities in access to employment; (5) parental influences on daughters’ educational and occupational trajectories; and (6) institutions and strategies that empower adolescent girls and young women to make informed decisions about their education, marriage, and work. 10 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Box 1. Sources of the quantitative data for the analysis • Afrobarometer Round 7 Survey on gender attitudes • Demographic and Health Survey (DHS) 2008–09 and 2021 • International Labor Organization (ILO) estimates • Multiple Indicators Cluster Survey (MICS) Madagascar 2018 • Permanent Household Survey (EPM) 2021–2022 • United Nations Educational, Scientific and Cultural Organization (UNESCO) statistics database • The World Bank’s Women, Business, and the Law data set 2023 • The World Bank’s World Development Indicators (WDI) database Qualitative data were collected through individual in-depth interviews, focus group discussions, and key informant interviews. Individual in-depth interviews were run with several subsamples of participants: (1) women ages 18–24, (2) women ages 25–35, (3) mothers of adolescent girls, and (4) so-called positive deviants—young women who have managed to delay early family formation and succeed in their educational and work endeavors despite encountering the same challenges as other subsamples of young women in their communities. Furthermore, focus group discussions included the following subsamples of participants: (1) women ages 18–24, (2) women ages 25–35, (3) mothers of adolescent girls, and (4) fathers of adolescent girls. Last, key informant interviews were held with religious and traditional leaders, elected officials, and a wide range of representatives from civil society and the education, health, and private sectors. Collection of the qualitative data took place from June through August 2022 in three geographically and culturally diverse regions of Madagascar: Analamanga, Atsimo- Atsinanana, and Sofia. The Analamanga region was represented by the capital city Antananarivo, which displays the lowest proportion of illiterate women (8.7 percent) and the lowest share of women ages 20–24 who married before the age of 18 (17.9 percent) (DHS 2021). In Antananarivo, two urban communities were chosen with a concentration of industrial companies, businesses, and stores in each area. The Atsimo- Atsinanana and Sofia regions were selected because they have high rates of illiteracy among adult women (54 percent and 25 percent, respectively) and high prevalence rates of child marriage (54.5 percent and 65.0 percent, respectively, of women ages 20–24 were first married by age 18) (DHS 2021). The districts of Mandritsara (Sofia region) and Vangaindrano (Atsimo-Atsinanana region) were selected because they display large gender disparities in favor of boys in secondary school enrollment and attendance rates. A more detailed description of the methodology can be found in appendix A. Introduction 11 The key findings from this mixed-method study are: • Access to education is a challenge for all in Madagascar, but girls face additional gender-specific barriers. Although girls outnumber boys in primary and secondary school attendance and completion, the access to schooling is very low for all children: only 36.6 percent of girls and 34.3 percent of boys ages 12–15 complete lower secondary school (WDI UNESCO statistics database 2019). Moreover, the overall rate of educational attainment remains concerningly low and a significant share of adult women is illiterate (23.9 percent vs. 21.4 percent for men; DHS 2021). Although free on paper, attending school involves multiple indirect costs—uniforms, school materials, fees, lunches, and other unforeseen expenses—that are often exacerbated by the impacts of climate change on school infrastructure. Parents are expected to make financial or in-kind contributions to the salaries of unsubsidized non–civil servant teachers, who in some cases make up most of the teaching staff. In addition to the overall scarcity of schools, existing schools often lack appropriate facilities and capacity to accommodate all students. Participation in farming and widespread engagement in labor activities interrupt the school trajectories of adolescents (both girls and boys). Although most of the barriers in access to schooling are universal, girls’ chances to complete secondary education are lowered by high involvement in domestic chores, gender-based violence in schools, limited agency, and—above all—child marriage and early pregnancy. • Access to sexual, reproductive, and maternal health services remains limited, especially for adolescent girls and young unmarried women. Malagasy women and girls are largely disadvantaged in knowledge on and access to maternal, sexual, and reproductive health services, as seen from a low share of professionally assisted births (45.8 percent) (DHS 2021) and a high unmet need for contraception (14.6 percent). Maternal mortality rate is also high (335 deaths per 100,000 live births) (WDI 2017). Overall, the scarcity of health centers and prohibitive costs of consultations limit women’s and girls’ access to health services in general. At the same time, young women’s chances of seeking SRH services are further constrained by the lack of reliable sources of information on SRH, absence of quality youth- friendly clinics, and negative social norms that discourage use of family planning services among unmarried women/ women without children. All those barriers contribute to high share of teenage pregnancies (31.1 percent of girls ages 15–19 have begun childbearing) (DHS 2021), which is associated with numerous risks for girls’ well-being, with potential long-term adverse effects for their education, health, employment opportunities, and vulnerability to poverty. • The continuum of barriers to finding good-quality employment disproportionately affects women and girls. Malagasy women are less likely than men to participate in the labor market: 71.3 percent versus 82.4 percent respectively (EPM 2021–22). Moreover, women have limited access to better-quality jobs: only 24 percent of working women are waged employees versus 35 percent of working men, and female employees are over-represented among contributing family workers (14 percent vs. 5 percent of male workers) and in subsistence farming (32 percent vs. 23 12 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar percent respectively) (EPM 2021-22). This lack of access to better-quality jobs can be partially explained by the factual absence of jobs and the existence of legal forms of discrimination that prevent women from undertaking certain jobs (e.g., in the industrial sector). Additionally, young women lack required skills and competencies, knowledge, clear vision and instruments on how to translate their job aspirations into action. Based on the interviews, women also encounter discrimination based on their gender, ethnic origin, and physical appearance in the recruitment process; women in informal employment often face degrading working conditions, low and unstable income, and abuse and sexual harassment by their bosses. • Women and girls are strongly limited in their agency and decision-making power, as manifested in high rates of intimate-partner violence (41 percent of ever- partnered women have experienced at least one of its forms) and child marriage (38.8 percent of women ages 20–24 were married by age 18) (DHS 2021). The onset of family formation occurs at a very early age for many Malagasy girls and young women. For many poor girls and their families, the decision to start a family at a very early age is driven by the lack of means, as the marriage ritual implies economic benefits for the household (a dowry). In addition, widespread negative attitudes toward unmarried women and to out-of-wedlock pregnancies often drive adolescent girls and their families to pursue marriage early, partly in order to comply with social norms and expected patterns of behavior. Importantly, practices of child marriage are diverse and show striking geographical differences. With the exception of the capital Antananarivo, child marriage is often celebrated under customary law. Based on the in-depth interviews and focus group discussions from three regions in Madagascar, several intersecting and interconnected factors drive the observed gender inequalities and affect the ability of Malagasy girls and women to make informed life decisions and to hope for a better life (figure 1). To start with, poverty and lack of means are the major barriers that prevent adolescent girls and young women from accumulating their human capital in education and health, delaying early family formation, and accessing better-quality jobs. Additionally, patriarchal social norms and inequitable gender roles largely drive the observed inequalities: the pressure to comply with socially accepted patterns of behavior drives many young women (especially those from the poor households) to start family formation at a very early age, often compromising their chances to complete their schooling and access better-quality jobs later in life. Moreover, women’s inability to access basic services and participate in economic opportunities can be attributed to limited institutional capacity and service delivery. Finally, vulnerability to shocks and climate change poses additional challenges and disproportionately affects women by exacerbating their burden of domestic work, amplifying food insecurity and malnutrition, and obstructing access to education. Altogether these factors severely restrict the context in which adolescent girls and young women can operate and advance in life, often not leaving them options or choices. Across all themes, even when options or choices are available, young women fundamentally lack agency, or the ability to make decisions and act on them. Importantly, while gender gaps are high overall, women and girls from rural areas and poor households are particularly disadvantaged. Introduction 13 Figure 1. Structural issues affecting gender outcomes in Madagascar according to the qualitative research POVERTY AND LACK OF MEANS AND PATRIARCHAL SOCIAL NORMS INEQUATABLE GENDER ROLES Education AND SERVICES DELIVERY LIMITED INSTITUTIONS Access to SRH Agency and voice Quality of work VULNERABILITY TO EXTERNAL SHOCKS AND CLIMATE CHANGE Source: Original figure developed for this report. Note: SRH = Sexual and Reproductive Health The following sections present the key gender gaps in Madagascar across four dimensions: education, health, economic opportunities, and agency (see table 1). Based on the identification of gaps and barriers in each dimension and on the evidence of what works best, each section provides strategic directions for policy actions that could apply to Madagascar’s context. More detailed findings are presented in the accompanying stand-alone thematic notes: • Note 1: Challenges and Opportunities in Education provides deeper insights into the status of girls’ education in Madagascar. • Note 2: Challenges and Opportunities in Health discusses the status of women’s and girls’ maternal, sexual, and reproductive health in Madagascar. • Note 3: Challenges and Opportunities in Increasing Women and Girls’ Economic Empowerment analyzes the status of women’s and girls’ economic opportunities in Madagascar. • Note 4: Challenges and Opportunities in Enhancing Girls’ and Women’s Agency provides deeper insights into the status of women’s and girls’ voice and agency in Madagascar. 14 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Table 1. At a glance: Key gender gaps and respective barriers in Madagascar Maternal, sexual, and reproductive Girls’ and women’s Education Economic opportunity health agency Gender gaps • Female illiteracy is • Maternal health services are largely • Labor force participation among • GBV is widespread: widespread, especially underutilized: over 50 percent of women (ages 15–64) is high but 41 percent of ever- in rural areas: 28 percent births are not assisted by skilled staff. lower than that of men: 71.3 percent partnered women ages of rural women ages vs. 82.4 percent among men (EPM 15–49 have experienced 15–49 cannot read vs. • Contraception use is low: only 2021–22). some form of intimate 24.9 percent of rural men 49.7 percent of married/partnered partner at least once in (DHS 2021). women ages 15–49 use contraception • The quality of women’s their lives (DHS 2021). (32.3 percent among women from employment remains low: women • School completion rate the poorest wealth quintile vs. 55.4 are overrepresented among • Social norms widely is higher among girls percent among women from the contributing family workers (14 tolerate GBV: 40.6 than boys, on both the richest one) (DHS 2021). percent of all women workers vs. percent of women primary (66 percent vs. 5 percent of men workers), and in justify wife-beating for 61 percent) and lower- • Maternal mortality is high: 335 subsistence farming (32 percent vs. at least one specific secondary levels (36.6 deaths per 100,000 live births (WDI 23 percent of all female and male reason vs. 27.8 percent percent vs. 34.3 percent 2017). employment respectively) (EPM of men (DHS 2021). respectively) (DHS 2021). 2021–22). • Access to health care for women • Child marriage is a is limited: 70 percent of Malagasy • Gender wage gaps are wide, common phenomenon: women ages 15–49 experience at least standing at 28.9 percentage points in 38.8 percent of women one barrier in accessing health care favor of men (EPM 2021–22). ages 20–24 were (DHS 2021). married before age 18 • Women’s financial inclusion is (58.3 percent of women • Adolescent pregnancy is low: only 4.4 percent of women ages from the poorest wealth widespread: 31.1 percent of girls ages 15–49 have a bank account vs. 5.3 quintile vs. 15 percent 15–19 have begun childbearing (47.7 percent of men (DHS 2021). of women from the percent among girls from the poorest richest one). The share wealth quintile vs. 12.2 percent • Rural women face discrimination in reaches 65 percent in among girls from the richest one) land ownership: only 10.7 percent the Sofia region (DHS (DHS 2021). of rural women ages 15–49 own land 2021). alone vs. 24.8 percent of rural men (DHS 2021). Drivers of observed gender gaps • Financial barriers • Barriers in access to maternal, sexual, • Mismatch between the skills • Poverty and lack of (unaffordable costs of and reproductive health services: acquired in school and those means schooling, the necessity demanded on the labor market to prioritize work over • Low coverage of health care • Unequitable gender studies, malnutrition, facilities (lack of hospitals and health • Scarcity of jobs on the labor market roles and patriarchal additional financial care centers, shortage of equipment social norms that and contraception, lack of trained • Low women’s agency and limit women’s agency, expenses due to the [female] medical staff) aspirations in relation to job tolerate GBV, and impacts of the climate seeking discourage seeking SRH change) • Unaffordable costs of treatment, and FP services consultations, contraception and • Nepotism, corruption, and • Infrastructure- and professionally assisted deliveries discrimination (based on sex, • High value attached school-related physical appearance, ethnic origin, to fertility and family barriers (scarcity of • Poor quality of medical services etc.) formation schools, lack of relevant infrastructure, lack • Drivers of teenage pregnancy: • Legal discriminationa • Lack of alternative life of qualified [female] options teachers, poor quality of • Lack of information on SRH and • GBV in the workplace teaching, misalignment contraception (limited knowledge on • Inability to pursue between the school and SRH, myths and misconceptions on • Burden of unpaid domestic work education (due to lack agricultural calendar) contraception; lack of reliable sources and childcare of means) of information on SRH and FP) • Gender-specific • Lack of access to and barriers (child marriage, • Limited access to quality youth- knowledge on SRH early pregnancy, burden oriented family planning services and FP of domestic work, (discrimination of girls in access to school-based GBV, FP services; negative social norms limited girls’ agency) around seeking FP by unmarried women) Sources: World Bank staff compilation based on Demographic and Health Survey (DHS), 2021; Permanent Household Survey (EPM), 2021–22; World Bank, World Development Indicators (WDI), 2017 and 2019. Note: GBV = gender-based violence; FP = family planning; SRH = sexual and reproductive health. a. See appendix B on the list of legal forms of discrimination preventing women’s and girls’ access to the labor market in Madagascar. Introduction 15 Access to education is a challenge for all in Madagascar, but girls face additional gender- specific barriers A ssisting girls and young women in completing primary and secondary education is of the utmost priority for Madagascar. Global evidence shows that women’s education triggers a sequence of improvements in reproductive health dimensions (Kabeer 2005) and is positively associated with women’s decision-making in the household (Riaz and Pervaiz 2018). Each additional year of schooling decreases the risks of early marriage and teenage fertility (World Bank 2012) and increases women’s chances of securing better-quality employment later in life (Habib et al. 2019). Furthermore, women’s education is positively associated with better investments in children’s human capital (Diamond, Newby, and Varle 1998; Klugman et al. 2014; World Bank 2012). It is also a key driver of women’s agency (Klugman et al. 2014). All these factors combined can help lift households, communities, and countries out of poverty and accelerate economic growth (Schultz 1993; Summers 1994). Educational attainment remains low in Madagascar among both men and women, and a significant share of adult women is illiterate. As of 2021, only 3.1 percent of Malagasy women and 3.4 percent of men ages 15-49 had completed lower-secondary education, and about 2.7 percent of women and 3.2 percent of men had completed higher education (DHS 2021). Women are more likely than men to have no formal education at all: 19.5 percent versus 18.7 percent (DHS 2021). Moreover, 23.9 percent of women ages 15–49 are illiterate (vs. 21.4 percent of men). When compared to men, women tend to display lower literacy rates in almost all regions. In some southern provinces, the gender literacy gap is particularly high (for example, up to a 29-percentage-point difference in Menabe) with women at a disadvantage (DHS 2021). At the same time, among children of relevant school age, girls are achieving better outcomes than boys in primary and secondary educational enrollment and completion. As of 2021, 75.4 percent of girls ages 6–10 were attending primary school, compared to 71.3 percent of boys (DHS 2021). Similarly, the net secondary attendance rate was higher among girls than boys ages 11–17 (30.8 percent vs. 27.6 percent; DHS 2021). Significant progress was registered in primary and secondary school completion rates over the past two decades. As of 2019, more girls than boys of relevant school age had completed primary school (66 percent vs. 61 percent) and lower-secondary school (36.6 percent vs. 34.3 percent) (UNESCO statistics database; WDI 2019). The qualitative data findings show that, while all children encounter difficulties in accessing and attaining education in Madagascar, girls face gender-specific constraints. Although girls outnumber boys in school attendance and completion rates, a significant share of Malagasy children of relevant school age has no access to education. Thus, exploring unique challenges and barriers that obstruct access to education in Madagascar offers great instrumental value for enhancing schooling outcomes of all children, and girls in particular. The following paragraphs present those barriers grouped into three broad categories: (1) financial barriers, (2) school-related barriers, and (3) gender-specific barriers (figure 2). Access to education is a challenge for all in Madagascar, but girls face additional gender-specific barriers 17 Figure 2. Barriers that prevent girls’ access to schooling in Madagascar Financial barriers School-related barriers Gender-specific barriers Direct and indirect Shortage of schools/ long distances to Child marriage costs of schooling schools Expenses related to Inadequate school rennovation of infrastructure Early pregnancy school infrastructure damaged due to climate change Lack of qualified (female) teachers Domestic chores Malnutrition Teacher misconduct and poor quality of GBV in schools teaching Child labor (as a consequence of Language of poverty) instruction (French Limited agency rather than local of girls language) Source: Original figure developed for this report. Note: GBV = gender-based violence. First, many households in Madagascar cannot afford schooling for their children because of its associated direct and indirect costs. Parents have to pay registration fees as well as cover the costs of school supplies, lunches, and uniforms. After extreme weather events, parents must also cover unforeseen expenses such as the rehabilitation of classrooms and renovation of damaged infrastructure. Parents are expected to contribute to the salaries of unsubsidized non–civil servant or FRAM teachers,1 who in some cases make up almost the whole teaching staff. Paying tuition is increasingly difficult for poor families and single mothers, especially because tuition increases with grade level. Importantly, in addition to the direct costs of schooling, study participants in all three regions repeatedly mentioned the related issue of food insecurity as an important cause of early school dropout: children affected by undernourishment often come to class hungry, struggle to concentrate, and feel shame, which further demotivates them from pursuing their studies. The inability to pay tuition fees, provide 1 FRAM stands for Fikambanan’ny Ray Aman-drenin’ny Mpianatra, which is the Malagasy equivalent of the association of parents of students. FRAM teachers are those recruited by the community and funded mostly by students’ parents. Often such teachers have no initial training in teaching. Although the recruitment of nonstaff teachers has been prohibited since 2014, the practice continues because of the lack of alternative employment options for recent graduates and lack of school funds allocated to teaching staff. According to the Ministry of National Education statistical yearbook (2020-2021), FRAM teachers represent 62 percent of the teaching staff in Madagascar, of which 19 percent are subsidized by the state and 43 percent are funded by students’ parents. 18 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar lunches, and cover other direct and indirect expenses often interrupts school trajectories of girls and leads to permanent school dropout. Lack of financial means creates the pressure to prioritize work over studies, leading to the high involvement of children in income-generating activities. Evidence from the study shows that parents actively involve their children in farming, which negatively affects school attendance. Many students never return to school after their temporary agricultural work, and those who do return sometimes have a few months’ delay, resulting in age-grade distortion. Parents expressed their willingness to reenroll their children after the cultivation season; however, in some cases, teachers are reluctant to accept students back to school after prolongated absenteeism. Second, in addition to financial constraints, access to schooling is constrained by supply-side barriers. The scarcity of and distance to schools constitute an important physical barrier for school attendance, particularly for girls. In remote and rural areas, the concentration of schools, especially upper-secondary schools, in specific localities forces young people from the surrounding communes to make long journeys to study. Because such journeys are physically exhausting, students arrive in class tired, hungry, and unable to concentrate, which adversely affects their academic performance. Regional evidence indicates that the problem of long distances to schools affects girls more than boys: parents, fearing for the safety and well-being of their daughters on the road, might be reluctant to send them to schools located far from home (Colclough, Rose, and Tembon 2000; Shahidul and Karim 2015). Several interviewees also referred to the limited water, sanitation, and hygiene facilities available in schools; dissatisfactory conditions of school bathrooms; and overall poor conditions of school-relevant infrastructure. Another important school-related barrier is the fact that instruction takes place in French or English, with which many students, especially in rural areas, are not familiar. Madagascar also faces a serious shortage of qualified (female) teachers. Most of the teachers are recruited from among the community members and do not have the qualifications and training necessary to meet teaching standards, and they do not receive training even when integrated into the public service. Study participants reported common misconduct among teachers, including being systematically absent, late, or drunk. Additionally, women are still underrepresented among educational staff, particularly at the secondary school level. As of 2019, women constituted more than half of the teaching staff in primary school (53 percent), but only 41 percent of all educators in secondary school (WDI 2019). Global and regional evidence indicates that recruiting more female teachers is positively associated with improved schooling outcomes among girls (Agyapong 2018; Herz 2002; Mouganie and Wang 2020). Finally, girls are particularly constrained in access to schooling by the existence of gender-specific barriers. First, child marriage and early pregnancy are among the key reasons for girls to drop out of school early with little chance of returning. Additionally, girls’ heavy involvement in domestic chores and unpaid care severely limits their ability to go to school. Girls also reported issues related to school violence and sexual harassment from teachers. Importantly, although young women and girls do place a Access to education is a challenge for all in Madagascar, but girls face additional gender-specific barriers 19 high value on learning, they might lack interest in studies because of doubts about the potential returns from education.2 Girls do not perceive education as a guarantee of better opportunities, because they see no clear benefits of pursuing education in the context of limited economic opportunities. Under such circumstances, girls may lack the interest, aspirations, and knowledge to make informed decisions on pursuing education. At the same time, protective factors for completing education—once the financial, nutritional, and other barriers are not insurmountable—relate to the positive aspects of learning and to a supportive environment and encouragement from their families, friends, and peers. A relationship of trust between teacher and student is another key factor for girls’ success, a finding that aligns with other research globally (Banerjee et al. 2018; Gunderson et al. 2012; Li 1999; Machado and Muller 2018; Tiedemann 2002). Figure 3. Factors that enable and support girls’ education in Madagascar Individual resilence • Clear life goals, aspirations and hope for a better future • High value attached to education • Intention/ willingness to postpone early marriage • Balance between studies, leisure and domestic tasks School-related support Community support School-related support Supportive/ involved Support from friends • Qualified and encouraging parents and relatives teachers • Provision of school meals • Reduced financial costs Source: Original figure developed for this report. 2 The latest available data suggests that returns to education tend to be higher for men than women. For instance, having complete primary education is associated with a 30.4 percent increase in earnings among women vs. 36.7 percent among men, and incomplete secondary education – with a 60.1 percent among women and 64.6 percent among men. However, returns from complete secondary education appear to be slightly higher for women than men (86.4 percent among women and 85.6 percent among men) (EPM 2021–22). 20 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar These findings call for dedicated policy efforts. In the short term, facilitating access to schooling for all children and for girls in particular can be achieved through lifting financial costs of education, e.g., implementing effective school subsidies and ensuring timely and transparent payment of teachers’ salaries. Another critical priority for Madagascar is the implementation of the proposed reform on aligning school and agricultural calendars. Regarding infrastructure, the short-term response could include provision of safe and reliable transportation options and resumption of school canteen initiatives. Finally, adopting regulations to encourage pregnant girls to resume their education free from complex processes for withdrawal and reenrollment will also likely bring significant gains in the short term for girls’ schooling outcomes. Table 2 summarizes the main identified barriers, potential strategic directions, and policy recommendations for assisting girls and young women in Madagascar in completing their schooling. Table 2. Policy recommendations to assist girls and young women in completing schooling Barriers Term Policy recommendations Strategic direction 1: Lift financial constraints to accessing, staying in, and completing school Prohibitive costs of Short term • Implement effective school subsidies by allocating resources to the zero ariary policy and schooling disbursing them timely. • Ensure that salaries of and subsidies to teachers are covered by the state, not by parents. High involvement Short term • Resume efforts to implement the reform to align school and agricultural calendars. of children in labor/ agricultural work Medium term • Offer financial support to vulnerable families through child benefits, and/or financial incentives through unconditional cash transfers, school vouchers, and scholarships. Malnutrition; food Medium term • Expand the government program of canteens in schools, with a focus on the poorest and insecurity most vulnerable areas. • Empower households economically through the provision of food vouchers/subsidies. Strategic direction 2: Address school infrastructure–related barriers and the poor quality of teaching Scarcity and remoteness of Short term • Provide safe and affordable transportation options. schools Long term • Improve availability and access to schools, especially in remote areas. • Provide boarding facilities for girls from rural or remote areas. Lack of adequate and Long term • Improve school-relevant infrastructure and facilities (classrooms, WASH facilities, climate-resilient school electricity supply, provision of separate toilets). infrastructure • Insure school infrastructure against climate-related hazards and provide for repairs. Lack of qualified (female) Medium term • Recruit more civil servant teachers, especially female teachers. teachers Poor quality of teaching; Medium term • Improve the working conditions of teachers and ensure on-time payment of salaries. language barrier • Provide (quality) instruction in the mother tongue beyond the first years of schooling. Strategic direction 3: Eliminate gender-specific barriers in access to schooling, particularly those related to child marriage and early pregnancy School-based GBV Medium term • Enact and enforce anti–sexual harassment policies. • Enforce a child-friendly complaints mechanism to report cases of teacher misconduct. Medium term • Implement GBV sensitization in school-based programs and as teacher certification requirements. Access to education is a challenge for all in Madagascar, but girls face additional gender-specific barriers 21 Barriers Term Policy recommendations Girls’ limited agency and Long term • Develop adolescent empowerment programs to encourage girls to complete their lack of sense of control schooling. over their lives • Provide female peer mentorship and role models. Child marriage and Short term • Adopt regulations to encourage pregnant girls to resume their education free from teenage pregnancy complex processes for withdrawal and reenrollment. Medium term • Provide financial support for adolescent mothers to continue and complete their education. • Promote positive attitudes toward education of pregnant girls and adolescent mothers. Strategic direction 4: Improve adult women’s literacy rates Problem identified Policy recommendations Low levels of literacy Medium term • Provide basic literacy classes for adult women with flexible schedules and childcare among adult women provision. • Organize weekly/monthly community meetings and safe spaces for adult women with the provision of literacy classes. Source: World Bank. Note: ECDE = early childhood development and education; GBV = gender-based violence; WASH = water, sanitation, and hygiene. 22 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Access to sexual, reproductive, and maternal health services remains limited, especially for adolescent girls and young unmarried women E nsuring adequate access to professional health services and preventing maternal mortality matter not only for women’s well-being but also for their families and for economies at large. Evidence suggests that women and girls’ access to health care in Madagascar is likely to be adversely affected by multifaceted negative impacts of climate change and the COVID-19 crisis (de Paz, Gaddis, and Muller 2021; Harivola 2021). For instance, large service disruptions in Madagascar caused by the COVID-19 pandemic have likely left many women without access to facility-based deliveries and family planning (FP) services, which could result in increases in infant and maternal mortality (GFF 2021). Maternal mortality is associated with an increase in infant and child morbidity rates, loss of economic opportunities, and intergenerational transmission of poverty in the families and communities where women die from pregnancy-related complications (Miller and Belizán 2015). Additionally, maternal mortality comes with high financial costs and lost opportunities for children’s education and imposes significant economic shocks on families, often forcing households to resort to negative coping strategies such as borrowing money and selling assets (Kes et al. 2015; Knight and Yamin 2015). Therefore, preventing maternal mortality and ensuring availability and accessibility of health services are likely to bring important economic and social gains for Madagascar. The lack of access to adequate maternal health services appears to be an important driver of the high maternal mortality rate in the country. As of 2017, Madagascar’s maternal mortality rate stood at 335 deaths per 100,00 live births—a decrease from 559 deaths per 100,00 live births in 2000 (WDI). Maternal deaths account for 22.1 percent of all female deaths (MICS 2018). This phenomenon is related to limited access to maternal health services: 10.3 percent of pregnant women ages 15–49 do not receive any prenatal care, and more than half of all pregnant women ages 15–49 (52.6 percent) do not undergo any postnatal examination. Moreover, less than half of all births (46 percent) in Madagascar are attended by a skilled medical professional (DHS 2021). Participants in the qualitative study for this report indicated that, apart from deliveries in the hospital, other options included assistance by midwives (trained professionals), matrons (traditional birth attendants without formal training), or female relatives—or no assistance at all. Madagascar’s total fertility rate (TFR) is high and only slightly above the wanted fertility rate. As of 2021, the TFR was 4.2 births per woman, decreasing from 4.6 births per woman in 2018 (DHS 2021; MICS 2018). A gap persists between rural (4.6 births per woman) and urban (3.2 births per woman) areas (DHS 2021). TFR decreases with wealth quintile, educational attainment level, and delayed age at first marriage. Notably, the wanted fertility rate in Madagascar is also high and only slightly lower than the TFR. In 2021, the wanted fertility rate was estimated at 3.8 births per woman. A significant share of married women and men ages 15–49 report that the ideal number of children is 4 (34.4 percent of women and 30 percent of men reported this preference) (DHS 2021). This tendency confirms that fertility and childbearing are highly valued and accepted in Malagasy society. 24 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar The observed high rate of wanted fertility is among the factors that partly explain low use of contraception among Malagasy women. In 2021, contraceptive use was 49.7 percent among married women ages 15–49 (DHS 2021). The use of contraception among married women differs only slightly by place of residence, although important disparities are observed by region, educational attainment level, and wealth quintile. At the same time, although the use of contraception among married women increased in the past decade, the unmet need for contraception3 remains high, at 14.6 percent. Malagasy girls and women face several challenges in accessing (general) health care services. According to the DHS 2021, 70 percent of Malagasy women ages 15–49 experience at least one barrier in accessing health care. For example, more than half of all women (56.7 percent) report that getting money to pay for treatment is a significant problem. About 33.7 percent of women report long distances to the nearby health facility as a problem in accessing healthcare. The lack of healthcare facilities is particularly urgent in the southern regions, where it is not uncommon to have 35-45 health facilities per 100,000 women ages 15–49, in contrast to 65-75 health facilities per 100,000 women ages 15–49 in the western and eastern regions (2018 Madagascar Census). Notably, these problems affect rural and urban women nearly equally, but with important differences observed by wealth quintile and level of education. Women interviewees in the qualitative study reported the lack of health facilities and related infrastructure as one of the main reasons for not accessing official health services. Despite the presence of a basic health center for first contacts in some communes, most rural areas have no professional health care facilities. The inequitable spatial distribution of the (female) medical workforce is also a barrier to access to care for girls and young women in the areas studied. Indeed, study participants reported that, even when medical facilities exist in their area, those facilities lack doctors. Even more important, women appear to be reluctant to consult with male doctors in maternal units because of feelings of shame. Furthermore, according to our study participants, the costs of health care are high and prevent women from seeking professional maternal, sexual, and reproductive health care. The need to pay for contraception was reported as one of the factors preventing interviewees from using it when they had no alternative FP services available free of charge. In addition, the costs of medical consultations and professionally assisted childbirth are beyond the economic means of most women, which explains the high popularity of matrons, especially in rural and remote areas. Importantly, in Atsimo- Atsinanana, women are requested to pay slightly more for the birth of a boy than of a girl, regardless of whether they give birth in a hospital or at a matron’s house. Women are also required to cover the costs of potential surgical interventions, such as cesarean delivery, and of transportation. 3 Women with unmet need for contraception are those who are fertile and sexually active but not using any method of contraception, and who report not wanting any more children or wanting to delay the next child. Access to sexual, reproductive, and maternal health services remains limited, especially for adolescent girls and young unmarried women 25 Moreover, many young women reported the poor quality of services offered at medical centers as an obstacle. Participants in the sample noted dissatisfaction with doctors’ treatment, believing that the services received were not helpful for their condition. It also appears that women have a general low trust in doctors and professional health care. Such low confidence in professional health services could potentially be attributed to women’s inability to benefit from those services because of the prohibitive costs of care and the scarcity of facilities, equipment, and medical staff. Partly because of the above-mentioned barriers in access to maternal, sexual, and reproductive health services, adolescent fertility is a common phenomenon in Madagascar. Madagascar’s adolescent fertility rate of 104 births per 1,000 women ages 15–19 is above the average of 98 in the Sub-Saharan Africa region (WDI 2020). According to DHS 2021 data, 31.1 percent of adolescent girls ages 15–19 have already begun childbearing.4 Teenage pregnancy is associated with numerous risks for girls’ well-being, with potential long-term adverse effects on their education, health, and employment opportunities. Interviewees reported teenage pregnancy as one of the main reasons for dropping out of school with little chance of returning. On the one hand, pregnant girls often drop out because they encounter bullying and mocking by peers. On the other hand, teenage pregnancy imposes a significant economic and financial burden on young women, forcing them to combine care and work activities right after childbirth. Importantly, although in most cases marriage precedes childbearing in Madagascar (in line with the evidence from many other Sub-Saharan African countries),5 in some cases pregnancy can be the reason for rushing girls into a union. In the southern region in particular, fear of having an unmarried pregnant daughter pushes parents to formalize a union for their daughter as soon as she begins a relationship with a partner. Child marriage appears to be a key driver of teenage pregnancy in Madagascar. In addition, teenage pregnancy can be partly linked to the aforementioned supply-side barriers, such as lack of health care facilities, limited availability of contraception and FP services, lack of medical staff, and so on. Finally, teenage pregnancy in Madagascar is also driven by the lack of information on sexual and reproductive health (SRH) and contraception, as well as by limited access to quality youth-oriented FP services. Young women interviewees exhibited very limited knowledge about SRH and contraception. In all three regions visited, women reported receiving their first information about menstruation from their mothers, sisters, or teachers with very limited explanations. In fact, detailed explanations on the relationship between menstruation and sexual activity are often missing, likely because of the general stigmatization of the topic; the weight of tradition, which creates distance between 4 This share includes adolescent girls ages 15–19 who have already given birth and have been or are pregnant with their first child. 5 Findings from our study show that most early childbirths take place after marriage in Madagascar, and the same tendency is observed in many other countries in Sub-Saharan Africa, such as the Republic of Congo, Ghana, Mali, Mauritania, Mozambique, Niger, and Zambia (see, for example, Male and Wodon 2016). There is also evidence that in some countries (for example, Angola) early pregnancy occurs before marriage and is the driving force behind forming a union (Machado, Kalle, and Muller forthcoming). 26 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar parents and children, makes it difficult to discuss SRH. Similarly, there appear to be many misconceptions and myths regarding the use of contraception. Many believe that FP represents a danger to the health of women who use it. Apprehension and concern about the use of contraceptive methods by young women who have not yet given birth are prevalent. For instance, young women in Antananarivo expressed fears of becoming infertile if they use contraceptive methods, and girls in Atsimo-Atsinanana reported that contraceptive methods could make them sick and give them headaches. Low levels of knowledge on SRH and contraception can be partly attributed to the lack of reliable and credible sources of information. For instance, schools—often young women’s first source of information on SRH—generally lack comprehensive sex education as part of the curriculum, meaning that SRH-related topics are only discussed briefly during science classes. Similarly, existing media campaigns on SRH and FP have limited outreach: the broadcast of radio campaigns in the official Malagasy language means that some communities in the provincial regions (where people use local dialects) might be unable to understand the messages. Some women also receive SRH and contraception information from social media, because they fear going to a health center and encountering social judgment. Receiving FP information from sources other than official health centers or trained educators, however, can pose certain risks to women’s health, especially for women who have preexisting health conditions that require medical consultations. Finally, lack of access to quality youth-friendly FP services is yet another important driver of teenage pregnancy. Despite legal provisions recognizing the right of all individuals to access SRH,6 adolescent girls and young women continue to be constrained in their ability to benefit from those provisions. In our sample, participants in Antananarivo reported cases of young women going to health centers specifically to receive SRH information, but such cases are not frequent. Broader evidence from our study suggests that SRH services and FP efforts are targeted toward pregnant women and mothers, rather than as a preventive measure for younger women or those who have not yet begun childbearing. Moreover, unmarried women might feel discouraged from seeking SRH and FP services, fearing negative and judgmental reactions from their family or community. These findings are in line with the global literature: in many developing countries, young women and adolescent girls report being discouraged from accessing SRH services for fear of receiving a negative reception from clinic staff and community members (Kiluvia and Tembele 1991; Otoide, Oronsaye, and Okonofua 2001; Rasch et al. 2000; Richter and Mlambo 2005; Wood and Jewkes 2006). These findings call for dedicated policy efforts. Priority policies should focus on alleviating financial barriers to health care, which can be achieved through the provision of vouchers and subsidies for vulnerable populations, including for coverage of transportation fees and medication. Moreover, specific actions are required to improve the code of conduct of medical personnel and guidance on communication with patients. In addition, improving girls’ knowledge on SRH, FP, and prevention 6 Law No. 2017-043 of January 25, 2018 setting the general rules governing Reproductive Health and Family Planning. Access to sexual, reproductive, and maternal health services remains limited, especially for adolescent girls and young unmarried women 27 of pregnancy is essential so that they can make decisions about the timing and composition of their families. Improving such knowledge and decision-making will not be possible, however, without training and sensitizing health care staff on how to work/ communicate with adolescent/ young patients. Table 3 summarizes the main identified barriers and policy recommendations for enhancing access to maternal, sexual, and reproductive health services and reducing Madagascar’s teenage pregnancy rate. Table 3. Policy recommendations to improve access to professional health care by Malagasy women and girls Barriers Term Policy recommendations Strategic direction 1: Address supply-side barriers in access to maternal, sexual, and reproductive health services Low coverage of health Long term • Improve availability and accessibility of maternal health care services. care facilities • Expand access to frontline health care providers. Prohibitive costs of Short term • Provide vouchers and subsidies for health care for vulnerable populations, including for treatment transportation fees and medication. Preference for traditional Medium term • Acknowledge and address the important role of traditional medicine. birth attendants (partly because they are more • Educate and sensitize pregnant women on how to recognize dangerous symptoms during affordable) pregnancy. • Educate traditional healers and midwives to treat pregnancy complications. Staff misconduct Short term • Train medical staff on effective communications with patients. Strategic direction 2: Improve girls’ knowledge on SRH, FP, and prevention of pregnancy Low levels of knowledge Medium term • Improve the availability of technical and reliable information on contraception and its use, and existence of especially in schools, by expanding existing initiatives. misconceptions on the use of contraception • Strengthen education, edutainment, and social marketing and develop awareness-raising campaigns on SRH to counteract misconceptions and harmful beliefs around the use of contraception. Strategic direction 3: Enhance access to youth-friendly SRH services, and empower girls and young women to seek them Inadequate access to SRH Short-term • Train and sensitize health care staff on how to work/ communicate with adolescents/ health services especially young patients. for adolescents and young women. Medium term • Establish youth-friendly clinics and set up guidelines for implementation of quality standards for clinics. Limited girls’ agency in Long term • Create a supportive environment for girls’ school education.a decisions on pregnancy and seeking SRH services • Use community mobilization programs and adolescent empowerment programs to encourage girls to delay family formation. Source: World Bank. Note: FP = family planning; SRH = sexual and reproductive health. a. See Note 1, “Challenges and Opportunities in Education.” 28 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar The continuum of barriers to finding good- quality employment and accessing productive assets disproportionately affects women and girls P romoting women’s access to economic opportunity offers a wide variety of benefits not only for women themselves but also for their families, their communities, and societal and economic development at large. Based on the global evidence, economic empowerment expands the role of women in the household and society, because of its association with increased decision-making power (Acharya et al. 2010), reduced vulnerability to gender-based violence (Aizer 2010; Lenze and Klasen 2017; Vyas et al. 2015), and increased likelihood of delayed early marriage and fertility (Chakravarty, Das, and Vaillant 2017). Moreover, improving women’s economic status positively affects household consumption and food security and brings gains for future generations (Burroway 2015; Doss 1996). At the same time, enhancing women’s labor force participation (LFP) is likely to bring macroeconomic gains, being associated with an increase in national gross domestic product (Aguirre et al. 2012). Conversely, lack of effort to improve women’s economic opportunity is associated with income loss and reduced labor productivity (Cuberes and Teignier 2016), as well as heightened vulnerability to poverty and shocks (Faborode and Olugbenga Alao 2016; Wei et al. 2021). Malagasy women are less likely than men to participate in the labor market. Although women’s LFP is high in Madagascar (71.3 percent in 2021), it is still lower than that of men (82.4 percent) (EPM 2021–22). The gender gap in participation persists among young population (ages 15–19), albeit to a smaller extent (a 53.4 percent LFP rate among men vs. a 47.8 percent rate among women of that age group; EPM 2021–22). Agriculture remains the most important sector of employment for both women and men. As of 2021, 39.4 percent of employed women worked in agriculture, compared to 48.7 percent of employed men (excluding subsistence farming) (EPM 2021–22). Female workers are more likely than male workers to concentrate in low-quality jobs and to receive lower wages. For example, women are overrepresented among contributing family workers (14 percent of all female workers vs. 5 percent of all male workers) and in subsistence farming (32 percent vs. 23 percent of all female and male employment, respectively). Only 24 percent of female workers are wage employees compared to 35 percent of male workers (EPM 2021–22), meaning that a vast majority of all women are concentrated in the informal sector. Informality poses threats for women’s income generation, and its association with lower productivity and limited security might further amplify poverty traps (Aga et al. 2021; Fernández and Meza 2015). At the same time, men are slightly more likely than women to be self-employed (31 percent vs. 27 percent). Finally, earning differentials between men and women persist; as of 2021, the median monthly earnings were 150,000 MGA (US$34.1) among working men and 106,666.7 MGA (US$24.2) among working women, meaning that the gender wage gap in Madagascar stood at 28.9 percentage point in favor of men (EPM 2021-22). The limitations that women encounter in access to better-quality employment can be partly attributed to different forms of legal discrimination as well as to harmful social norms. Women in the formal sector face legal barriers to access employment in certain types of jobs, sectors, and industries.7 At the same time, women’s limited 7 For example, Labor Code (Articles 85, 93, and 99) and Decree No. 62-152 of March 28, 1962 (Articles 1 and 7) restrict women from working in jobs deemed dangerous or in certain industries. For more legal restrictions in economic opportunities see appendix B. 30 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar access to quality employment results also from harmful social norms and traditional values. The recent Afrobarometer Round 7 survey highlights those values: 24 percent of men and 16.6 percent of women strongly agree that men should have an advantage over women in getting a job when resources are scarce.8 In addition, most surveyed individuals supported the statement that it is better for a family if a woman has the main responsibility for taking care of children and the household (42.4 percent of respondents strongly agree and 43.1 percent agree). Based on our qualitative study findings, the low quality of women’s employment in Madagascar is the outcome of multiple barriers. According to the qualitative findings, women encounter obstacles at different stages of their professional lives—from their job search to recruitment and hiring, and finally in the workplace. Some barriers preventing access to good-quality jobs affect both women and men, whereas some are gender specific. Figure 4 summarizes the continuum of barriers that prevent women from finding a good-quality job in Madagascar. Figure 4. Barriers preventing women from finding a good-quality job in Madagascar In the workplace (the case Job search stage Recruitment/ hiring stage of informal employment) Lack of qualifications needed Corruption and nepotism in GBV and sexual harassment in the labor market the recritment process at workplace Limited work opportunities, Discrimination in hiring based especially in rural areas on gender and physical Degrading working conditions appearance Lack of expextations and Occupational gender Lack of legal protection aspirations among segregation and security young women Low and unstable income Women’s burden of domestic chores exacerbated by climate change Source: Original figure developed for this report. Note: Boxes outlined in red present gender-specific barriers. GBV = gender-based violence. 8 Afrobarometer 2016/18, https://www.afrobarometer.org/countries/madagascar/. The continuum of barriers to finding good-quality employment and accessing productive assets disproportionately affects women and girls 31 To start with, the ability to find better-quality employment is limited for all individuals in Madagascar by the overall scarcity of jobs and the mismatch between skills acquired in school and those required in the labor market. In all three regions, interviewees emphasized the lack of jobs as a serious problem that often drives young people to face unemployment or end up working in precarious jobs. Additionally, the gap between school or university qualifications and job requirements presents a clear problem for young people. Holding a diploma does not guarantee the ability of applicants to perform the tasks associated with a given position. Particularly in rural areas, where the main source of employment is agriculture, school diplomas do not offer any advantages for recent graduates. Overqualification concerns a significant number of graduates, who are forced to do the same work as those without formal education unless they seek opportunities elsewhere. At the same time, women encounter gender-specific barriers that further reduce their chances of finding better-quality employment. For instance, although the lack of qualifications affects all young people, it affects young women more than young men. Vocational training opportunities seem to be more accessible for young men, equipping them better for skilled work opportunities, compared to women. In addition, young women have difficulty envisioning their economic future or a pathway into better-quality work, likely because of their limited agency, low sense of control over their lives, and inability to hope for a better future. Finally, traditional social norms regarding women’s and men’s roles in the private and public spheres constitute a key factor in preventing young women´s labor market inclusion and their access to quality jobs. Participants in the study repeatedly mentioned that girls are expected to help mothers with housework and to prepare for future marriage and motherhood. Importantly, although aware of the negative consequences of their extensive domestic work duties, young women in the sample appeared to internalize such attitudes and comply with the traditional division of duties in the household—potentially as a way to be accepted and valued in their family and community. At the job hiring stage, interviewees frequently cited corruption as an integral part of the recruitment process in both the private and public sectors, which particularly affects young woman. Interviewees reported demands for bribes, requests for sexual favors, and favoritism toward family members. The necessity to pay bribes presents a real obstacle for young women who have difficulty collecting the required amount of money. Some young women went into debt in order to be hired or gave up their first salary payment for that purpose. Evidence from the study also indicates that some young women are forced to engage in transactional sex in order to get a job. In the absence of a regulatory framework, recruitment is left to the discretion of local administrative officials, which gives rise to corruption. Young women are also subject to multiple forms of discrimination during the recruitment process. In the capital, some participants mentioned that recruiters, especially if they are men, give advantage to attractive women who dress well. In addition to physical beauty, recruiters often discriminate on the basis of skin color, which results from prejudice regarding ethnic origin and affects both women and men. 32 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Motherhood, or the idea that a woman can become a mother at any time, adds to recruiters’ reluctance to hire female job applicants. In Antananarivo and the Atsimo- Atsinanana region, mothers reported difficulty finding work because employers assume that all of the women’s energy and availability are taken up by childcare and household duties. Women also face discrimination in access to physically demanding jobs: even when they are willing to engage in such jobs, they are denied because of the potential risks to their (maternal) health. Moreover, jobs in the technical and science fields are often considered the prerogative of men. Even in technical high schools, social perceptions about typical female and male skills push young women and men into different fields of study. It appears that young women who have pursued technical education end up in low-income jobs whereas young men have access to better jobs. Because of the difficulties outlined above, informal employment becomes one, if not the only, option available to many Malagasy women.9 Although informal jobs are easier to obtain, they are associated with a number of risks for female workers. Because they work without a written contract, informal employees can easily lose their job and income at any time, depending on the availability of work and customers. Moreover, informal workers are not covered by social protection programs, making them particularly vulnerable to various shocks (Guven, Jain, and Joubert 2021). The qualitative data collected show that young women who work informally are often exposed to abuse by employers and face undignified working conditions (for example, needing to work long hours or at night and being underpaid). Whether engaging in formal or informal work, women find that their domestic tasks affect their professional activities. Childrearing, childcare, and the burden of domestic work are time-consuming. In rural areas, young women’s tasks also include fetching water. All of these burdens fall on women and prevent them from participating actively at work and developing professionally. Apart from the difficulties in accessing employment opportunities, women also have limited access to formal financial services, with the exception of mobile money. In 2021, only 4.4 percent of women ages 15–49 had and used an account at a bank or other financial institution, compared to 5.3 percent of men. Nearly no woman or man without formal education and from the lowest wealth group has a bank account. The use of a bank account increases with level of education, and the increase is more pronounced for women than for men (DHS 2021). Although Madagascar performs well in terms of establishing legal equality between men and women in signing a contract, registering a business, and opening a bank account, it does not have legislation in place prohibiting gender-based discrimination in access to credit (WBL 2023). Notably, more women than men ages 15–49 use their mobile phones to conduct financial transactions (56.4 percent vs. 45.6 percent; DHS 2021). The use of mobile money is positively associated with educational level, wealth quintile, and living in an urban area. 9 According to the report of the 17th International Conference of Labor Statisticians, informal employment is characterized by noncompliance “with national labor legislation, income tax, social protection or the right to certain employment benefits (e.g., notice of termination, severance pay, paid annual or sick leave, etc.).” The continuum of barriers to finding good-quality employment and accessing productive assets disproportionately affects women and girls 33 With respect to other types of assets, women in Madagascar face discrimination in landownership. Although both men and women have the legal right to own land in Madagascar, in practice the vast majority of land belongs to men (USAID 2016). According to the latest DHS (2021), only 9.4 percent of women ages 15–49 own land alone, compared to 24.1 percent of men. At the same time, more than half of all women (58.8 percent) do not own land, in contrast to 43.7 percent of men. The share of women landowners decreases as level of education and wealth quintile go up. Despite the recognized value of women’s secure land tenure, customary practices often disadvantage women because of their matrimonial status, especially in rural southern areas. Because of the expectation that women will leave the family house when they get married, they systematically lose the right to inherit land. Women join their new home without any assets, which accentuates their financial and economic dependence on their husbands. Study participants in Atsimo-Atsinanana reported that women there have only two options to secure a land plot: either they buy it with their own money or their father or brother grants it to them. In the Sofia region, however, women have the same right to inheritance as men. In summary, access to quality employment is still limited for Malagasy women, who are deprived of the ability to own property and land, and to access productive assets. Malagasy women tend to have lower-quality jobs than men do, and vocational training opportunities are more easily accessible for young men, albeit such opportunities are overall scarce. As a result, young women often remain unemployed or end up working in precarious jobs that do not require specialization. Despite equal rights provided by law, customary practices and negative social norms can place women at a disadvantage in access to employment opportunities and productive assets. These findings call for dedicated policy efforts. In the short term, policy measures could focus on eliminating discrimination in the recruitment process through establishing clear and transparent protocols for recruitment for public sector jobs and allowing women to undertake all jobs in the same manner as men. Additionally, measures such as career and counseling services, in-company training opportunities, and professional career guidance services will be of special value to facilitate the school- to-work transition. Importantly, even though the share of formal female employees is very low in Madagascar, special policies should be undertaken to improve their working conditions, particularly through taking action to fight workplace gender-based violence and protect the survivors. Table 4 summarizes all policy recommendations for enhancing women’s economic opportunities in Madagascar. 34 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Table 4. Policy recommendations to improve women’s economic opportunities Barriers Term Policy recommendations Strategic direction 1: Enhance women’s access to better-quality jobs Mismatch between Short term • Provide opportunities for in-company training. education and skills demanded by the labor Medium term • Adapt education to the real demands of the labor market, especially in rural areas and market among girls. • Assist young women in developing their technical and life skills through facilitated access to training programs, including vocational training, particularly in the digital sector. Lack of jobs Long term • Expand productive economic inclusion programs with a gender-responsive design and targeted at vulnerable women. • Invest in rural markets and value chains that can generate better jobs for youth in rural areas. Limited vision regarding Short term • Improve information and guidance available to young women on professional careers. job preferences and prospects of girls and Medium term • Offer programs combining social and economic empowerment to adolescent girls. young women • Expand girls’ aspirations and access to networks and knowledge dissemination (for example, female role models and mentorship programs). Strategic direction 2: Eliminate all forms of discrimination and corruption facing Malagasy women in the labor market Nepotism, corruption, Short term • Establish clear and transparent protocols for recruitment and selection for public sector and discrimination in the jobs. job recruitment process Legal discrimination Short term • Allow women to work in all jobs, including industrial jobs and jobs that seem dangerous, in the same manner as men. • Mandate equal remuneration for work of equal value. Strategic direction 3: Improve the working conditions of women in the informal economy GBV in the workplace Short term • Enforce legislation against different forms of GBV and other forms of violence. • Set up a functioning grievance redress mechanism for reporting cases of GBV. Long term • Ensure the availability of protection services for GBV survivors. Burden on women of long Long term hours of unpaid domestic • Promote affordable early childhood programs and access to ECDE facilities. work and childcare Strategic direction 4: Improve women’s access to finance and secure rural women’s land rights and ownership Rule of customary law Medium term • Establish default or mandatory joint titling of land for married/cohabiting couples. that prevents rural women from owning land • Ensure enforcement of statutory laws with regard to inheritance rights. • Explore subsidies conditional on joint titling. Women’s limited access Medium term • Offer specific programs that facilitate access to finance (through grants, credit, and so on) to finance to women entrepreneurs. • Explore the use of alternatives to collateral (such as psychometric testing). • Expand access to finance by women through mobile money services and digital financial inclusion. Source: World Bank. Note: ECDE = early childhood development and education; GBV = gender-based violence. The continuum of barriers to finding good-quality employment and accessing productive assets disproportionately affects women and girls 35 Women and girls face limitations to their agency and decision- making, particularly in the domain of family formation M alagasy women and girls face significant limitations with respect to their voice and agency. Agency is understood as one’s ability to make informed decisions and to transform them into desired actions and outcomes (Donald et al. 2017; Kabeer 1999; Sen 1985). It refers to the individual’s freedom to express their choice and voice, have a sense of control over their lives, and pursue preferred life goals. Women’s agency matters for their own well-being, because it is crucial for their ability to build their human and social capital, take up economic opportunities, participate in household and community decision-making, and live a life free of violence and discrimination. Women’s agency is also instrumental for families, communities, and society at large, because of its association with better chances for future generations and increased inclusion and diversity of social organizations and political institutions (World Bank 2012). Nevertheless, despite progress in the country’s institutional framework on gender equality,10 some critical issues persist, especially regarding women’s decision- making status and the prevalence rate of different forms of gender-based violence (GBV) including child marriage. Preventing GBV, and child marriage in particular, is critical—not only as a question of justice but also as a key to improving other development outcomes. Women survivors of GBV suffer from isolation, inability to work, loss of wages, higher medical costs, job instability, lack of participation in regular activities, and limited ability to care for themselves and their children (WHO 2019). On average, victims of GBV lost between 43 and 47 productive days of work during the year studied (Varna-Horna 2015). Children of families in which there is intimate partner violence (IPV) also suffer a range of negative outcomes. Studies show negative links between exposure to domestic violence and school outcomes (Lloyd 2018), and negative impacts linked to the intergenerational persistence of violence (World Bank 2012). Children exposed to violence are more likely to become perpetrators or victims of violence as adults (WHO 2017). Child marriage produces negative impacts for girls, their children, their communities, and society at large. A recent study by Wodon, Male, et al. (2017) finds large and significant impacts of child marriage on fertility, population growth, education, and earnings. The study estimates the benefits of ending child marriage, including an 11 percent reduction, on average, in the national total fertility rate; an approximately 75 percent reduction of the share of girls having children before the age of 18; and a 1 percent increase in the population’s earnings and productivity nationally. 10 In the past decades, the government of Madagascar has undertaken several initiatives to strengthen women’s agency. For instance, the country has signed several international and regional conventions regarding women’s rights and gender equity, and has adopted the National Strategy for Combatting Gender-Based Violence (GBV) (2017–2021), National Strategic Plan on Child Marriage (2018–2024), and a new law protecting women from different forms of GBV (Law N°009/2019 related to combating gender- based violence). Women and girls face limitations to their agency and decision-making, particularly in the domain of family formation 37 Despite the various policy and legal frameworks supporting the advancement toward gender equality, in practice women enjoy less decision-making power than men in the public spheres. As of 2021, women in Madagascar held only 18 percent of seats in the national parliament, down from 21 percent in 2016 (WDI). Women’s level of participation within decentralized authorities is also low. According to the country’s National Electoral Commission, as of 2016, no woman was head of a region, only 18 percent of heads of districts or prefects were women, and only 5 percent of mayors and 6 percent of local councilmembers were women (Harivola 2021). The qualitative data collected for this report reveal strong regional disparities regarding women’s participation in social life. For instance, in Sofia and Analamanga, women are widely encouraged to form associations, and awareness-raising campaigns are dedicated to this subject. The situation is quite the opposite in the Atsimo-Atsinanana region, where women’s public role in the community is almost nonexistent; however, traditional leaders in the Atsimo- Atsinanana region expressed a certain openness with respect to the possible integration of women, especially when hearing positive examples of women’s social participation in other districts. Within the household, Malagasy women seem to have good decision-making power— although that power is still limited when compared to men’s. According to DHS 2021, only 2 percent of women ages 15–49 do not participate in major household decisions, and figures vary only slightly across regions and by place of residence. Additionally, women are largely involved in decision-making about reproductive health and family planning: in only 5 percent of cases was the decision to use contraception among married women ages 15-49 undertaken mainly by their partner (DHS 2021). Nevertheless, the qualitative data collected indicate the nuances of limitations in decision-making power in the household. For instance, in the Atsimo-Atsinana region, fathers have the final say regarding, for instance, children’s education. The constraints to women’s household roles and decision-making in that region are largely due to patriarchal social norms that restrict women’s roles to those of mothers and caregivers. According to the law, only a man can be the legal head of a household.11 One of the starkest negations of women’s agency and capacity to make their own decisions is the high prevalence of different forms of GBV. According to DHS 2021, 41 percent of ever-partnered women ages 15–49 have experienced physical, sexual, or emotional IPV in their lifetimes. IPV is supported or reinforced by gender norms and values that put women in a subordinate position to men. In Madagascar, women are consistently more likely than men to justify wife-beating: 41 percent of women and 29 percent of men ages 15–49 report that wife-beating is justified in at least one circumstance. Importantly, according to the global evidence, the economic tensions and confinement measures related to COVID-19 have put women and girls at increased risk of violence (Bradbury-Jones and Isham 2020; De Paz Nieves, Gaddis, and Muller 2021; Peterman, O’Donnell, and Palermo 2020; UN Women 2020). In Madagascar, too, income loss and limited mobility, compounded by existing gender role expectations, have likely contributed to increases in IPV and other forms of GBV. 11 Law no. 2007-022 of August 20, 2007 on marriage and matrimonial regimes, Art. 54. 38 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar In addition to IPV, Malagasy girls are exposed to the risk of other forms of violence, abuse, and exploitation. According to rights experts appointed by the United Nations, child sex abuse and prostitution are widespread and conducted openly in tourist hot spots, nightclubs, massage salons, and hotel establishments (CRC 2022; United Nations 2022). Additionally, sex and human trafficking is an important problem in Madagascar, particularly affecting women and girls from rural and coastal regions and those from impoverished families in urban areas (US Department of State 2021). Despite the high prevalence of GBV in Madagascar, findings from our qualitative study indicate that care services for GBV survivors are limited and women often lack awareness or knowledge about available support. Some of the available care centers are supported by the government and operated across the country, whereas others are managed by private actors and are mainly concentrated in the capital area. Some of the mentioned services include the Integrated Center set up by the Fitia association and chaired by the First Lady, the Tabita center set up by the Protestant church, the Trano Aro Zo counselling center, the ASEFFEMA12 association, and the Vonjy Center. Nevertheless, even though support services for GBV survivors do exist, they lack adequate infrastructure and qualified personnel. Key informants emphasized the lack of comprehensive psychological counseling for GBV survivors in the country, as well as the lack of capacity to temporarily house GBV survivors. Finally, the majority of women survivors of violence do not know about the existence of support services, and the few survivors who do receive care report dissatisfying conditions and treatment at the support centers. Child marriage is a form of violence, with devastating effects on the lives and development of girls and adolescents. Child brides face increased risks of poor health outcomes, having children at younger ages, dropping out of school, earning less over their lifetimes, and living in poverty when compared to their peers who marry later (Wodon, Tavares, et al. 2017). Young women who marry before the age of 18 may also be more likely to experience IPV, restricted mobility, and limited decision-making. Despite the legislative prohibition13 of child marriage, the practice continues widely. The latest data from DHS 2021 show that 38.8 percent of Malagasy women ages 20– 24 were first married by the age of 18, and 12.7 percent by age 15. At the same time, only 11.2 percent of men ages 20–24 were first married and age 18, and none was first married by age 15. In all regions, girls are exceptionally more likely than boys to be 12 Association pour la Sensibilisation et Education des Femmes et Enfants Maltraités (Association for the Sensitization and Education of Women and Children who Experienced Abuse). 13 In 2007, the Law on Marriage and Matrimonial Regimes was amended to increase the legal age of marriage to 18 years for both women and men. An exception, however, allows the Court to authorize the marriage of minors. Such authorization can be granted if the marriage is entered into for “serious reasons” not specified by the law, and if the request and consent of the child’s parent are provided. Women and girls face limitations to their agency and decision-making, particularly in the domain of family formation 39 married as children. In some regions of the country (for example, Sofia), as many as 65 percent of women ages 20–24 were first married by age 18. According to the qualitative study, in Sofia and Atsimo-Atsinanana, the age at first marriage can be even lower for girls (12, 13, or 14 years). Based on the qualitative study, the legal registration of marriage is typical only for the capital Antananarivo. Families in Antananarivo typically celebrate a legal or administrative marriage at the Town Hall as well as a religious marriage in church, which reflects the high value attached to Christian beliefs. The celebration of a religious marriage represents an important event in the life of the Malagasy couple and their respective families. Notably, unlike in other studied regions, a marriage ceremony in the capital Antananarivo is not based on ancestral customs. In two other regions, research participants reported the existence of various marriage traditions that are commonly celebrated in accordance with customary law. The fact that most marriage rituals imply economic benefits for girls’ families and are associated with a high social value and prestige can partly explain the high prevalence of child marriage in the studied regions. Despite the geographical distances between the regions, two of the most frequently mentioned marriage traditions (Moletry14 in Sofia and Fafy15 in Atsimo-Atsinanana) offer several similarities: (1) prior arrangement between the parents of the future bride and groom; (2) use of a zebu and money as a bride’s dowry; (3) little latitude left to the young women in the decision about the marriage; and (4) community involvement in the ritual. Child marriage in Madagascar persists for a number of reasons, and both young women and their families appear to play a significant role in perpetuating this practice. To discuss the variety of factors that drive child marriage in Madagascar, we first discuss girls’ reasons for deciding to marry and then families’ (parents’) reasons for marrying off their adolescent daughters (figure 5). 14 Moletry is characterized by an agreement between the parents of the spouses-to-be, followed by the handing over of the didin-karena (marriage dowry, composed of a zebu—a type of cattle—and a sum of money) to the girl’s parents. The Moletry contract is valid for one year, after which the spouses choose either to continue their marriage or to separate and start a new relationship. If the union lasts for at least one year, a woman benefits from the didin-karena. If, however, during the first year the woman decides to separate without having serious cause (for example, no adultery committed by her spouse), her husband’s parents keep the dowry; such a result would be considered a dishonor for her and her family, and the woman would not be entitled to possess any shared property. 15 In Fafy, a man comes to the parents of the girl and asks for the permission to marry her. In some cases, parents of both spouses-to-be meet and make agreements on the marriage. In this ritual, the blessing for the marriage is obtained through the handing over of a zebu by the parents of the future husband to the family of the young woman. The public celebration of the marriage represents parental blessing for their children and is associated with great honor for the girl’s status within the community. 40 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Figure 5. Drivers of child marriage in Madagascar Girls’ reasons to pursue Parents’ reasons to marry marriage: their daughters: Aspirations to escape poverty and unfavorable environment at home Poverty and financial difficulties AA; S A desire to guarantee a good future for A desire to be independent from their their daughters through arranging a parents/ make treir parents proud marriage with “a good family” AA Prestige of having a married daughter/ To avoid/ in response to early shame of having a daughter who is pregnancy; negative attitudes toward pregnant out of wedlock single mothers Social expextations and norms No other life options available No resources to pay for girl’s AA education Romantic feelings; falling in love Compliance with the Christian TANA religion (concept of virginity) Source: Original figure developed for this report. Note: Unless specified otherwise, presented barriers are typical for all studied regions. AA = Atsimo-Atsinanana; S = Sofia; TANA = Antananarivo. In all three regions studied, young women might decide to pursue marriage because they desire independence from their parents. In this respect, marriage is the only available option for Malagasy girls to separate from their parents. As such, a girl wanting to escape psychological or material violence or an unfavorable family climate may see marriage as a form of emancipation. Unfortunately, entering into a marriage does not always provide a refuge or safe space for young women—and can end up amplifying their financial problems and vulnerability to violence. Alternatively, young women may pursue marriage because of their aspirations to acquire improved social status and bring honor and pride to their family. Malagasy society highly values the institution of marriage: whereas marriage is considered a source of pride for young women and their families, being single or unmarried might result in social stigmatization and discrimination. In fact, many participants reported the high prevalence of negative attitudes toward unmarried (young) women. Participants in all three regions also emphasized that a girl’s status in the community changes positively once she becomes a married woman. Furthermore, the decision to get married might be driven by the desire to avoid pregnancy out of wedlock. Although fertility is highly valued in Madagascar and children are regarded as a blessing and wealth, no such attitudes are expressed toward pregnancies that precede the marriage ceremony. Both young women and parents in Women and girls face limitations to their agency and decision-making, particularly in the domain of family formation 41 the study pointed out that early marriage appears for many girls a viable option to avoid the shame and dishonor related to an out-of-wedlock pregnancy. Finally, even when girls appear to actively seek marriage, their decisions may derive from the lack of alternative options, showing the influence of numerous external factors and not necessarily reflecting girls’ own aspirations and hopes. The interviews suggest that the choice of marriage is often made out of necessity and lack of alternatives. For example, when education or job prospects are nonexistent, marriage turns out to be the only viable life option perceived. The interview findings also indicate that young women demonstrate little control over their lives and do not think about being able to succeed in life on their own—that is, without getting married. Young women in the sample repeatedly mentioned that a woman has little value without a man and cannot survive on her own, partly because of social norms that discriminate against single people. Moreover, they explicitly referred to their intention to help their parents as one of the central motivations to start family formation. For that reason, the statement that a young woman makes an informed decision to get married should be taken with caution. From the perspective of parents, financial difficulties and poverty are the key factors in their decisions to marry off their daughters early. Participants in the study repeatedly mentioned economic precariousness as the main driver of the traditional marriage contract. Poverty as a driver of child marriage is particularly pronounced in Atsimo- Atsinanana: some participants from the region explained that marrying off a daughter not only brings some economic value for the family (money and cattle) but also reduces household expenses when the girl leaves her parents’ home and joins the family of her husband. The informal and transactional nature of Moletry most often works to the disadvantage of the girls involved. Participants explained that women commonly marry several times in a series of traditional marriages so that their parents can acquire the Moletry dowry each time—which might partly explain why couples’ separations are widespread in the north. Unlike in the center and south of the country, northern families do not follow the principle of lamban’akoho no isarahana (eternal marriage). Early marriage is clearly linked to the inability to pay for schooling. Evidence from the Atsimo-Atsinanana and Sofia regions shows that, with the monetary poverty that affects the majority of Malagasy households, parents find it impossible to pay for their children’s schooling. Thus, the many girls taken out of school are deprived of their means of subsistence and are influenced by their parents to find a spouse to support them. In addition, parents might marry off their daughters to protect them and ensure that they will be in a good family. Particularly in the region of Atsimo-Atsinanana, parents prefer arranged marriages. It is a long-lasting tradition there for parents to agree on their children’s marriages, often as a way to strengthen ties and protect both families from the intrusion of a stranger. Although often well intended (to “protect” the girl), the practice deprives both young people of any part in the decision-making: in some cases, families make such a decision before their children are born. Young women, therefore, have very little control over their own lives because of the persistent weight of traditions. 42 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Having a married daughter is a source of pride for the family, whereas a daughter pregnant out of wedlock can bring dishonor and shame to the entire household. In this respect, compliance with social norms appears to be central in the motivation behind child marriage. Parents’ urgency to marry a girl as soon as she starts spending time with boys is mainly to avoid her falling into disgrace as an abandoned woman or unmarried mother. Furthermore, particularly in Antananarivo, important value is attached to Christian principles, one of which implies that young women must remain virgins until their wedding day. Elsewhere in the country, however, maintaining virginity before marriage does not appear to be binding. In the Atsimo-Atsinanana region, conflicting evidence exists on the value attached to virginity. On the one hand, participants mentioned that there is no social expectation that women remain virgins until the day of their marriage. On the other hand, some parents in the sample admitted they would prefer their daughters to abstain from the sexual relations—likely because of their worries related to early pregnancy. According to positive deviants (PDs), the factors that help delay early family formation—once financial difficulties are alleviated—relate to young women’s strong individual resilience and sense of control (figure 6). In contrast to their non-PD counterparts, PDs articulate a clear vision for the future and intentions to delay family formation. Their aim is to be financially ready to take on household expenses with or without the support of a husband. PDs see completing their studies and accumulating savings as key steps before they consider starting a family. Figure 6. Supportive factors to delay early family formation in Madagascar Economic security Support and acceptance from parents/ family • Financial stability within the household • Parents who value and encourage girl’s • Food security education • Family’s ability to invest in girls’ schooling • Parents who accept and support their unmarried daughters (no judgement/ shame) • Social norms that do not create pressure on women to marry and form a family Girl’s empowerment • Strong sense of control over own life • Availability of alternative life options (e.g., work, studies) • Delayed early pregnancy Source: Original figure developed for this report. Women and girls face limitations to their agency and decision-making, particularly in the domain of family formation 43 These findings call for dedicated policy efforts. Priority actions should focus on strengthening relevant legislation related to the minimum age at marriage and, even more, on tackling the underlying drivers of this phenomenon (see table 5). Tackling social norms involves initiating community dialogue with parents, girls, and traditional and religious leaders to advocate for delaying family formation. Moreover, acknowledging that many marriage traditions in Madagascar arise from poverty, providing financial incentives for families of adolescent girls and subsidizing girls’ education can have direct positive outcomes on girls’ agency and well-being. Special attention should also be paid to preventing GBV and strengthening the capacity and availability of support services for its survivors. Table 5. Policy recommendations to improve women’s agency in Madagascar Barriers Term Policy recommendations Strategic direction 1: Empower girls and young women to delay family formation Poverty and lack of means Medium term • Provide economic incentives to girls and their families through cash transfers, microcredit, as the main driver behind or loans to families in need. child marriage • Provide material, in-kind, or food aid to vulnerable households. • Assist girls and young women in enrolling and completing school education.a Long term • Develop alternative livelihood programs for adolescent girls. Social norms that Long term • Promote positive social norm change within the community—with parents, girls, and with encourage women to traditional and religious leaders—through awareness-raising campaigns and community marry early mobilization programs. • Offer life skills training, safe spaces, and vocational and livelihoods skills training to girls. Rule of customary law Short term • Strengthen the enforcement of relevant legislation on marriage, prohibiting marriage of underage individuals under all circumstances. Medium term • Engage religious and traditional leaders to promote the delay of family formation and encourage positive attitudes toward unmarried women. Strategic direction 2: Prevent GBV and address its consequences Patriarchal traditional Medium term • Develop community mobilization programs and awareness-raising campaigns to promote and cultural practices intolerance toward all forms of GBV and child abuse. that accept and tolerate different forms of violence Medium term • Implement school-based interventions to educate and promote unacceptance of GBV against women among adolescents and youth. Long term • Reduce women’s vulnerability to GBV through economic/ financial empowerment. • Introduce behavioral components on GBV in all financial support programs (+ component). Limited access to support Short term • Ensure the adequate enforcement of the existing legislation on different forms of GBV services and justice for (domestic violence, sexual harassment in the workplace, and others) and provide support GBV survivors for the survivors. • Strengthen and improve the quality of existing GBV support services by focusing on psychological advice and offering survivors adequate shelter. Medium term • Implement gender-sensitive training of professionals (first responders) across sectors. • Enable access to justice and GBV support services for survivors. Source: World Bank. Note: GBV = gender-based violence. a. See Note 1, “Challenges and Opportunities in Education.” 44 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Conclusions M alagasy women and girls continue to have low potential to accumulate their human capital in education and health. Despite the fact that girls outnumber boys in primary and secondary school attendance and completion, their overall rates of educational attainment remain concerningly low, especially among rural girls. Adult women are more likely than men to be illiterate and to have no formal education at all. In terms of health, Madagascar displays a high maternal mortality rate, which is likely linked to the severe underutilization of professional health services and the high rate of adolescent fertility. In fact, teenage pregnancy is a common phenomenon in Madagascar, which strongly compromises women’s health outcomes and bears important implications for their educational and work trajectories. Lack of investment in human capital strongly affects girls’ and women’s potential to participate actively and productively in economic opportunities. Malagasy women participate in the labor market to a lower extent than men and are often concentrated in low-paid, precarious jobs in the informal sector. Legal discrimination, harmful social norms, occupational segregation, and earning differentials between men and women persist, further limiting women’s chances to engage in quality employment. Malagasy women also appear to be disadvantaged in access to landownership and formal financial services, although they are more likely than men to use mobile money transactions. Additionally, Malagasy women experience many limitations with respect to their agency and encounter different forms of gender-based violence. Family formation occurs at a very early age for most Malagasy women, often as a result of poverty, socio- cultural norms, inequitable gender roles, and lack of alternative options in life. Girls and young women appear to be significantly constrained in their ability to make informed decisions about family formation and possess little sense of control over their lives. Limited agency and absence of alternative options place young women in a particularly vulnerable situation and increase their risks of encountering poverty and discrimination. Finally, Malagasy women and girls are disproportionally affected by the impacts of climate change and other recent crises such as COVID-19. In particular, climate change disproportionally affects the hours spent by women and girls on domestic work with potentially negative impacts on their ability to participate in professional activities. Likewise, evidence suggests that the multifaceted negative impacts of the COVID-19 crisis are likely to adversely affect women’s and girls’ access to health care in Madagascar, potentially resulting in increases in maternal mortality and adolescent fertility rates. 46 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar To narrow existing gender gaps, four strategic directions have been identified. A set of recommendations is provided for each strategic direction, based on the regional evidence of effective interventions and programs. These strategic directions include a set of actions on improving and strengthening the legal environment. The four strategic directions for Madagascar are as follows: 1. Assist girls and young women in completing schooling. 2. Improve women’s and girls’ access to professional health care. 3. Enhance women’s economic opportunities. 4. Improve women’s and girls’ voice and agency and eliminate all forms of gender- based violence. In light of the multidimensional aspects of gender equality—and the existing disparities across endowments, economic opportunities, and agency—it will be crucial to initiate comprehensive, multisector efforts to address existing gender gaps. Conclusions 47 Appendix A. Methodology of the qualitative background study This report is based on qualitative data collected in three regions of Madagascar in June and July 2022. Before the qualitative data collection with young women and parents of adolescent girls, existing quantitative data were analyzed, followed by a literature review, a review of the current legal system, and 10 key informant interviews. The key informants interviewed included a range of representatives from relevant government institutions, development partners, researchers, nongovernmental organizations active in relevant areas, and activists. The interviews followed a series of questions intended to explain girls’ and young women’s experiences in relation to education, family formation, and labor market participation. Key informant interviews helped to reflect on and discuss barriers, facilitators, and other important aspects of observed gender gaps in the country. Findings from the interviews informed the design and focus areas of the subsequent qualitative research. Based on those key informant interviews, initial quantitative data analysis, and literature review, a subsequent dedicated qualitative data collection effort focused on exploring the issues faced by young women in Madagascar. The overall qualitative research aimed to generate knowledge about a range of factors that contribute to gender inequalities in education, family formation, employment, and access to health care, with a particular focus on adolescent girls and young women. Building on a life- cycle approach, the study focused on the issues young women in selected regions face in their educational, family, and work trajectories. This research followed the principles of protection of human subjects outlined by the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 1979) and the World Health Organization’s “Putting Women First: Ethical and Safety Recommendations for Research on Domestic Violence against Women” (WHO 2001). All research protocols were submitted to an ethical review board for approval before data collection. In addition, all World Health Organization and national COVID-19 protocols were followed to ensure the safety of the research team and participants. The qualitative data collection took place in three regions in order to capture the geographical diversity of Madagascar. In addition, selected regions differ significantly in terms of gender disparities observed (Table A.1). In particular, the Analamanga region was represented by the capital city Antananarivo, which displays the lowest proportion of illiterate women (8.7 percent) and the lowest share of women ages 20–24 who married before the age of 18 (17.9 percent) (DHS 2021). In Antananarivo, two urban communities were chosen with a concentration of industrial companies, businesses, and stores in each area. Atsimo-Atsinanana and Sofia regions were selected because they have high rates of illiteracy among adult women (54 percent and 25 percent, respectively) and high prevalence rates of child marriage (54.5 percent and 65 percent, respectively, of women ages 20–24 were first married by age 18) (DHS 2021). The districts of Mandritsara (Sofia region) and Vangaindrano (Atsimo-Atsinanana region) were selected because 48 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar they display large gender disparities in favor of boys in secondary school enrollment and attendance rates. Table A.1. Justification of the choice of regions for the study Analamanga (capital Atsimo-Atsinanana Sofia Antananarivo) Women’s 8.7 percent 54 percent 25 percent illiteracy rate Sofia Child marriage 17.9 percent 54.5 percent 65 percent rate Antananarivo Net secondary 54.8 percent (vs. 45 16.5 percent (vs. 23.1 21.6 percent (vs. 22 school Atsimo percent of boys) percent of boys) percent of boys) attendance rate Atsinanana Source: World Bank. Data collection used the following three main instruments: 1. Key informant interviews with a wide range of representatives from the education, health, and private sectors; religious and traditional leaders; elected officials; and representatives from civil society. 2. Focus group discussions with women ages 25–34 and mothers and fathers of adolescent girls. Because of COVID-19 considerations, each focus group consisted of up to five persons. 3. In-depth interviews with young women ages 18–24 and mothers of adolescent girls. A subsample of young women for individual in-depth interviews consisted of positive deviants (PDs). A PD approach implies a focus on researching individuals who confront similar challenges and constraints as their non-PD peers but who employ strategies and behaviors that help them overcome those constraints and achieve positive outcomes that are unusual in their own contexts. The advantage of the PD approach is the ability to identify solutions that some individuals already employ (Pascale and Monique 2010). In this study, the PDs consisted of young women who (1) completed high school without interruptions, (2) reentered school after dropping out, (3) completed professional training, or (4) launched their own small business. Conclusions 49 Interview guides for the different groups of interviewees or focus groups included questions related to the aspects of education, family formation, and labor market participation of young women in Madagascar. Local authorities, particularly the fokontany (chiefs), supported the recruitment of participants for the individual in- depth interviews and focus group discussions. The research team provided them with the desired criteria as well as the quotas to be reached for each subsample of participants. The local authorities were then responsible for identifying potential participants. Volunteers who came to register were screened to ensure that they met the criteria (age, status as a parent of an adolescent girl, educational background, and so on). Additionally, snowball sampling complemented the volunteer-based sampling in identifying the four types of PDs. See table A.2 for a summary of the study participants, their region, and which activities they participated in. Table A.2. Distribution of study participants, by region and instrument of data collection Atsimo- Region Analamanga Sofia Atsinanana FGD IDI KII FGD IDI KII FGD IDI KII Young women ages 18–24 2 3 2 2 2 2 Young women ages 25–34 2 2 2 Mothers of adolescent girls 1 2 2 2 2 2 Fathers of adolescent girls 1 2 2 PD (completed high school) 1 1 2 PD (reentered school after dropping out) 1 2 PD (completed professional training) 1 1 PD (created small business) 1 2 Representatives from civil society 1 1 Representatives from education sector 1 2 1 Representatives of health sector 1 1 Religious and traditional leaders 1 1 2 Representatives from private sector 1 Local elected officials 1 1 Total 6 8 6 8 9 5 8 8 4 Source: World Bank. Note: FGD = focus group discussion; IDI = in-depth interview; KII = key informant interview; PD = positive deviant. All individual interviews and group discussions conducted in Malagasy were voice- recorded, transcribed, and translated into French. Generic coding, a method of coding that involves classifying each interviewee’s statements into previously established thematic codes, was used (Huberman and Miles 2003). As new information became available, the list of preestablished codes was revisited and expanded. 50 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar The team encountered several challenges during fieldwork. The research team encountered a language barrier in the Atsimo-Atsinanana region. Most group discussions were conducted in the presence of the focal point, who provided translation from the local dialect to official Malagasy and vice versa. Because that translation occurred only at the end of each discussion so as not to cut off the interviewees’ answers, it is possible that the rephrasing could have distorted some of the comments. In addition, many factors such as the interviewer’s attitude, the interviewee’s social status, and existing taboos come into play in interview situations, affecting the authenticity and richness of the information collected. These factors elicited reactions described from some of the interviewees during the various interviews including inhibition (manifested in either abrupt and underdeveloped responses during interviews or limited participation in focus groups discussions) or defensive attitudes (specifically in the case of one traditional leader in the Atsimo-Atsinanana region). Conclusions 51 Appendix B. Entry points for legal reform to expand women’s empowerment in Madagascar Women, Business and the Law (WBL) 2023 measures the laws and regulations across several areas that affect women’s economic opportunities in 190 countries. From the basics of movement in the community to the challenges of working, parenting, and retiring, WBL data offer objective and measurable benchmarks for global progress toward gender equality. Analysis of the WBL data shows that Madagascar has opportunities to reform and close the gap with global leaders in six of the regulatory areas measured by WBL: the Mobility, Work, Entrepreneurship, Parenthood, Marriage, and Assets indicators. Table B.1 recommends eight reforms that range from those designed to give women more choice in employment decisions (by removing restrictions on the types of jobs they may have or the industries they may work in), to make it less expensive for companies to hire women (by pushing the cost of maternity leave from private employers to the state and by enacting paternity and parental leave policies), to improve legislation in areas affecting women’s freedom of movement (by removing procedural barriers concerning application passports for women) and their rights within marriage (by equally allowing women to be head of household and to inherit property in the same manner as men), and to pass legislation mandating equal remuneration for work of equal value and prohibiting discrimination based on gender in access to credit. Table B.1. Recommended legal reforms to expand women’s empowerment in Madagascar Entry Points Recommended Legal Reforms Mobility Can a woman apply for a passport in the same way No Mobility as a man? Can a woman travel outside the country and her 1. Equalize passport application Yes procedures between women and men. home in the same way as a man? Can a woman choose where to live in the same way Yes as a man? Work Work Does the law mandate equal remuneration for work 2. Allow women access to employment in No of equal value? all jobs and all sectors and industries. Can a woman work the same night hours as a man? Yes 3. Introduce a provision that mandates Are women able to work in the same industries and in equal remuneration for work of equal jobs deemed dangerous? No value. Entrepreneurship Does the law prohibit discrimination in access to Entrepreneurship No credit-based gender? Can a woman sign a contract and register a business 4. Enact legislation prohibiting Yes discrimination based on gender in as a man? access to finance and credit. Can a woman open a bank account in the same way Yes as a man? 52 Unlocking the Potential of Women and Adolescent Girls Challenges and Opportunities for Greater Empowerment of Women and Adolescent Girls in Madagascar Entry Points Recommended Legal Reforms Parenthood Is paid leave of at least 14 weeks available to Parenthood Yes mothers? 5. Introduce legislation or amendments Does the government pay 100% of maternity leave for maternity leave benefits to be fully No benefits? paid by the government. Is there paid leave available to fathers and parental 6. Introduce paid parental and paternity No leave? leave. Is the dismissal of pregnant workers prohibited? Yes Marriage Is the law free of legal provisions that require a No Marriage married woman to obey her husband? Can a woman legally be “head of household” or in the 7. Allow women to be the “head of No same way as a man? household” in the same way as men. Can a woman obtain a divorce and remarry in the Yes same way as a man? Assets Do men and women have equal ownership rights to Yes immovable property? Do sons and daughters have equal rights to inherit No Assets assets from their parents? Do female and male surviving spouses have equal 8. Allow women to inherit assets in the No rights to inherit assets? same manner as men do. Does the law grant equal administrative authority Yes over assets during marriage? Does the law provide for the valuation of Yes nonmonetary contributions? Source: World Bank, based on Women, Business and the Law. Note: Red boxes indicate needed reforms. Conclusions 53 References Acharya, D. R., J. Bell, P. Simkhada, E. Van Teijlingen, and P. Regmi. 2010. “Women’s Autonomy in Household Decision-Making: A Demographic Study in Nepal.” Reproductive Health 7 (1): 1–12. Aga, G., F. Campos, A. Conconi, E. Davies, and C. 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