In Madagascar the minimum legal age for women to marry is 14 years, and girls under the age of 18 can be married without giving their consent, providing their parents agree. A 2004 UN report estimated that 34 per cent of Malagasy girls between 15 and 19 were married, divorced or widowed, and more than a quarter had at least one child. The organisation Femmes Interessee au Development de Antalaha (FIDA) provides information about reproductive health and better access to contraceptives, but funding is becoming hard to come by.

A surge in new leprosy cases in a remote region of Madagascar could not have come at a worse time. Once a prosperous vanilla-exporting town, Antalaha has suffered the economic consequences of two years of political instability that began with the March 2009 coup in which Andry Rajoelina, with the support of the military, deposed President Marc Ravalomanana. Numerous foreign aid and trade benefits on which the country was heavily reliant, particularly for the funding of social sectors, have since been suspended.