Reaching the Sustainable Development goals is a complex challenge to tackle, and COVID-19 has halted or even reversed progress against targets. However, sexual and reproductive health and rights is arguably one of the most catalytic areas for impact. As a cross sectorial intervention that impacts everything from poverty reduction to education to climate change, family planning is potentially a fulcrum to bring us closer to achieving SDGs. 
Yet, for women and girls around the world, the sexual health journey is grueling and unmet need is high. 218 million women in LMICs do not have access to modern contraception.  Unreliable markets, siloed approaches, and deeply entrenched taboos are just three of the many barriers that stand in the way of the fundamental human right to owning their health choices and having voice, choice, and agency across their sexual and reproductive health and rights lifecycle. 
Activating the SRHR lever of change requires a disruption in the narrative around women's health and a Social and Behavioral Change Communications movement that will shift the discourse from disease to wellness, from prevention to pleasure. PSI is bringing these conversations to the fore, breaking down taboos and stigma, and engaging women and girls around the world to talk freely about their health through its first global sexual wellness brand. VIYA leverages technology to provide women with the tools needed to take charge of their sexual health at every touchpoint and is generating a movement of women who own their health journeys - from menstruation to menopause.  

This talk tells the story of how participants in a USD45m food security program set the agenda for their behavior change program: choosing the interventions they wanted, setting the steps to behavior change, and monitoring the results of their efforts. It is rare that participants are empowered to take such control of a program and this talk shows how they achieved this despite being marginalized, non-literate, and accustomed to three decades of humanitarian interventions that have provided them with food but have robbed them of choice and agency.
This setting is southern Madagascar: the poorest region of one of the world's poorest countries and site of what has been called the planet's first "climate change famine". It is also known to agencies as 'a project graveyard'. 
So how did it happen that people normally described as marginal victims empowered themselves to choose their own food security path and translate that into behavior change results for which they are happily accountable? This talk tells the story of that double-award-winning initiative in two parts.
The first part is practical: it describes the inclusive approach, the visual and tactile participatory tools, and the community animation that created the structure for community-conducted barrier analysis, behavior change planning, communication strategy and results monitoring.
The second part is polemic: it argues for the crucial role of truly participatory SBCC in ensuring that those most impacted by projects – rather than those who fund or administer them – shape and lead their change on their terms.