Anosy is one of the 22 regions of Madagascar. It is located in the southeast of the country. Due to a strategic sea route running along its coast, Anosy had been an important crossroads for the Malagasy, Muslims, and Europeans. In the mid-1600s, it was the location of the first French colonial settlement in the Indian Ocean. The region was part of the French colony of Madagascar from the late 1800s to 1960. The region suffers from poverty; 80% of inhabitants lack access to clean water, 16% suffer from serious respiratory illnesses, and literacy is less than 20%.