|© UNICEF Madagascar/2011/Corbett|
|In southern Madagascar, community health worker Francoise Soamaniry measures one-year-old Fairson’s mid-upper arm circumference, an indicator of a child’s nutritional status.|
By Christine Corbett
ITAMPOLO, Madagascar, 14 October 2011 – It is 7.30 a.m. in the village of Itampolo, on Madagascar’s remote south-west coast. Outside the village health centre, Tilda Rainivomalala, 35, is among a group of women and children waiting in the shade of a mango tree. She has 10 children, and today she has brought Mahatratse, one, and Momoni, four, to the health centre to be screened for malnutrition.
“The community health worker in the village told us about the screening,” says Ms. Rainivomalala. “I came because I want to know more about my children’s health.”
Malnutrition is a permanent challenge for Madagascar. The country ranks sixth globally among countries with the worst rates of malnutrition, with 50 per cent of children under five years of age suffering from stunted growth.
In the semi-arid south, where unreliable rainfall or flooding often damage harvests, the situation is punctuated by repeated peaks of acute malnutrition, particularly during the annual lean season when food supplies are limited.
At the health centre in Itampolo, nearly 600 children are expected to be screened as part of a UNICEF-supported Plumpy’doz distribution campaign that is targeting 20,000 of Madagascar’s most vulnerable children in the south.
Children showing signs of malnutrition will receive further treatment. Those aged 6-36 months, who are not yet showing signs of malnutrition, will be enrolled in a scheme in which they receive two months’ supply of Plumpy’doz – a supplementary food rich in vitamins and minerals, designed to help prevent malnutrition in children.
“Before a child starts to show signs of malnutrition, there will already be a significant lack of vitamins and minerals in their diet,” explains UNICEF nutritionist Dr. Leonide Rasoahenikaja. “The Plumpy’doz provides these vitamins and minerals, and so can prevent that child from becoming malnourished. Used as a supplement to other food, Plumpy’doz completes a child’s nutritional intake and helps the child grow and develop immunity to disease.”
|© UNICEF Madagascar/2011/Corbett|
|Plumpy’doz is a supplementary food rich in vitamins and minerals, designed to help prevent severe acute malnutrition in children.|
Care for the most vulnerable
For Voatiana Vaha, a 32-year-old mother of six, the opportunity to provide her children with such care is essential. “The biggest problem we face here is finding enough money. I don’t have land to farm, so I have to find money in other ways,” explains Ms. Vaha.
“I buy fish from the fishermen here and sell it on to other buyers,” she adds. “When the sea is calm I can earn some money, but when it is rough the fishermen don’t go out and I have nothing to sell, and cannot buy enough food for my family.”
In southern Madagascar, reaching communities isolated by distance and a lack of roads is challenging. But in order to address the country’s high malnutrition rates, UNICEF is targeting the most vulnerable children in these hard-to-reach areas.
By tackling food insecurity, improving water and sanitation, and supporting health services, UNICEF is working to prevent the nutritional situation from worsening. The Plumpy’doz distribution campaign forms part of this wider strategy to reduce malnutrition rates.
More support needed
Identifying children with malnutrition early on is a key part of this work. In April, UNICEF worked with its partners to screen around 260,000 children across southern Madagascar in an effort to ensure the early detection and adequate treatment of severe acute malnutrition.
However, ongoing political instability and economic decline in Madagascar means that many specialist nutritional centres are increasingly short of skilled staff, and of the therapeutic food and milk used to treat malnutrition – making UNICEF’s work critical.
“UNICEF is calling for more support from the international community,” says UNICEF Representative in Madagascar Bruno Maes, “to ensure that this essential programme for child survival and development can continue in a context where the socio-political crisis is deeply impacting on the functioning of the health system."