The big picture
Situated in the Indian Ocean, cast adrift from the east coast of mainland Africa more than 14 million years ago, Madagascar is the fourth largest island in the world. Yet despite its image of a remote tropical paradise, Madagascar's children face some immense challenges.
Many of Madagascar's nearly 20 million people live in the pastoral landscapes of the central high plateau, or among the palm trees that line the white beaches of the coast, but the country remains one of the poorest in the world: in 2009 annual gross national income per capita was US$461.
A total of 76.5 per cent of the population, are considered poor, in 2005 this figure stood at 68.7 per cent. Among children and young people, an estimated 82 per cent of under-18 year-olds live in poverty. This means that these children and their families cannot afford the necessary food to ensure sufficient nutritional intake - and have no resources to cover the cost of basic health and social services. Maternal mortality is high - every year around 3,000 women, or 8 a day, die as a result of pregnancy related causes.
The difficulties are acute. Only 30 per cent of people live in towns and cities, while 70 per cent live in rural areas. Outside of the country's urban centres, communities are often isolated and remote, cut-off by poor road networks that leave many children and women with no access to basic health care.
Although Madagascar is one of few African countries to show a decline in the under-five mortality rate in recent years, increasing poverty means that continuing progress is at risk.
Malaria, diarrhoeal diseases and respiratory infections claim the most lives. Every year some 38,000 children - or 104 children a day - die before their fifth birthday. Of these children, nearly 27,000 - or 74 children a day - die in the first 28 days of life.
Chronic malnutrition affects large swathes of Madagascar's population, leaving 50 per cent of children under-five stunted. In the remote, semi-arid southern regions of the country, persistent food insecurity is exacerbated by increasingly unreliable seasonal rains, and insect invasions.
Throughout the country, massive deforestation has led to soil erosion that has left once productive farmland degraded. This is a profound problem in a country with a predominantly rural population that is largely dependent on agriculture for survival.
Elsewhere annual flooding and cyclones destroy crops, homes and infrastructure leaving children vulnerable to malnutrition and disease, and disrupting their education. To help mitigate the impact of these disasters, UNICEF plays a major role in leading intitiatives for emergency preparedness and response.
What we do
UNICEF at a Glance
UNICEF at a Glance provides the who, what, why and how of UNICEF, in a succint and easy-to-read format. Included are up-to-date statistics on the health, social and economic issues facing children worldwide.