Nutrition
The destructive wave of malnutrition in Chad needs to be halted
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Challenges
The 2024 national nutrition survey revealed that 15 of 23 provinces had global acute malnutrition (GAM) rates above the WHO emergency threshold of 10%. Children under two are most affected, with GAM at 17.1% (including 3.6% severe), compared to 7.5% (including 1.3% severe) among children aged 24–59 months. These findings underscore the need to strengthen infant and young child feeding (IYCF) practices in both emergency and development contexts. Indeed, exclusive breastfeeding was estimated only at 4.8 percent at countrywide. The diet diversity among children aged 6 – 23 months was estimated at 27.9 percent. Nearly three-quarters (72.2%) of children under five suffer from food poverty nationwide, either severe (28.7%) or moderate (43.5%).
The nutritional situation in Chad remains highly fragile. Without relevant programmatic shifts, the situation is expected to deteriorate further over the next years due to overlapping humanitarian, epidemic, natural disaster, and socio-economic crises that continue to weaken household resilience and strain local health and food systems.
According to projections from the nutrition cluster for the 2026 Chad Humanitarian Needs and Response Plan, 3.1 million people will require nutritional assistance, including 1.7 million children under five. This includes an estimated 483,670 cases of severe acute malnutrition (SAM) and 1,215,863 cases of moderate acute malnutrition (MAM).
Malnutrition in Chad persists due to interconnected structural and systemic factors that limit the impact of nutrition investments.
First, despite well-established policy frameworks, implementation at decentralized and community levels remains weak. Nutrition interventions are still largely delivered through vertical, sector-specific approaches, with limited operational synergies across health, food systems, social protection, water and sanitation, education and community development sectors.
Second, service delivery models remain heavily treatment-oriented rather than prevention-focused. Reliance on often understaffed and overstretched health facilities limits early detection, follow-up, and sustained behavior change, particularly in remote and climate-affected areas. Recent funding shortfalls have further reduced service coverage, exposing the fragility of facility-based approaches.
Third, sociocultural and behavioral barriers continue to drive poor nutrition outcomes. Suboptimal infant and young child feeding practices, low dietary diversity, limited awareness of micronutrient needs, and restrictive gender norms all undermine nutrition improvements.
Fourth, capacity gaps constrain both community nutrition promotion and food system performance. Nutrition counseling and household follow-up are not systematically institutionalized, while local producers face technical and regulatory barriers to scaling up the production of quality fortified foods.
Fifth, weaknesses in food systems and markets contribute to persistent low minimum acceptable diet and micronutrient deficiencies. Diets remain dominated by staple foods, fortified products are insufficiently available or demanded, and regulatory and quality-control systems lack the capacity to ensure consistent fortification standards.
Finally, poverty, population displacement, and recurring climate shocks exacerbate all other drivers by reducing household access to nutritious diets, while social protection systems remain insufficiently nutrition-sensitive.
Overall, malnutrition in Chad reflects not a lack of effort, but weaknesses in system design, characterized by fragmented prevention, limited community engagement, and underutilized food-system solutions. This underscores the need for multisectoral approaches centered on community platforms linked to food systems including food fortification to achieve sustainable, large-scale nutrition outcomes.
Solutions
Solutions
Chad should prioritize an integrated high-impact package combining: Family MUAC and community screening; community nutrition platforms; reliable treatment services and supplies; food fortification and local nutritious food production; nutrition-sensitive cash transfers; WASH and disease prevention; and climate-resilient livelihoods. This approach will address the immediate causes of acute malnutrition, including inadequate diets and disease, while also tackling underlying drivers such as poverty, food insecurity, weak services, gender barriers, poor social norms, displacement, and climate shocks. Indeed, acute malnutrition in Chad requires a coordinated multisectoral response that combines prevention, early detection, quality treatment, food-system strengthening, WASH, and nutrition-sensitive social protection through key systems: food systems, health system, water and sanitation system, education system and social protection system. Priority actions include:
1. Shift from treatment to prevention
- Scale up community-based nutrition services during the first 1,000 days of life through the expansion of Mother-to-Mother Support Groups (GASPA) considered as multisectoral community-based platforms for Nutrition, an approach integrated into Chad’s Integrated Management of Acute Malnutrition (IMAM) guidelines, which were aligned with the 2023 WHO recommendations and finalized in September 2025. In 2026, UNICEF supported 9,943 GASPA groups across ten provinces ) covered 1,898 villages, and reaching more than 406,000 caregivers with nutrition education messages. A key bottleneck to further expansion is the current reliance on NGO Programme Documents for implementation, highlighting the need for stronger ownership and leadership by the health system, particularly through the National Nutrition Directorate.
- Promote exclusive breastfeeding through a monitoring system addressing during the first six months the local barriers.
- Support complementary feeding, improved dietary diversity and reduced child food poverty through strengthening policy environments, incentivizing local production and stimulating adequate consumption of nutritious, safe, affordable and sustainable first foods for children. From this perspective UNICEF is supporting in Tchad the implementation of the “First Food Africa” global initiative, notably through local production and the stimulation of demand for nutritious, safe, affordable, and sustainable first foods for children aged 6 to 23 months within their respective communities, led by women's agricultural cooperatives, while promoting household self-consumption and the development of income-generating activities. This women-centered agricultural cooperative approach builds on and strengthens community engagement and women's empowerment, while also enabling sustainable changes in behaviours and social norms. As a result, 8,937 mothers received training in improved food production, 1,000 households received small livestock, and 2,000 households received nutrient-rich seedlings.
2. Expand early detection and referral
- Institutionalize Family MUAC and mother-led screening. To further harmonize the implementation of the Family MUAC approach across the country, UNICEF, in 2026 facilitated the development of a national Family MUAC Implementation Guide. The guide provides standardized procedures and key recommendations for community-based screening, referral and follow-up of children with acute malnutrition. It is now used by humanitarian and development partners as the main reference document for implementing the approach in Chad.
- Mass community screening in high-burden and hard-to-reach areas should be supported during the lean period season and community health workers ensure referral and follow-up mechanisms.
3. Improve the quality and coverage of treatment integrating a supply chain strengthening
- Ensure uninterrupted availability of RUTF, therapeutic milks, essential medicines, and anthropometric equipment
- Strengthen outpatient treatment sites and stabilization centres.
- Provide continuous training, mentorship, supportive supervision, mortality audits, and quality-of-care monitoring. From this perspective a 2026 Supervision Guideline for Improving the Quality-of-Service Delivery in Outpatient Therapeutic Programmes (OTP) was supported by UNICEF to strengthen the capacity of the Nutrition Focal Point at Health district and provincial levels.
- Effective implementation of the RUTF Risk Management Plan, originally developed in 2021 and revised in 2023 following the supply chain assessment. In this regard, the Strategic Plan for the Operationalization of the Prime Minister’s Directive Prohibiting the Sale of Nutritional Supplies, validated in April 2026, serves as a key reference framework for strengthening accountability and safeguarding nutrition commodities.
- UNICEF Chad, in collaboration with the Government and partners, has implemented cost-effective solutions to digitalize both IMAM programme data and supply chain data through an advanced RapidPro pilot. This system enables the monthly collection and analysis of data through interactive dashboards.
4. Strengthen food systems and micronutrient interventions
- Promote locally available nutrient-rich foods, home gardens, small livestock, and climate-resilient agriculture. In this context, UNICEF is supporting the implementation of the First Foods Africa Initiative, through women-centered agricultural cooperative approach allowing to increase local production and the stimulation of demand for nutritious, safe, affordable, and sustainable first foods for children aged 6 to 23 months. Moreover, mother-to-mother support groups provide an effective platform for equipping mothers and caregivers with the knowledge and skills needed for homestead food production.
- Support local production and quality assurance of fortified foods.
- Sustain vitamin A supplementation and deworming interventions through a health system strengthening approach that will guide the next programme cycle.
- Scaling up micronutrient supplementation among pregnant women.
- Scaling up staple-food fortification.
5. Coordinate in synergy nutrition, health, and WASH services
- Integrate nutrition screening, counselling, and treatment into primary health care, immunization, and maternal and child health services.
- Improve access to safe water, sanitation, and hygiene services.
- Strengthen prevention and treatment of diarrhoea, malaria, measles, and other childhood illnesses.
6. Expand nutrition-sensitive social protection
- Provide targeted cash or food assistance during the lean season and after climatic or displacement-related shocks.
- Prioritize vulnerable children, pregnant and breastfeeding women, refugees, returnees, displaced people, and host communities.
- Link assistance to nutrition counselling, health care, and livelihood support.
7. Improve governance, financing, and accountability
- Strengthen coordination across health, agriculture, WASH, education, social protection, and community development sectors.
- Decentralize nutrition planning, budgeting, and monitoring to provincial, district, and community levels.
- Increase domestic financing, strengthen surveillance and digital monitoring, and engage communities in accountability mechanisms.
