In Madagascar, training parents to monitor their children’s nutritional status

More than 100,000 parents in the southern Madagascar have received training in how to use a simple tool to screen their children for malnutrition.

Abela Ralaivita
Sanasoanandrasana washes the sweet potatoes with her son Razafimanfimby who is happy to be able to eat them for lunch.
UNICEF/UN0602388/Ralaivita
13 March 2022

In the village of Bevoalavo in the south of Madagascar, Sanasoanandrasana, 25, laboriously plows the maize field belonging to her parents, as the temperature approaches 30°C. At the same time, she is caring for her son, Razafimandimby, 2, who is patiently waiting for her under while playing with his brother Nicolas. Razafimandimby is suffering from severe acute malnutrition. “This is the second time in a year that he has been admitted for treatment because the food I can afford to give him is not enough to keep him healthy," says his mother.

Sanasoanandrasana is a single mother, supported by her parents. She is one of the parents in who received training in how to use a crucial, but simple tool used to assess a child’s nutrition status. The MUAC – measurement of upper arm circumference – bracelet is made up of three-color codes: green, yellow and red. Green means all is well, yellow that the child is moderately malnourished and red that the child is severely malnourished. “My son was continuing to lose weight and when I checked his arm circumference with the bracelet, I saw that he was in the red zone. I immediately took him to the nearest health center, which is thirty minutes from our house,” says Sanasoanandrasana. UNICEF and its partners have trained more than 100,000 parents to help them to identify malnutrition in their children. In the village of Bevoalavo, Tirisoa, 18, is one of the community agents who conducted the training. “Parents are attentive and follow the instructions given to them,” he says.

Sanasoanandrasana plowing the land in the cornfield that belongs to her parents
UNICEF/UN0602392/Ralaivita
Sanasoanandrasana plowing the land in the cornfield that belongs to her parents
Sanasoanandrasana showing other parents how to measure arm circumference to detect malnutrition
UNICEF/UN0602370/Ralaivita
Sanasoanandrasana showing other parents how to measure arm circumference to detect malnutrition

The latest analysis of acute malnutrition in the region revealed that around 309,000 children in the southern Madagascar are at risk of acute malnutrition in the coming months. This includes around 60,000 at risk of severe malnutrition. Mass screening supported by UNICEF is a key element in the fight against malnutrition. About 130,000 children are screened each month by health workers with the help of these parents. Thanks to this, children can receive the right treatment, which usually involves a program of nutrient-rich therapeutic food.  

Every Friday Sanasoanandrasana arrives at the health center to receive a weekly ration of therapeutic food for her son. These supplies are provided by UNICEF and donors such as the European Commission for Humanitarian Aid and Civil Protection (ECHO), the Foreign, Commonwealth & Development Office (FCDO), the U.S. Agency for International Development (USAID) and the Government of Japan. Razafimandimby is expected to recover in a few weeks. "From now on, I will try to ensure my son is able to eat nutritious food even if we live in precarious conditions", says Sanasoanandrasana.  

A community agent weighing Razafimandimby for the weekly check-up at the Ambohimalaza health center
UNICEF/UN0602377/Ralaivita
A community agent weighing Razafimandimby for the weekly check-up at the Ambohimalaza health center
Razafimandimby eating ready-to-use therapeutic food leaving the Ambohimalaza health center
UNICEF/UN0602381/Ralaivita
Razafimandimby eating ready-to-use therapeutic food leaving the Ambohimalaza health center