A multi-pronged response to a complex emergency in southern Madagascar

An analysis of child malnutrition in the region shows that more than 300,000 children are at risk in the months ahead - this includes approximately 60,000 children suffering from severe malnutrition.

Abela Ralaivita
Sambeirake, 20, looking to her four days baby Mananantsoa look at her home, in southern Madagascar.
UNICEF/UN0595854/Andrianantenaina
13 March 2022

In the village of Andranotsiriry, 20 kilometers from the town of Ambovombe in southern Madagascar, doctor Raymondine leads a mobile medical team that provides health care to communities living in remote areas. She is supported by another health worker who screens and treats malnutrition in children. Among the first to be seen is Lohambosie who arrived at the clinic with her eight-month-old daughter Jessica and six other children after walking 30 minutes from her village. Jessica is being screened for malnutrition which involves using a color-coded strap that measures the circumference of her upper arms. When put around a child’s arm it shows either green, yellow or red – with red meaning the child is seriously malnourished. Jessica MUAC test (measurement of upper arm circumference) shows yellow. She is moderately malnourished. “I am a community worker and my role is to bring health services to sick and malnourished children. Unfortunately, my daughter is one of them,” says Lohambosie, worried about the state of health of her child who will receive adequate treatment at the community site in her village.  

Lohambosie came with her daughter to be screened for malnutrition
UNICEF/UN0595888/Andrianantenaina
Lohambosie came with her daughter to be screened for malnutrition
A cornfield destroyed by drought and the “Tiomena”
UNICEF/UN0595863/Andrianantenaina
A cornfield destroyed by drought and the “Tiomena”

Southern Madagascar continues to experience its worst drought in 40 years, leaving part of much of the population struggling to survive. Consecutive years of severe drought have wiped out crops and created widespread food insecurity. A recent analysis estimated that 37 percent of the population in the region is experiencing “crisis” or “emergency” levels of food insecurity. That’s more than 1.5 million people.     

Fighting together against malnutrition

In 2021, UNICEF and partners treated approximately 60,000 children for severe acute malnutrition. One in every three of these cases was treated by mobile teams like the one led by Doctor Raymondine. Treatment involves the use of therapeutic food supplements provided by UNICEF. To know the nutritional status of children in the south, health workers and community workers carry out an average of 130,000 screenings per month. Parents have even been trained and given arm circumference measurement bracelets so they can detect malnutrition in their children.  

Langesa, 42, a farmer and mother of 12 children, is one of them. “Thanks to the bracelet, I can now detect malnutrition in my children quite early. I even offer my help to other parents in the village who have not yet received a bracelet,” she explains. 

A child eating ready-to-use therapeutic food at the health center
UNICEF/UN0496738/Andrianantenaina
A child eating ready-to-use therapeutic food at the health center
Portrait of Langesa, 42
UNICEF/UN0595913/Andrianantenaina
Portrait of Langesa, 42

Water, a crucial element

The passage of cyclones Batsirai and Emnati in February 2022 increased the underground reserve of the Mandrare River from which thousands of people around the town of Amboasary draw their water. Not long ago, the riverbed was completely dry, and the return of water has given farming communities up and down the river new hope.   

In the village of Ehavo vegetables grow again thanks to a UNICEF-supported water system that provides irrigation as well as safe drinking water. Vatsaonjoe, 56, is among the 600 people in the village who have benefitted. "The quantity of water produced by this system is sufficient for consumption and the agriculture practiced by the members of our village association," she says. Students at the local primary school can now also wash their hands regularly and avoid illnesses by maintaining good hygiene.

Vatsaonjoe cultivating the soil in the vegetable garden of Ehavo village
UNICEF/UN0599410/Andrianantenaina
Vatsaonjoe cultivating the soil in the vegetable garden of Ehavo village
Persia receiving medicine for her son at the health center
UNICEF/UN0595856/Andrianantenaina
Persia receiving medicine for her son at the health center

The fight against malnutrition in southern Madagascar requires multiple interventions and the involvement of everyone. In 2021, 35,000 people including 22,500 children, benefited from a cash transfer program that supports the most vulnerable. Persia, 20, was able to buy medicines for her 23-month-old son because of the cash she received. Years of drought continue to take a toll on southern communities and UNICEF, together with its partners continues to accelerate emergency responses to strengthen the resilience of the population so that every child in these regions can enjoy their right to good development.