A Black woman with her hair in cornrows sits on a bed with pink paisley sheets. A small child wearing a red jacket and blue socks sits on her lap. They participated in an early childhood development project in Madagascar in 2007

Lingering famine risks childhood development

As food insecurity in Madagascar worsens, Humanity & Inclusion uses stimulation therapy and food aid to prevent long-term disabilities in malnourished children.

As the south of Madagascar—an island country off the east coast of continental Africafaces its worst drought in 40 years, its people continue to face the brutal consequences of starvation and malnutrition. Years of insufficient rainfall and the added impact of climate change have ravaged the land and devastated the agricultural production that much of the population depends on. Today, more than 1.35 million people in the Atsimo Andrefana region face acute food insecurity, and are experiencing dangerous levels of hunger. Death rates are soaring and local health and social services are unable to meet such high demand. These challenges are worsened by the Covid-19 pandemic.

“Accessing food has become a real challenge for many families,” says Emilie Sauvanet, Humanity & Inclusion’s Country Director for Madagascar. "In this already very difficult context, the situation is made even worse for people with disabilities. They experience discrimination and socio-economic inequalities, high levels of insecurity, poor access to drinking water and sanitation facilities, difficulties in moving around and, above all, a lack of consideration for their specific needs. As in any crisis situation, people with disabilities, children and women are most affected.”



Long-term risks of malnutrition

The increasingly high levels of malnutrition and undernutrition in children under the age of 5 put them at heightened risk of delaying their growth or developing long-term disabilities.

Severe acute malnutrition (SAM) affects approximately 20 million children worldwide and is the estimated cause for 400,000 child deaths each year. In Madagascar, nearly half of all children under the age of 5 experience SAM, which is only worsening amid the current crisis. SAM can lead to difficulties in developing motor skills such as crawling, sitting and grasping, or to Hypotonia, a disorder that affects motor nerve control by the brain. If not properly managed, these developmental delays can transform into lifelong disabilities. 

Humanity & Inclusion teams in the region have already identified more than 800 children in need of nutrition support and physical therapy to facilitate normal growth and development. Physical therapists use functional exercises, early childhood stimulation therapy and physical therapy to enable children with SAM to maintain normal weight gain, growth patterns and cognitive development. Through individual therapy sessions with trained professionals, children gain skills through interactive play. Techniques are also taught to their caregivers so they can continue therapy at home. 

HI's TIALONGO project

After an assessment, Humanity & Inclusion launched the “TIALONGO” project in the Madagascar program. Teams provide urgent food support to people with disabilities and their households and are working to reduce the development of disabilities linked to malnutrition and undernutrition in children. Among others, the key outcomes include: 

  • Providing quality and sufficient food to people disproportionately affected by the crisis
  • Improving the nutritional situation of children below the age of 5 and reducing the development of disabilities linked to malnutrition
  • Educating local health professionals on early identification and management of disabilities
  • Training physical therapists and occupational therapists in stimulation therapy

The project is expected to reach nearly 115,000 people in need of support. 


Image: A mother and her children from Humanity & Inclusion’s early childhood project in Tana, Madagascar. Copyright: S. Bonnet/HI Archives, 2007