In Antananarivo, poverty is a source of malnutrition

Run jointly with 8 partners, AKANY TAFA is a social support center for the well-being of families, especially women and children. “It’s a first door for local residents who don’t have access to health care, family planning, psychosocial services, administrative or legal assistance, or who are looking for a helping hand in their professional lives”, explains Rodolphe. The center aims to be a safe place for vulnerable people requiring free services that meet their needs. “We welcome around 15 people a day,” he says.

In the midst of other women and children who have come for the occasion, Felana attends an awareness-raising session on hygiene and menstrual hygiene in particular. These slightly embarrassed women laugh among themselves and listen attentively to the advice of Andrianiry FIHARIANTSOA, community mobilizer for Action contre la Faim.

“There’s a real bond of trust that develops with the families,” adds Andrianiry. “Some of them confide in us that they prefer to come to AKANY TAFA rather than to the town’s CSBs (Basic Health Centres), because they know that here they are welcome and won’t be judged”, she adds.

It’s this bond of trust that Aurore, a midwife for 15 years working for the NGO FISA (Fianakaviana Sambatra), which specializes in family planning and is a partner of the social center, tries to forge with the women she sees.  In a more intimate room, Aurore examines a young woman wishing to have a contraceptive implant. “Surprisingly, the majority of women choose long-term contraception because they don’t want to have any more children, so they can have a good job and support their family,” says Aurore. “The situation is really alarming for these young women, most of whom don’t have enough to eat and prefer to deprive themselves to feed their children.

Child malnutrition, an under-addressed issue

In addition to the social center, Action contre la Faim teams support the establishment and operation of 4 community nutrition sites run by the Ministry of Health. At these sites, which are managed by the Fokontany (town councils for the city’s districts), community workers trained by Action contre la Faim organize sessions to promote and monitor growth among children, as well as screening and cooking demonstrations.

In a cramped room made available by the Fokontany Faami, Faniry, a community worker receives mothers wishing to find out about their child’s nutritional status.

“When I was pregnant with my first child, I was suffering from malnutrition. So I went to the Action contre la Faim center, where I received treatment,” says Faniry. “I then took part in training sessions, which really interested and pleased me. That’s why I decided to do this job as a community agent, which I particularly like, because I can help the community, especially the people in my Fokontany, I can give them advice and guidance, and I really like that”.

If a case of severe acute malnutrition is detected, the agents refer the families to the nearest CSB, or to hospital if there are complications, so that the child can be medically monitored in a CRENI (Centre de Récupération d’Education Nutritionnelle et Intensive).

“Over the past 3 years, the spotlight has focused on the drought situation in the South of Madagascar. However, the situation in the capital is no less important”, explains Annick Rakotoanosy, Antananarivo base coordinator for Action contre la Faim Madagascar.

In the capital alone, there is a prevalence of chronic global malnutrition of almost 50% and a rate of global acute malnutrition approaching 5%, according to the latest figures from the SMART nutrition survey carried out in 2019.

“In Madagascar, and Antananarivo in particular, poverty is the fundamental cause of chronic malnutrition. This malnutrition causes stunted growth and has a considerable impact on children’s health and intellectual development,” adds Annick.

Chronic malnutrition is under-addressed by the Malagasy government and donor agencies. Funding is mobilized more to respond to emergencies in the South, and particularly in the Southeast, to the detriment of this fundamental problem, which affects the capital and more generally the central part of the island.

Action contre la Faim teams and their partners are currently in the process of seeking funding in order to maintain their interventions with the capital’s most vulnerable inhabitants.