Anticipate to Prevent Malnutrition : a pilot project in Mali and Madagascar

When a crisis occurs, it is often too late to avoid its most devastating consequences. Floods, droughts, cyclones, epidemics, conflicts… These events, which are becoming more frequent and intense, disrupt the lives of millions of people, destroy crops, hinder access to water and healthcare, and exacerbate poverty and the nutritional situation of communities. In these circumstances, malnutrition is not just a side effect: it becomes one of the most serious consequences that can be prevented by taking anticipatory action.

Preventing Malnutrition in Times of Crisis

In several projects, Action Against Hunger teams have implemented protocols designed to act before  predictable shocks occur, based on predefined warning signs and indicators. The idea is quite simple: prepare and protect communities and enhance health systems rather than waiting to intervene.

In practical terms, teams can store food and medical supplies in advance at emergency shelters, broadcast alerts and risk warnings to help communities secure their crops and livestock, or set up cash transfers so that families can protect their property, reinforce their shelters, and access healthcare in advance. After several years of experimentation and according to a recent study, the results show that this approach is more economical, with a ratio of $7 in damage avoided and benefits created for every $1 invested.

Through a project funded by the Swedish International Development Cooperation Agency (SIDA), Action Against Hunger teams aimed to integrate malnutrition management into anticipatory measures. These measures are designed to prevent disruptions in care and better protect children as well as pregnant or breastfeeding women. The main objectives are to reduce the peaks of malnutrition usually observed after a traumatic event and to ensure continuity of care and nutritional pathways, even during times of crisis.

Project Initiatives in Mali and Madagascar

Before implementing this initiative, an initial phase of research and discussions was conducted with the population, authorities, and health and nutrition stakeholders to map risks and needs, analyze the impact of hazards on nutrition, and define concrete actions tailored to each context.

In Mali, in Ségou and Bamako, the population is mainly concerned about difficulties in accessing health facilities when the waters of the Niger River rise. Participants proposed setting up mobile clinics, relocating health centers threatened by flooding, and creating safe spaces for women and children. Stocks of nutritional products, medicines, and hygiene kits can also be stored in waterproof containers, ready to be deployed in an emergency. It was also recommended that alerts be reinforced through messages broadcast on the radio, WhatsApp, and even town criers, in order to reach as many people as possible. 

In Madagascar, where drought and cyclones are a constant threat, workshops in Antananarivo and Ambovombe have helped to define appropriate measures: cash transfers to help families access healthcare early on, distribution of nutritional supplements for children and pregnant or breastfeeding women, and awareness-raising on good dietary practices. Evacuation plans and mobile clinics have been incorporated into the plans, while malnutrition screening has been stepped up to enable rapid intervention for the most vulnerable.

Following these discussions, Action Against Hunger teams worked with their partners to improve early warning systems. Radios were provided to local committees and awareness-raising activities were organized among the population to better anticipate and respond to these crises, thereby regaining control over events rather than simply enduring them. In Mali and Madagascar, nearly 350,000 people will now be better protected in the event of an alert or shock. Action Against Hunger experts continue to follow up on the implementation of these recommendations and their use by the populations concerned. This approach and its initial experiences will also be shared with Action Against Hunger partners so that these steps can be replicated in other contexts and nutritional anticipatory action becomes standard practice in risk management.

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