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The NCA was conducted in the context of a food security crisis in the Kanem region of Chad. The survey period took place during a peak period of admission rates for severe acute malnutrition. The results of the study support the following causal pathways of undernutrition: insufficient production of agriculture and livestock, climatic shocks, lack of agricultural training and tools, post-harvest crop destruction by bird and insects, lack of access to water, and insufficient access to markets.