In 2018, Madagascar was hit by two tropical storms (Ava and Eliakim), displacing 70,000 and preventing more than 50,000 children from attending school.
While plague epidemics remained under control in 2018 - following strong preparedness efforts - a measles epidemic started in September in urban areas, with 14, 788 notified cases by the end of December.
Although no nutrition or food security crises were declared by the Government in 2018, the nutritional status of the population in the drought prone districts of southern Madagascar remains precarious.
In 2018, the political situation was relatively calm. The second round of the presidential election was held on 19 December, with the proclamation of the official results scheduled for 9 January 2019.
Situation Overview and Humanitarian Needs
In the first half of 2018, Madagascar was hit by two cyclones with more than 200,000 people affected, including 70,000 people displaced. UNICEF and partners worked together to support the affected communities to recover from the impact of these cyclones. In 2018, UNICEF prioritized the need for continued support to the Government to reinforce community resilience in the face of disasters in areas that are vulnerable to the effects of recurring cyclones on critical systems. Currently, there is a need to prepare for the upcoming 2019 cyclone season.
In 2018, two Integrated Food Security Phase Classification (IPC) exercises were completed in June and October. As forecasted, the food security situation in one out of 15 (Ampanihy District) southern drought-prone districts (Map 1 and 2) deteriorated, while the situation remains the same in Beloha Districts. In the last quarter of 2018, this represented six per cent (298,000 people) of the total population in Food Security Phase 4 (Emergency), 17 per cent (760,000) in Phase 3 (Crisis) and 26 per cent (1,194,000) in Phase 2 (Stressed).
The IPC results are in line with the information from the Nutrition Surveillance System, which screens about 250,000 children aged six to 59 months every quarter for acute malnutrition at community level in southern Madagascar. The surveillance system, developed by the Nutrition Cluster in 2017 and enhanced in 2018 with UNICEF support, revealed a deterioration in the nutrition situation in some communes in the second quarter in Ampanihy District. However, the nutrition situation remained under control in Beloha Districts due to on-going multi-sectoral food security interventions initiated in early 2018 by different partners, including the World Food Programme (Map 3). Nutrition surveillance results in the first quarter were confirmed by a SMART survey conducted in March and April 2018 in three of the eight droughtprone districts (Ampanihy, Beloha and Tsihombe). In the third quarter, 18 out of 140 (13 per cent) communes were in Nutrition Alert (proxy Global Acute Malnutrition prevalence of 10 – 14.9 per cent) and Nutrition Emergency (proxy Global Acute Malnutrition prevalence of 15 per cent and more). The evolution of the number of SAM admissions in treatment facilities corroborates the analysis with an increasing trend in the third quarter above the two previous years (Graph 1).
Chronic drought continues to fuel food insecurity due to low agricultural output in addition to lack of access to safe water, sanitation and hygiene (WASH) facilities in the south, with more than 475,000 people in need of WASH services. Access to health services is also limited in the south with more than 70 per cent of the population living more than 5 km away from basic health centers.
From mid-August 2018, the seasonal plague hit Madagascar, and as of 14 December, 148 cases with 18 deaths were recorded. Due to the recurrence of the plague over the years, Madagascar has basic plague control measures in place and good technical expertise especially via the Institute Pasteur Madagascar (IPM). Based on the current epidemiological situation, the Ministry of Public Health did not declare a plague epidemic but started a regional focused response.
On the other hand, a worrying measles epidemic started in September 2018, including in main urban areas (Antananarivo and Tamatave were the two main conurbations). By the end of December, there were 14, 788 notified cases.