From February to April 2020, corresponding to the hunger gap period (peak of malnutrition), 4 districts were classified in the Serious phase (IPC Phase 3) and 2 districts in the Alert phase (IPC Phase 2). In total, more than 100,000 children are expected to suffer from acute malnutrition during the year 2020, including more than 19,000 severe cases in the 6 districts analysed, based on the combined prevalence of the 3 forms of acute malnutrition from the nutrition surveys conducted between February and March 2020. Between May and August 2020, the nutritional situation will not experience a marked change in all 6 districts analysed, which will therefore remain in the same phase as that of February – April 2020. From September 2020, if useful measures are not taken, a rather significant deterioration of the nutritional situation will be observed leading to a change of phase for 2 districts. Thus, 1 district will switch to a Critical phase (IPC Phase 4) and the other to a Serious phase (IPC Phase 3), along with the 3 districts already in a Serious phase (IPC Phase 3). 1 district will remain in the Alert phase (IPC Phase 2).
During the period from February to April 2020, six districts were classified in the Serious Phase (IPC Phase 3): Tulear 2, Ampanihy in the region of Atsimo-Andrefana, then Beloha and Ambovombe in the region of Androy. The districts of Betioky in the AtsimoAndrefana region and Tolagnaro in the Anosy region were classified in the Alert phase (IPC Phase 2). However, there were no districts classified as Critical (IPC Phase 4) or Extremely Critical (IPC Phase 5). A slight improvement in the nutritional situation is expected in all districts following the post-harvest period, which would be negatively impacted by an increase in diseases and the negative impacts of COVID-19 on food systems and access to health services between May and August 2020. Furthermore, the nutritional situation is expected to deteriorate in all the six districts beyond August due to the agricultural lean season and the persistence of the effects of COVID-19, which will push Betioky district into IPC Phase 3 (Serious) and Ambovombe district into the Critical phase (IPC Phase 4), requiring special attention and an urgent and targeted response.
Major contributing factors to the deterioration of the nutritional situation include inadequate food intake, poor dietary diversity of children and women, high prevalence of diseases (diarrhoea, ARI, malaria) linked to restricted access to health services. The high level of acute food insecurity (IPC AFI Phase 3+) in most districts and the low access to safe drinking water also contribute to increased levels of acute malnutrition. Finally, the COVID-19 epidemic is an unusual and aggravating shock to acute malnutrition, with the serious disruption it causes to the food and health systems.