1. Situation overview including Security Issues
The Grand Sud of Madagascar (Great South), an arid zone populated by 3.51 million people, has been affected by three successive years of extreme drought, which has resulted in widespread food insecurity and malnutrition. In particular, more than 1/3 of the total population of the Great South, (over 1.14 million people) are currently facing severe food insecurity with many households running out of basic staple food. Significant agricultural resource deficits linked to low rainfall over the protracted period, limited access to alternative employment and rising poverty levels linked to COVID-19, with limited access to health and nutritional services are the main underlying causes for the current nutritional crisis, which has worsened in the last one year.
The unmet need for Family Planning, maternal mortality and GBV remained high in the southern regions.
A rapid assessment of the impact of Covid-19 indicated a decrease of the access to integrated SRHR services during the first and second waves of the pandemic in Madagascar (UNFPA, 2020). Indeed, 77.7% of women reported that they were victims of GBV (UNFPA, 2020).
Within a district, some municipalities are in emergency zone, others are in alert zone and control zone (see map). To ensure that the population in the Alert and Under Control zones do not fall into the Emergency zone, UNFPA interventions will provide differentiated responses to all these zones.
Following development of a humanitarian response plan in October 2020 in order to implement multisectoral interventions until May 2021, with support from partners, 1.35 million people have been assisted in kind or in the form of a cash transfer, out of the 1.5 million in need, including more than 108,180 children and women receiving health and prenatal care.
Despite concerted efforts, the institutional delivery rate at the health centers has not improved (33% in january 2021; 31% in April 2021). Percentage of skilled attendance at birth in the Grand Sud is still lower than the national average, reflecting challenges in access of sexual and reproductive health services, especially in the districts of: Betioky Sud, Betroka, Bekily, Ambovombe, Tsihombe and Taolagnaro.
The distribution of the population affected by this drought and corresponding to the UNFPA targets is described below: