Nutrition

Country Assessment in Madagascar

Landscape Analysis

Madagascar was the first country to undertake the Landscape Analysis country assessment in March and April 2008.

Aims and objectives

The assessment constituted a mid-term review of the national nutrition plans and a review of sector cooperation. It aimed to identify activities that would need to be prioritized in order to scale up proven nutrition actions. The expected outcome was a strategic plan for accelerating the reduction of maternal and child undernutrition in Madagascar.

Country assessment team

The assessment team was led by the Office National de Nutrition (ONN) with representatives from the Ministry of Health, SEECALINE (Surveillance Education des Ecoles et des Communautés en matière d’Alimentation et de Nutrition Elargie), CISCO (Circonscription Scolaire), UNICEF, WHO, UN Standing Committee on Nutrition (SCN) and Helen Keller International (HKI).

Methodology and study sites

The team conducted interviews with representatives from public sector, private sector companies and development partners at national level, and with local government, hospitals, primary health care centres, schools and SEECALINE centres in the three regions of Analamanga, Boeny and Anosy.

Findings

The assessment found a strong political commitment linked to the highest levels. This commitment was however, diluted by a poor perception of the real nutrition problems and the interventions needed, especially at the sub-national level. Despite the existence of budget lines for nutrition at the district level, the programme budget for nutrition activities relied almost completely on donors and not on governmental funds.

The assessment noted that Madagascar has considerable strengths in terms of human resources to accelerate nutrition actions, such as the Regional Technical Managers of ONN, but that staff with a formal training in nutrition are in very short supply.

Consensus meeting and recommendations

A stakeholder consensus meeting was held on 7 April 2008 with members of the Bureau Permanent de Nutrition and stakeholders from various sectors and partners. Participants at the meeting agreed on eight specific recommendations including increasing coverage of community based nutrition activities and strengthening nutrition coordination and leadership. The results were also presented on 7 April 2008 to the Permanent Bureau of the Conseil National de Nutrition (CNN) as well as to the Prime Minister in a special audience.

Follow-up action

There are a number of examples of how the recommendations have been implemented. For example, there has been a higher focus on actions to improve maternal nutrition such as multiple micronutrients supplementation and deworming among pregnant women.

Following on the Landscape Analysis country assessment, the Malagasy country team has used the findings as an input to develop policy briefs in order to operationalize and prioritise interventions outlined in the second national nutrition action plan (Plan National d’Action pour la Nutrition II 2012-2015).

In March 2012, the country joined the Scaling-Up Nutrition (SUN) movement. The Prime Minister officially launched the Madagascar SUN Road Map (Feuille de route SUN de Madagascar pour la réduction de la malnutrition chronique) in a high level meeting with government and development partners.

Further information and links


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Contact information:

Nutrition Policy and Scientific Advice Unit (NPU)
WHO Department of Nutrition for Health and Development (NHD)
Geneva, Switzerland
Fax: +41.22.791.4156
E-mail: NPUinfo@who.int
NHD website: www.who.int/nutrition