Communicating on Nutrition in Madagascar
When we talk about child nutrition, who should we focus on for a simple, clear and effective communication, which provides useful information to support a healthy growth of all children?
Women.
In Madagascar, acute malnutrition affects 8.2% of children under 5 years old at the national level, with three regions exceeding WHO’s serious threshold of 10%. Women are also affected by malnutrition and anemia, which affect 27% and 35% respectively. Concerning adolescents, 28% of them suffer from malnutrition and 35% from anemia as well.
According to the Global Analysis of Food Security and Nutrition Vulnerability (AGSANV), the proportion of children 6 to 23 months receiving a varied diet is low (30.9%), even in the richest households. Only 46.1% of these children consume foods rich in vitamin A and 36% consumed foods rich in iron in the 24 hours preceding the study.
Child care practices are not adequate. A situation aggravated by the high proportion of teenage mothers or pregnant women (36%).
A test phase of the MIARO approach of the World Food Programme (WFP) was set up in Madagascar between 2014 and 2016, in two communes of Ampanihy district (Fotadrevo and Itampolo), in the Region of Atsimo Andrefana. WFP and UNFPA (United Nations Population Fund) have joined forces to combat chronic malnutrition by focusing on pregnant and breastfeeding women, as well as children from 6 to 24 months of age. Both work in close collaboration with the National Office of Nutrition (ONN) and the Ministry of Health (MINSAN) of Madagascar. This approach has led to improved dietary diversity, attendance at health facilities for perinatal care and child care practices. It has also had an impact on reducing the prevalence of chronic malnutrition. The multi-sectoral approach includes the following activities: nutritional supplementation for children aged 6–23 months and pregnant and lactating women; strengthening of reproductive health services; communication promoting behavioral change at community level; capacity building of the health system for monitoring child growth and nutrition-sensitive agriculture.
The WFP is responsible for bi-monthly distribution of specialized nutritional products, screening for malnutrition, communication for social and behavioral change, and support for community and school gardens.
In this regard, sensitization sessions for pregnant and breastfeeding women are regularly organized before, during and after the distribution of nutritional supplements for their children. The goal is to make them understand the importance of these distributions, but also to determine who can benefit from nutritional supplements (depending on the mid-upper arm circumference of their children). Finally, these sessions emphasize the importance of adopting good nutrition practices, and breastfeeding coupled with a varied and diversified diet.
A Communication promoting social and behavioral change is essential to recognize the importance of improving children’s dietary diversity and promoting women’s nutritional and health status (before, during and after childbirth). This communication must be accompanied by changes in knowledge, attitudes and practices, and by an holistic participation of the entire targeted community to make the measures effective.
Simple, clear and repeated messages are displayed on posters, banners, or through voice messages in meeting places, in public spaces, or in distribution areas. They present to the people of Madagascar ideas of daily actions to adopt to improve their health and that of their children.
Visualize, explain, show, repeat, are very effective communication techniques to strengthen the health and nutrition of children in Madagascar. This same communication encourages women to initiate change towards a more conscious and child-sensitive population, so that they can benefit from all the nutritional inputs necessary for their socio-cognitive development.
