IPC ANALYSIS OF FOOD INSECURITY AND ACUTE MALNUTRITION MADAGASCAR SOUTH AND SOUTH EAST March 2019 ‐ March 2020 Published in July 2019 CURRENT ACUTE FOOD INSECURITY PROJECTED ACUTE FOOD INSECURITY (June 2019 ‐ July 2019) (August 2019 ‐ December 2019) Phase 5 Phase 5 000 000 000 000 Catastrophe Catastrophe 730 522 Phase 4 916 201 Phase 4 134 595 171 421 21 % of the population Emergency 26% of the population Emergency Phase 3 Phase 3 595 927 744 780 Crisis Crisis People facing severe acute People who will be facing Phase 2 Phase 2 food insecurity 1 280 949 severe acute food insecurity 1 280 052 Stressed Stressed (IPC Phase 3 +) (IPC Phase 3 +) Phase 1 Phase 1 IN NEED OF A 1 550 716 IN NEED OF A 1 365 934 URGENT ACTION Minimal URGENT ACTION Minimal ACUTE MALNUTRITION August 2019 – February 2020 SAM* 188 550 35 393 Number of cases *SAM = severe acute malnutrition; Number of 6‐59 months children MAM* MAM = moderate acute malnutrition; acutely malnourished 153 158 Number of cases GAM = global acute malnutrition IN NEED OF TREATMENT 188 550 GAM* Number of cases How severe, how many, and when? Up to July 2019, SEVEN of THIRTEEN analyzed Districts are classified in IPC phase 3 (Crisis‐ IPC Acute Food Insecurity). 730,522 people, including 134,595 in IPC Phase 4 (Emergency) are estimated to be facing severe acute food insecurity. They represent 21% of the population of the areas analyzed (13 districts). 188,550 children are likely to suffer from acute malnutrition, with 35,393 severe cases located in the 12 districts analyzed based on the combined prevalence of the three forms of acute malnutrition from SMART surveys. Where and who? The Districts of Ambovombe, Beloha, Tsihombe, Amboasary, Ampanihy, and Betioky are facing both acute food insecurity‐phase 3 (crisis) and acute malnutrition‐phase 3 (serious). Bekily is classified in IPC Phase 4 (Critical ‐ IPC Acute Malnutrition), the District of Toliara II is in IPC phase 3 (Serious ‐ IPC Acute Malnutrition), and the 5 communes of Taolagnaro are classified in IPC Phase 3 (Crisis ‐ IPC Acute Food Insecurity). Compared to the results of the last IPC Acute Food Insecurity analysis in October 2018, the food security situation in Beloha and Ampanihy districts has significantly improved. The improvement can be attributed in part to humanitarian intervention packages carried out in these two districts: Beloha moved from IPC Phase 4 to IPC Phase 3 with the proportion of households in Phase 3 and 4 falling from 67% in 2018 to 25% in June 2019. The District of Ampanihy was projected to be in IPC Phase 4 but its current phasing is maintained in Phase 3. Why? This situation of localized severe acute food insecurity is caused by several aggravating factors: more than 30% of households in these areas have inadequate food consumption at least 65% of households have reduced portion sizes at meals, a fairly significant proportion of households (between 15 and 38%) adopted crisis strategies, reflected in the accelerated depletion of productive assets, particularly the sale of productive livestock (around 10% of households have reduced their cattle herds). Major contributing factors to the deterioration of the nutritional situation in these areas include inadequate food intake, low dietary diversity of children, high prevalence of diseases (diarrhea, Acute Respiratory Infection, malaria and measles) with more than 30% related to poor access to health services. The high level of food insecurity (IPC Phase3) in most districts and low access to safe drinking water contribute to increased levels of acute malnutrition. IPC ANALYSIS OF FOOD INSECURITY AND ACUTE MALNUTRITION MADAGASCAR SOUTH AND SOUTH EAST March 2019 ‐ March 2020 Published in July 2019 OVERVIEW OF THE ACUTE FOOD INSECURITY SITUATION AND DETERMINING FACTORS 2 Overview of the current situation (June-July 2019) The period of analysis covers the beginning of the harvest for all analyzed areas. The majority of districts in the South are in IPC Phase 3 (Crisis) except Bekily and Toliara II Districts that are classified in IPC Phase 2 (Stress). In the South East, Farafangana, Vangaindrano and Vohipeno Districts are also classified in IPC Phase 2 (and Manakara Atsimo is in IPC Phase 1 (Minimal). More than 730,000 people, i.e. 21% of the population of the analyzed areas are in IPC Phases 3 and 4 (Crisis and Emergency) and therefore require urgent action. A significant decrease in the proportion of the population categorized in these phases was observed compared to the IPC analysis results in 2018 for the same period. For Beloha District, the proportion of population in IPC Phase 3 and 4 has decreased considerably from 65% to 25% for the same period (June 2018/2019); slight improvements have also been recorded in the other Districts: Ampanihy from 49% to 40%; Ambovombe from 30% to 22%; Bekily from 28% to 18%; and Tsihombe from 27% to 23%. For Amboasary district and the 5 communes of Taolagnaro, the situation has stabilized slightly. In general, despite the attack of insect pests and a somewhat unfavourable meteorological context, harvests in 2019 were better than the critically low levels in 2017 and 2018. However, difficulties persist, even if they are transient and localized. Food security in the south remains critical because although the harvests from the main season crop have improved, this has been very marginal. Household incomes remain very low, limiting purchasing power. Insect damage, irregular rainfall in terms of quantity received and geographical distribution, have destroyed cereal crops such as rice and maize. There was a significant crop loss of almost 100% in Ambovombe. As for the South East, the weather conditions were more favorable. Spared by cyclones and major floods and benefiting from sufficient rainfall, the harvests of the main season crop were better than in 2018. Compared to 2017, the harvest improved better. Moreover, no one is in IPC Phase 4 and the proportion of the population in IPC Phase 3 (crisis) does not exceed 15%. Overview of the projected situation (August to December 2019) The projected period corresponds to the period of off‐season preparation that takes place during the lean season. It coincides with the period of significant expenses: funeral ceremony, back‐to‐school time, preparation of farmland. These conditions lead to the risk of deterioration in some districts. For a large part of the population, stocks from the harvest of the main season will be depleted early. For the South, the harvest of tubers, cassava and sweet potato would help to mitigate this shortage. However,it is primarily middle‐income and wealthy households that can see major impacts from this opportunity and poor households with limited access to land will benefit on a smaller scale. The weather conditions, though quite conducive, do not give hope for more favorable harvests with the threat of pest attacks. The lean season from September to November 2019 will exacerbate household difficulties. Household living conditions will deteriorate. For the South East, Manakara would move from Phase 1 to Phase 2 IPC (Stressed). For the other districts, the proportion of households in phase 3 will remain relatively stable (Vangaindrano and Vohipeno) even increase slightly by around 5% for Farafangana. For the South the proportion of the population in IPC Phase 4 (Emergency) in Beloha, Taolagnaro and Tsihombe) will increase slightly. IPC ANALYSIS OF FOOD INSECURITY AND ACUTE MALNUTRITION MADAGASCAR SOUTH AND SOUTH EAST March 2019 ‐ March 2020 Published in July 2019 OVERVIEW OF THE ACUTE MALNUTRITION AND CONTRIBUTING FACTORS 3 Overview of the current situation (March-July 2019) For all the analyzed districts, the current period corresponds to the end of the lean season up to the period of main season crop harvest, which coincides with the peak of acute malnutrition cases between March and April, according to nutritional monitoring data and SMART surveys. For the current period, the Districts of Betioky, Ampanihy, Toliara II, Tsihombe, Beloha, Ambovombe and Amboasary are classified in IPC phase 3 (Serious), followed by the Districts of Mananjary, Taolagnaro, Vangaindrano in IPC phase 2 (Alert) and Farafangana in IPC phase 1 (Acceptable). The high prevalence of diseases in Bekily, including diarrhea (34%), fever and malaria (60%) and acute respiratory infections (68%) combined with the persistence of inadequate feeding practices (33% exclusive breastfeeding) and low vaccination coverage (vitamin A‐64%, measles‐ 50%) have increased levels of acute malnutrition in the district and led to its classification in IPC phase 4 (Critical), requiring a crucial and targeted response. Major contributing factors to the deterioration of the nutritional situation in the analyzed districts during this period include: exposure to relatively high acute food insecurity (IPC phase 3 for all southern districts and IPC phase 2 for the southeastern districts) of households with negative impacts on children's dietary diversity; inadequate food intake; the prevalence of diseases such as diarrhea, acute respiratory infection (ARI), malaria, access to drinking water; and the measles epidemic. Overview of the projected situation (August to October, and November to February 2020) The first projected period (August‐October 2019) corresponds to a post‐harvest period implying an improvement in food availability and a dry period leading to a decrease in the number of cases of malnutrition‐related diseases. Thus, a more marked improvement in nutrition is expected in 4 Districts (Bekily, Toliara II, Mananjary and Vangaindrano) which will lead to a reclassification to a lower phase, notably Tulear‐II (3 to 2), Bekily (4 to 3), Mananjary (2 to 1) and Vangaindrano (2 to 1), and less pronounced in the other 8 districts where a phase change is not to be anticipated. The second period (November 2019 to February 2020) coincides with the beginning of the lean season, which is characterized by the depletion of household food reserves, declining access to food, and the rainy or even cyclonic season in the Southeast, with risks of an upsurge of diarrhea and malaria cases.