Strong seasonality in diets and alarming levels of food insecurity and child malnutrition in south-eastern Madagascar

Rural areas of Madagascar face a tense food and nutrition security situation. The country reports some the highest rates undernourishment malnutrition worldwide. Evidence is scant, however, about how rural people’s diets vary over course agricultural year, different household types deal with fluctuating availability. This lack detailed understanding situation across time social strata currently limits development stakeholders’ ability to tailor interventions local needs. Using randomly sampled survey data from Farafangana District in south-eastern Madagascar, this study analyzes households’ three points within one year (minor lean period, major main post-harvest period). In addition, anthropometric on children aged 6–59 months were collected during period determine levels chronic acute child malnutrition. Overall, insecurity stood at high all times, but substantial variation year. Shortly before rice harvest, prevalence moderate severe was 78%, twice as shortly after harvest. With 57% stunted 17% wasting, observed exceed reported previously. By studying what households eat they source it (own production vs. purchases), we found distinct patterns acquisition between periods. Diminishing reflected by substituting cassava, unripe jackfruit period), tuber tavolo (major well lower diversity side dishes. Our results underline need for long-term strategies that contribute greater self-sufficiency especially But alarming level also calls more immediate humanitarian aid public health interventions.