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Madagascar
The burden of malnutrition at a glance
Madagascar is 'on course' to meet one of the global nutrition targets for which there was sufficient data to assess progress.
Madagascar is 'on course' to meet one target for maternal, infant and young child nutrition (MIYCN). No progress has been made towards achieving the target of reducing anaemia among women of reproductive age, with 37.8% of women aged 15 to 49 years now affected. Meanwhile, there has also been some progress towards achieving the low birth weight target with 17.1% of infants having a low weight at birth. No progress has been made towards achieving the exclusive breastfeeding target, with 50.6% of infants aged 0 to 5 months exclusively breastfed. Madagascar has made some progress towards achieving the target for stunting, but 39.8% of children under 5 years of age are still affected, which is higher than the average for the Africa region (30.7%) and among the highest in the world. Madagascar has also made some progress towards achieving the target for wasting but 7.7% of children under 5 years of age are still affected, which is higher than the average for the Africa region (6.0%). The prevalence of overweight children under 5 years of age is 1.8% and Madagascar is 'on course' to prevent the figure from increasing.
Madagascar has shown limited progress towards achieving the diet-related non-communicable disease (NCD) targets. 9.2% of adult (aged 18 years and over) women and 3.8% of adult men are living with obesity. Madagascar's obesity prevalence is lower than the regional average of 20.8% for women and 9.2% for men. At the same time, diabetes is estimated to affect 5.4% of adult women and 7.4% of adult men.
Progress towards the global nutrition targets
Childhood stunting
Some progressAnaemia
No progress or worseningLow birth weight
Some progressChildhood overweight
On courseExclusive breastfeeding
No progress or worseningChildhood wasting
Some progressSodium intake, women and men
Off courseRaised blood pressure, women
Off courseRaised blood pressure, men
Off courseObesity, women
Off courseObesity, men
Off courseDiabetes, women
Off courseDiabetes, men
Off courseSource: WHO. Global Health Observatory Data Repository/World Health Statistics. Available at: https://www.who.int/data/gho/data/indicators. Accessed 16 November 2022.; UNICEF/WHO. Low birthweight estimates; published online 2019. Available at: https://data.unicef.org/topic/nutrition/low-birthweight. Accessed 16 November 2022; UNICEF. Global databases: Infant and young child feeding; published online July 2020. Available at: http://data.unicef.org/nutrition/iycf. Accessed 16 November 2022; UNICEF/WHO/World Bank. Joint Child Malnutrition Estimates Expanded Database: Stunting, Wasting and Overweight; published online July 2020. Available at: https://data.unicef.org/resources/dataset/malnutrition-data. Accessed 16 November 2022; NCD Risk Factor Collaboration. 2017. Available at: http://ncdrisc.org/data-downloads.html. Accessed 16 November 2022; Tufts University. Global Dietary Database; published online 2019. Available at: https://www.globaldietarydatabase.org/data-download. Accessed 16 November 2022
Notes: Progress towards the maternal, infant and young child nutrition (MIYCN) and diet-related non-communicable disease (NCD) global nutrition targets is classified as ‘on course’ if the target is met, ‘some progress' or ‘no progress or worsening’. MIYCN targets include anaemia among women of reproductive age (15–49 years), infants with low birthweight, exclusive breastfeeding among infants under 6 months of age, and childhood stunting, wasting and overweight. NCD targets include adult obesity and diabetes, raised blood pressure and sodium intake. Obesity and diabetes are based on age-standardised modelled estimates for adults aged 18 years and older, using the WHO standard population; they are reported by sex due to limitations in data availability. Anaemia and low birthweight are also based on modelled estimates. The specific targets set are: 40% reduction in the number of children under 5 years of age who are stunted; 50% reduction of anaemia in women of reproductive age; 30% reduction in low birth weight; no increase in childhood overweight; increase the rate of exclusive breastfeeding in the first 6 months to at least 50%; reduce and maintain childhood wasting to less than 5%; 30% relative reduction in the mean population intake of salt/sodium by 2025; 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances; and halt the rise in obesity and diabetes. The methodologies for tracking progress differ across targets. See Methodology for more information on the indicators.
Diet
Infant and young child feeding
Prevalence of infant and young child feeding indicators
Source: UNICEF. Global databases: Infant and young child feeding. Published online September 2021. Available at: http://data.unicef.org/nutrition/iycf. Accessed 16 November 2022.
Notes: Prevalence (%) estimates are presented for infants and young children aged 0–23 months (age varies by indicator). Location is classified as ‘urban’ or ‘rural’ (as defined in the survey). Education refers to the educational level of the mother and is classified as ‘none or primary’ or ‘secondary or higher’. Wealth is asset-based wealth scores at the household level, classified as quintiles: ‘lowest’, ‘second lowest’, ‘middle’, ‘second highest’ and ‘highest’. See Methodology for more information on the indicators.
Dietary intakes
Dietary intakes of key foods and nutrients in adults aged 20 years and over compared against minimum and maximum targets
Source: Tufts University. Global Dietary Database. Published online 2019. Available at: https://www.globaldietarydatabase.org/data-download. Accessed 16 November 2022
Notes: Intakes are reported in grams per day (g/d) for all dietary factors. Intakes are based on modelled estimates for adults aged 25 years and older. The dietary factors have been selected as those diet components that have a statistically significant relationship with at least one disease endpoint that can be generalisable to all populations. Recommended intake targets were determined by the EAT-Lancet Commission on healthy diets from sustainable food systems. This includes minimum recommended intakes of health promoting food groups (fruits, vegetables, legumes, nuts and wholegrains) and maximum recommended intakes of food groups with detrimental health and/or environmental impacts (red meat, dairy, and fish). Ideal intake for each food is within the shaded area of the graph.
Nutrition strategies and financing
National nutrition policies
Implemented national food and NCD policies
- Food-based dietary guidelines
- No
- Legislation for mandatory salt iodisation
- Yes
- Sugar-sweetened beverage tax
- No
- Policy to reduce salt/sodium consumption
- No
- Policy to limit saturated fatty acid intake
- No
- Policy to eliminate industrially produced trans fatty acids
- No
- Policy to reduce the impact of marketing of foods and beverages high in saturated fats, trans fatty acids, free sugars, or salt on children
- No
- Operational policy, strategy, or action plan to reduce unhealthy diet related to non-communicable diseases
- Yes
- Operational, multisectoral policy, strategy or action plan for non-communicable diseases
- Yes
- Operational policy, strategy or action plan for diabetes
- Yes
Source: Global Fortification Data Exchange. Available at: https://fortificationdata.org/interactive-map-fortification-legislation. Accessed 16 November 2022; Global Fortification Data Exchange. Available at: https://fortificationdata.org/interactive-map-fortification-legislation. Accessed 16 November 2022; WHO. Global Health Observatory Data Repository. Available at: https://www.who.int/data/gho/data/indicators. Accessed 16 November 2022.
Notes: Country with food-based dietary guidelines in 2018, sugar-sweetened beverage tax in 2017 and all other policies in 2019. 'Policy' is defined as a specific official decision or set of decisions designed to carry out a course of action endorsed by a political body, including a set of goals, priorities and main directions for attaining these goals, including legislation and product reformulation mandates. 'Strategy' is defined as a long-term plan designed to achieve a particular goal. Action plan is defined as a scheme or course of action, which may correspond to a policy or strategy, with defined activities indicating who does what, when, how and with what resources to accomplish an objective. ‘Operational’ describes a policy, strategy or plan of action being used and implemented in the country, with resources and funding available to implement it. ‘Multisectoral’ applies to a policy, strategy or plan of action that involves different sectors (e.g., health, agriculture, education, finance). See Methodology for more information on the indicators.
National policy targets
Inclusion of targets related to the global nutrition targets in national policies
- Reduce anaemia among women
- Yes
- Reduce number of infants born with low birth weight
- Yes
- Increase prevalence of exclusive breastfeeding in infants 0–5 months
- Yes
- Reduce childhood stunting
- Yes
- Reduce childhood wasting
- Yes
- Reduce childhood overweight
- Yes
- Reduce adolescent and adult overweight
- Yes
- Reduce salt/sodium intake
- No
- Reduce raised blood pressure prevalence
- Yes
- Reduce blood sugar levels/diabetes prevalence
- Yes
- Multisectoral comprehensive nutrition plan
- Yes
Source: WHO GINA. 2nd Global Nutrition Policy Review. 2016–2017.
Notes: Target included in national policies in 2017. Any national government-implemented policy, strategy or plan relevant to improving nutrition and promoting healthy diet was considered for 194 countries. Legislation, codes, regulations, protocols and guidelines, as well as non-governmental policies, were excluded. See Methodology for more information on the indicators.
Nutrition intervention coverage
Population coverage of key supplementation and fortification interventions
Coverage/practice indicator | Total (%) | Boy (%) | Girl (%) | Year |
---|---|---|---|---|
Children aged 0–59 months with diarrhoea in the past two weeks preceding the survey who received zinc treatment | 11 | 11 | 10 | 2018 |
Children aged 6–59 months who received two high-dose vitamin A supplements in a calendar year | 26 | No data | No data | 2020 |
Children aged 6–59 months given iron supplements in the seven days preceding the survey | 3 | 3 | 2 | 2021 |
Women with a live birth in the five years preceding the survey who received iron tablets or syrup during antenatal care | 74 | NA | NA | 2021 |
Households consuming any iodised salt | 68 | NA | NA | 2009 |
Source: UNICEF. Global databases: Child health coverage. Published online May 2022. Available at: https://data.unicef.org/topic/child-health/diarrhoeal-disease. Accessed 16 November 2022; UNICEF. Global databases: Vitamin A data. Published online September 2021. Available at: https://data.unicef.org/resources/dataset/vitamin-supplementation. Accessed 16 November 2022; STATcompiler. The DHS Program. Available at: www.statcompiler.com. Accessed 16 November 2022; UNICEF. Global databases: Iodized salt. Published online October 2021. Available at: https://data.unicef.org/topic/nutrition/iodine. Accessed 16 November 2022
Notes: Estimates are reported as percentages (%). See Methodology for more information on the indicators.
Official development assistance (ODA)
Allocation of ODA for nutrition
Source: Global Nutrition Report based on OECD DAC CRS. 2020.
Notes: Gross official development assistance (ODA) received or disbursed for basic nutrition (CRS code: 12240) reported in US$ millions (constant 2020 prices) and as percentage (%) of the total ODA received/disbursed. Estimates include ODA grants and loans, but excludes other official flows and private grants. See Methodology for more information on the indicators.
Environmental impacts
Environmental impacts of the food system
Pressure from the food system on environmental factors as a percentage of total pressure
Source: New analysis based on estimates of food demand from the Food and Agriculture Organization (FAO) (FAO. Food Balance Sheets: A Handbook. Rome, Italy: FAO, 2001) and a database of country- and food group-specific environmental footprints (Springmann et al. Nature 2018; 562: 519–25; Poore & Nemecek. Science 2018; 360: 987–92).
Notes: Data on food demand for each country from FAO was paired with a comprehensive database of environmental footprints, differentiated by country, food group, and environmental impact. The footprints take into account all food production, including inputs such as fertilisers and feed, transport, and processing, e.g., of oil seeds to oils and sugar crops to sugars. The displayed total pressure is in the units stated for each environamental domain and has been rounded to the nearest 10 units. See Methodology for more information on the indicators.
Food system impact on planetary boundaries
Source: New analysis based on estimates of food demand from the Food and Agriculture Organization (FAO) (FAO. Food Balance Sheets: A Handbook. Rome, Italy: FAO, 2001) and a database of country- and food group-specific environmental footprints (Springmann et al. Nature 2018; 562: 519–25; Poore & Nemecek. Science 2018; 360: 987–92). The target values for sustainable food production are in line with Sustainable Development Goals specified by and adapted from the EAT-Lancet Commission (Willett et al.The Lancet 2019; 393: 447–92.; Springmann et al. The British Medical Journal 2020; 370: 2322).
Notes: Planetary boundaries define the threshold related to global environmental processes beyond which humanity should not go. Planetary boundaries align with the targets for sustainable food production as set out by the Sustainable Development Goals. If impacts exceed 100% of the planetary boundary, the dietary pattern of that particular country can be considered unsustainable in light of global environmental targets, and disproportionate in the context of an equitable distribution of environmental resources and mitigation efforts. See Methodology for more information on the indicators.
Social determinants of nutrition
Population composition
Source: UN Department of Economic and Social Affairs, Population Division. World Population Prospects. 2019. Available at: https://population.un.org/wpp/Download/Standard/Population. Accessed: 16 November 2022
Notes: Estimates are reported in thousands for total population, population group aged under 5 years, population group aged 65 years and over and as percentage (%) for population living in rural areas. All estimates are based on modelled estimates for 2022. See Methodology for more information on the indicators.
Prevalence of undernourishment
Source: FAO Statistics Division. Food Security/Suite of Food Security Indicators. 2019. Available at: http://www.fao.org/sustainable-development-goals/indicators/211/en. Accessed 16 November 2022.
Notes: Prevalence (%) is calculated from three-year averages of modelled estimates, with the associated year being the middle year of those three (e.g., 2018 estimate is the average of 2017–2019). The prevalence of undernourishment is defined as the proportion of the population whose habitual food consumption is insufficient to provide the dietary energy levels required to maintain a normal active and healthy life. Due to estimation limitations, low undernourishment prevalence below 2.5% can not be accurately represented. For visualisation, we have presented these as 2.4 where relevant. See Methodology for more information on the indicators.
Under-5 mortality rate per 1,000 live births
Source: UNICEF. Global databases: Under-five mortality. Published online December 2021. Available at: http://data.unicef.org/child-mortality/under-five. Accessed 16 November 2022
Notes: Number of deaths of children aged 0–59 months per 1,000 live births, based on modelled estimates up to 2019. See Methodology for more information on the indicators.
Population density of health workers per 1,000 people
Source: World Bank. Global Health Workforce Statistics. Available at: https://data.worldbank.org/indicator. Accessed 16 Novemrber 2022
Notes: Number of health workers per 1,000 people, based on modelled estimates. Health worker definition and training vary across countries and human resources tend to be concentrated in urban areas, so inferences may be affected. Medical doctors include generalist and specialist medical doctors. Nurses and midwives include professional, auxiliary and enrolled nurses and midwives, as well as other associated personnel, e.g. dental and primary care nurses. Community health workers include various types of community health aides, many with country-specific occupational titles such as community health officers, community health-education workers, family health workers, lady health visitors and health extension package workers. See Methodology for more information on the indicators.
Source of drinking water
Source: WHO/UNICEF. Joint Monitoring Programme for Water Supply and Sanitation. 2020. Available at: https://washdata.org/data. Accessed 16 November 2022
Notes: Percentage (%) of population using each drinking water source, based on modelled estimates up to 2020. ‘Safely managed’ refers to using an improved (i.e. by design and construction has the potential to deliver safe water) drinking water source located on the premises, available when needed and free from faecal and priority chemical contamination. ‘Basic’ refers to using an improved source, for which water collection time is not more than 30 minutes for a round trip, including queuing. ‘Limited’ refers to an improved source for which water collection time exceeds 30 minutes for a round trip including queuing. ‘Unimproved’ refers to an unprotected dug well or unprotected spring. ‘Surface water’ refers to drinking water directly from a river, dam, lake, pond, stream, canal or irrigation canal. See Methodology for more information on the indicators.
Type of sanitation facility
Source: WHO/UNICEF. Joint Monitoring Programme for Water Supply and Sanitation. 2020. Available at: https://washdata.org/data. Accessed 16 November 2022
Notes: Percentage (%) of population using different types of sanitation facilities, based on modelled estimates up to 2020. ‘Safely managed’ refers to using improved (i.e. designed to hygienically separate excreta from human contact) sanitation facilities not shared with other households and where excreta are safely disposed in situ or transported and treated off-site. ‘Basic’ refers to using improved facilities not shared with other households. ‘Limited’ refers to using improved facilities shared between two or more households. ‘Unimproved’ refers to using pit latrines without a slab or platform, hanging latrines or bucket latrines. ‘Open defecation’ refers to disposal of human faeces in fields, forests, bushes, open bodies of water, beaches and other open spaces or with solid waste. See Methodology for more information on the indicators.
Annual gross domestic product (GDP) per capita
Source: International Monetary Fund. World Economic Outlook database. Published online April 2022. Available at: https://www.imf.org/en/Publications/WEO/weo-database/2022/April. Accessed 16 November 2022
Notes: Annual gross domestic product (GDP) per capita based on purchasing power parity (PPP) in constant 2017 international dollars. See Methodology for more information on the indicators.
Population living below the poverty line
Source: World Bank. PovcalNet: an online analysis tool for global poverty monitoring. 2020. Available at: http://iresearch.worldbank.org/PovcalNet/home.aspx. Accessed 16 November 2022.
Notes: Percentage (%) of population living on less than US$1.90 or less than US$3.20 per day, based on 2011 purchasing power parity (PPP), up to 2020. See Methodology for more information on the indicators.
Country income inequality index
Source: World Bank. Gini index. 2020. Available at: https://data.worldbank.org/indicator/SI.POV.GINI. Accessed 16 November 2022
Notes: Country income inequality based on the Gini index, which measures the extent to which the distribution of income (or, in some cases, consumption expenditure) among individuals or households in an economy deviates from a perfectly equal distribution. The Gini index ranges from 0 (perfect equality) to 100 (perfect inequality). Countries are ranked from most equal (1) to most unequal (163). See Methodology for more information on the indicators.
Gender-related determinants
Source: UNICEF. Global databases: Maternal and Newborn Health Coverage. Published online May 2022. Available at: http://data.unicef.org/maternal-health/delivery-care. Accessed 16 November 2022; UN Development Programme. Human Development Report. Gender Inequality Index. Available at: http://hdr.undp.org/en/indicators/68606#. Accessed 16 November 2022
Notes: Early childbearing refers to the percentage (%) of women aged 20–24 years who gave birth before the age of 18. The Gender Inequality Index (GII) measures: gender inequalities in reproductive health, measured by maternal mortality ratio and adolescent birth rates; empowerment, measured by proportion of parliamentary seats occupied by women and proportion of women and men aged 25 years and older with at least some secondary education; and economic status, expressed as labour market participation and measured by labour force participation rate of female and male populations aged 15 years and older. GII ranges from 0 (women and men fare equally) to 1 (one gender fares as poorly as possible in all measured dimensions). Countries are ranked from most equal (1) to most unequal (170). See Methodology for more information on the indicators.
Prevalence of female secondary school enrolment
Source: UNESCO Institute for Statistics. 2022. Available at: http://data.uis.unesco.org/. Accessed 16 November 2022
Notes: Percentage (net, %) estimates refer to the ratio of female children of official school age enrolled in secondary school to the population of the corresponding official school age. See Methodology for more information on the indicators.