| Table of contents |
Executive Summary............................................................................................ 13
Background ..................................................................................................... 13
Coverage and methodology................................................................................ 14
Summary findings............................................................................................. 14
Education ........................................................................................................ 15
Health and nutrition .......................................................................................... 15
Infrastructure................................................................................................... 16
Rural development............................................................................................ 16
Role of food aid ................................................................................................ 17
Part I - Background and Overview...................................................................... 19
Section 1.1 – Overview of national context ........................................................... 19
Section 1.2 – History......................................................................................... 19
Section 1.3 – Geography ................................................................................... 19
Section 1.4 – Population and ethnic groups .......................................................... 20
Section 1.5 – Poverty ........................................................................................ 20
Section 1.6 – Education ..................................................................................... 20
Section 1.7 – Infrastructure ............................................................................... 21
Section 1.8 – Health.......................................................................................... 21
Section 1.9 – Agriculture and land reform ............................................................ 21
Section 1.10 – WFP assistance............................................................................ 22
Part II – Objectives and Methodology ................................................................ 23
Section 2.1 – Objectives .................................................................................... 23
Section 2.2 – Methodology and data collection tools............................................... 23
Section 2.3 – Creating homogeneous district clusters ............................................. 24
Section 2.4 – Sampling procedure ....................................................................... 28
Section 2.5 – Data collection .............................................................................. 29
Training and number of enumerator teams......................................................29
Dates ................................................................................................................29
Instruments.......................................................................................................29
Equipment ........................................................................................................29
Section 2.6 - Data constraints and limitations ....................................................... 29
PART III – Community survey analysis .............................................................. 31
Section 3.1 - Community demographics ............................................................... 31
Section 3.2 - Migration and displacement ............................................................. 31
3.2.1 - Out-migration ...................................................................................... 31
3.2.2 - Immigration......................................................................................... 32
Section 3.3 - Infrastructure and access to community services ................................ 32
Section 3.4 – Quality of life ................................................................................ 33
Section 3.5 - Education...................................................................................... 33
Section 3.6 - Health .......................................................................................... 34
Section 3.7 - Livelihoods and economic activities................................................... 34
Section 3.8 - Shocks and Risks ........................................................................... 35
Section 3.9 - Food aid ....................................................................................... 36
Section 3.10 – Community facilities and associations ............................................. 36
Section 3.11 - The villagers’ development priorities ............................................... 36
Part IV – Household survey results by district cluster........................................ 39
Cluster 1 ......................................................................................................... 39
Cluster 2 ......................................................................................................... 42
Cluster 3 ......................................................................................................... 45
Cluster 4 ......................................................................................................... 48
Cluster 5 ......................................................................................................... 51
Cluster 6 ......................................................................................................... 54
Cluster 7 ......................................................................................................... 57
Cluster 8 ......................................................................................................... 60
Cluster 9 ......................................................................................................... 63
Part V - Women and child nutrition and health................................................... 67
Introduction..................................................................................................... 67
Section 5.1 – Women’s nutrition and health.......................................................... 67
5.1.1 – Methodology and sampling .................................................................... 67
5.1.2 – Education levels................................................................................... 67
5.1.3 – Current pregnancy and breastfeeding...................................................... 68
5.1.4 – Pregnancy history and number of children ............................................... 68
5.1.5 – Antenatal care ..................................................................................... 69
5.1.6 – Micronutrient supplementation ............................................................... 70
5.1.7 – Birth size and low birth weight ............................................................... 70
5.1.8 – Current health and hygiene of women ..................................................... 71
5.1.9 – Disease prevention measures................................................................. 71
5.1.10 – Macronutrient malnutrition in women .................................................... 72
Section 5.2 – Child nutrition and health ............................................................... 73
5.2.1 – Methodology and sampling .................................................................... 73
5.2.2 – Comparison to the 2003-2004 Madagascar Demographic and Health Survey. 73
5.2.3 – Comparison of malnutrition by age group ................................................ 74
5.2.4 – Malnutrition by district cluster ................................................................ 74
5.2.5 – Breastfeeding practices ......................................................................... 75
5.2.6 – Recent child morbidity .......................................................................... 77
5.2.7 – Vitamin A supplementation, measles vaccination and de-worming medicine.. 79
Section 5.3 – Knowledge of HIV and AIDS............................................................ 79
Part VI – Household Food consumption profiling................................................ 81
Section 6.1 - Food Access: frequency of consumption and dietary diversity ............... 81
6.1.1 – Methodology for analyzing food consumption data .................................... 81
6.1.2 – Household food consumption groups and profiles ...................................... 81
6.1.3 - Household access to food....................................................................... 83
6.1.4 - Asset ownership ................................................................................... 85
Section 6.2 - Refining the Food Security analysis................................................... 86
6.2.1 - Food Security and Risk Profiles ............................................................... 87
6.2.2 - Geographic distribution of food insecure/vulnerable groups......................... 88
Part VII – Conclusions and Recommendations ................................................... 91
Section 7.1 – Summary of main findings .............................................................. 91
Section 7.2 – Education ..................................................................................... 92
Section 7.3 – Health.......................................................................................... 92
Section 7.4 – Infrastructure ............................................................................... 93
Section 7.5 – Rural development......................................................................... 93
Section 7.6 – Overview of WFP-supported programme options ................................ 94
7.6.1 – Main causes of food insecurity................................................................ 94
7.6.2 – General interventions ........................................................................... 94
7.6.3 – Role of food aid ................................................................................... 95
Section 7.7 – Summaries and possible areas for interventions, by province ............... 96
Cluster 1: ...................................................................................................... 96
Main findings ............................................................................................ 96
Possible areas of intervention ...................................................................... 96
Cluster 2 ....................................................................................................... 96
Main findings ............................................................................................ 96
Possible areas of intervention ...................................................................... 97
Cluster 3 ....................................................................................................... 97
Main findings ............................................................................................ 97
Possible areas of intervention ...................................................................... 97
Cluster 4 ....................................................................................................... 97
Main findings ............................................................................................ 97
Possible areas of intervention ...................................................................... 98
Cluster 5 ....................................................................................................... 98
Main findings ............................................................................................ 98
Possible areas of intervention ...................................................................... 98
Cluster 6 ....................................................................................................... 99
Main findings ............................................................................................ 99
Possible areas of intervention ...................................................................... 99
Cluster .......................................................................................................... 99
Main findings ............................................................................................ 99
Possible areas of intervention.................................................................... 100
Cluster 8 ..................................................................................................... 100
Main findings .......................................................................................... 100
Possible areas of intervention.................................................................... 100
Cluster 9 ..................................................................................................... 101
Main findings .......................................................................................... 101
Possible areas of intervention.................................................................... 101
Annex I – Descriptive tables - household questionnaires ................................. 102
Table 1.1 – Main ethnic groups of respondents.................................................... 102
Table 1.2 – Household demographics................................................................. 102
Table 1.3 – Household size and education of head ............................................... 102
Table 1.4 – Students and absences ................................................................... 102
Table 1.5 – Housing ownership, age and crowding............................................... 103
Table 1.6 – Type of housing ............................................................................. 103
Table 1.7 – Source of drinking water, sanitation and housing amenities .................. 103
Table 1.8 – Distance to market and market access .............................................. 103
Table 1.9 – Ownership of non-productive assets.................................................. 104
Table 1.10 – Ownership of productive assets ...................................................... 104
Table 1.11 – Asset ownership categories ............................................................ 104
Table 1.12 – Borrowing and debt ...................................................................... 104
Table 1.13 – Vegetable garden ownership and cereal storage................................ 105
Table 1.14a – Livestock ownership .................................................................... 105
Table 1.14b – Livestock ownership .................................................................... 105
Table 1.15 – Land ownership and cultivation....................................................... 105
Table 1.16 – Type of land owned....................................................................... 106
Table 1.17 – Number of different crops cultivated................................................ 106
Table 1.18 – Main crops cultivated .................................................................... 106
Table 1.19 – Number of months main food crop harvest will last............................ 106
Table 1.20 – Sources of seeds for main crop ....................................................... 107
Table 1.21 – Per capita expenditure (FMG) and share total expenditure for food ...... 107
Table 1.22 – Sources of food consumed in past 7 days......................................... 107
Table 1.23 – Food gifts, food aid and external assistance...................................... 107
Table 1.24 – Number of recent shocks/unusual events ......................................... 108
Annex II - Women and child nutrition and health tables .................................. 109
Table 2.1 – Women’s education level, by cluster.................................................. 109
Table 2.2 – Pregnancy and breastfeeding status and reproductive history by age group ........ 109
Table 2.3 – Pregnancy and breastfeeding status and reproductive history by cluster . 109
Table 2.4 – Relation between women’s education and reproductive choices & outcomes ......... 109
Table 2.5 – Use of skilled antenatal care and reported birth size by cluster.............. 110
Table 2.6 – Micronutrient supplementation and recent illness by cluster.................. 110
Table 2.7 – Recent morbidity and use of mosquito nets by age group ..................... 110
Table 2.8 – Disease prevention measures by cluster ............................................ 110
Table 2.9 – Hand washing practices by cluster .................................................... 111
Table 2.10 – Women’s malnutrition by cluster ..................................................... 111
Table 2.11 – Women’s malnutrition by age group ................................................ 111
Table 2.12 – Child malnutrition and morbidity by age group.................................. 111
Table 2.13 – Child malnutrition by district cluster ................................................ 112
Table 2.14 – Breastfeeding and vitamin A supplementation by age group and sex .... 112
Table 2.15 – Breastfeeding practices and vitamin A supplementation by district cluster ..... 112
Table 2.16 – Recent morbidity and treatment by age group .................................. 112
Table 2.17 – Recent morbidity and treatment by district cluster............................. 113
Table 2.18a – HIV and AIDS knowledge and attitudes .......................................... 113
Table 2.18b – HIV and AIDS knowledge and attitudes .......................................... 113
Annex 3: Household questionnaire ................................................................... 114 |
