Integrating nutrition into social protection: a collaborative approach to tackling malnutrition in Comoros

In Comoros, integrating nutrition into social protection is making a real difference in the fight against malnutrition. With 31% of children under five suffering from stunting and 11% from wasting, the government and its partners, under the coordination of the Scaling Up Nutrition (SUN) Movement Focal Point, are piloting an innovative approach. 

By combining nutrition treatment with social support, families are receiving not only life-saving interventions but also the tools to sustain their children’s health over the long term. The results speak for themselves with 75% of children in the pilot project showing significant improvement in their nutritional status, and 79% of income-generating activities maintaining good progress.

This new initiative (Appui social à la prise en charge de la malnutrition aiguë) combines nutrition treatment with social support to address the root causes of malnutrition. Through cash transfers, families with children suffering from severe and acute malnutrition are empowered to invest in nutritious food and medical care. At the same time, the programme supports parents, especially women, in developing income-generating activities, helping to create economic resilience that strengthens household food security in the long run.

Comoros joined the SUN Movement in December 2013, committing to a multisectoral approach to improving nutrition. Recognizing that malnutrition is not just a health issue but also a social and economic challenge, the government (through the Family Health Directorate and the National Solidarity Directorate, with support from UNICEF) launched the pilot initiative in the district of Pomoni. The SUN Focal Point, who heads the Family Health Directorate, has been instrumental in coordinating the initiative.

The integrated approach builds on and complements the country’s broader nutrition efforts, including proactive malnutrition screening, awareness campaigns, and the expansion of nutrition recovery centres. What sets this initiative apart is its streamlined, data-driven design and tight coordination mechanisms which enabled rapid identification and support for children at risk.

Community health workers identified malnourished children through screenings, with the data entered into a real-time digital system that connected local efforts to national oversight. Thanks to this system, information quickly moved from the community level to regional and national teams, who worked together to validate cases and approve support. Once confirmed, families began receiving cash transfers without delay. Monthly coordination meetings bringing together frontline workers, social protection teams, and health authorities helped keep everyone aligned. Under the leadership of the SUN Focal Point, this collaborative process ensured that support reached families faster, cases were closely followed, and decisions were grounded in real-time data.

This initiative demonstrates how cross-sector collaboration, championed by the SUN Movement, enhances nutrition outcomes. Health authorities, including the Family Health Directorate with the support of community health workers, ensure timely diagnosis and treatment. Social protection agencies, such as the National Solidarity Directorate, facilitate cash transfers to vulnerable families. Development partners, including UNICEF, provide technical and financial support. Finally, local communities, particularly parents and caregivers, ensure children receive proper care. By leveraging the SUN platform, these actors have strengthened local capacities, raised awareness on nutrition, and built a framework for a sustainable, community-driven response to malnutrition.

The impact of this integrated approach has been promising, showcasing the co-benefits for both nutrition and social protection. A total of 137 children with severe acute malnutrition received cash transfers, surpassing the initial target of 100, and 75% of the children assessed post-intervention showed significant improvements in their nutritional status. Additionally, in the 52 households evaluated, all parents benefited from social support aimed at helping them establish income-generating activities, which not only supported their children’s health but also strengthened household economic resilience. While 79% of households demonstrated positive progress, some faced challenges, with a few families diverting the funds for non-nutritional needs. Nevertheless, the overall impact highlights the powerful synergy between nutrition and social protection, as families not only gained access to better nutrition but also acquired the tools to ensure their children's long-term health and well-being.

Community health workers have played a vital role in making this initiative successful. As one health worker noted, "Thanks to this project, parents have not only been able to meet their children's nutritional needs, but they have also gained skills to generate income. This has transformed many lives here, especially those of the most vulnerable. We continue to encourage the men in the village to take a more active role in their children's education and health."

Looking ahead, the next steps focus on expanding and strengthening the impact of the initiative. An analysis of the current situation is currently being conducted to identify areas most in need of intervention, followed by the selection of additional districts for project implementation based on the findings. To ensure seamless collaboration, regular coordination meetings will be organized with all stakeholders involved in the project, allowing for effective alignment and shared goals. Additionally, ongoing supervision visits will be scheduled to monitor progress and support beneficiaries, ensuring that the project continues to meet its objectives.

The success of this initiative highlights the transformative power of integrating nutrition into other sectoral policies, like social protection. By combining direct nutrition interventions with economic support, Comoros is setting a precedent for how countries can adopt a whole-of-government, whole-of-society approach to tackle malnutrition. As governments and partners across the SUN Movement continue to seek sustainable solutions, Comoros’ experience serves as a valuable model. With strong collaboration, data-driven approaches, and community engagement, integrating social protection into nutrition policies can be a game-changer in the fight against malnutrition worldwide.