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Madagascar to reduce child stunting through a transformative new 10-year program

  |   SUN Country Network, SUN Donor Network

On December 2017, the Government of Madagascar and the World Bank launched an ambitious program that will support efforts to reduce child stunting (low height for age) through a Multiphase Programmatic Approach. The Improving Nutrition Outcomes Program was approved by the World Bank. It will run over a period of 10 years, with the International Development Association (IDA) financing of up to USD 200 million.

With one child out of two being stunted in Madagascar, chronic malnutrition is the biggest impediment to a child’s potential and to Madagascar’s long-term human capital development and economic growth. The country’s annual costs associated with malnutrition are estimated at 7 to 12 percent of GDP. Stunting, which is a red flag indicator, is related to a range of complex issues—low dietary diversity, weak access to health services, poor water and sanitation, and harmful dietary behaviors in pregnancy and early childhood.


“The Government is set on reducing stunting from 47 percent to 38 percent by 2021. We are very proud that, as part of our National Nutrition Action Plan, our Health Ministry and the National Office for Nutrition have together conceived a program of local investments that will ensure that expecting mothers and children under the age 5 receive the necessary support in their communities so that children can have the best possible start in life, grow to their full potential and contribute to our country’s development. We are confident that the new strategies put in place by the Government, the role of IDA financing, and the growing commitment of development partners give historic momentum to Madagascar’s nutrition agenda

Solonandrasana Olivier MAHAFALY, Prime Minister of the Republic of Madagascar

This program is designed to reach close to 75 percent of children under the age of 5, starting in the 8 regions that have the highest stunting rates in the country and progressively expanding to 15 regions. By 2028, the program is expected to reduce the number of stunted children by 30 percent in targeted regions. That translates to 600,000 Malagasy children having a better chance in life.

All the building blocks to support strong early years programs are underway or ready to go in Madagascar, and we are very pleased now to turn them into a long-term partnership that lays a strong foundation for human capital development, for the prosperity of individual families, and the overall economic prospects of the nation,” said Keith Hansen, Vice President for Human Development at the World Bank Group and member of the SUN Movement Lead Group, who visited Madagascar in June 2017. “Sustained investment in people is not just the right thing to do; there is robust evidence that it is a smart thing too.”

The Multiphase Programmatic Approach, which will allow countries to structure a long, large, or complex engagement as a set of smaller linked operations (or phases), under one Program, is a new initiative recently approved by the World Bank. This novel approach encourages more learning and adaptation to ensure operations are more responsive to changing country circumstances. It supports faster integration of experiences within the phases, and from one to another to maximize results. Subsequent phases of the program will be prepared as separate operations with rigorous adherence to all applicable World Bank policies with regard to management reviews, fiduciary assessments, environmental and social safeguards assessments, and timely public disclosures and consultation with affected people.


The program is comprised of several overlapping phases. The first phase, a USD 80 million IDA grant and co-financed by a USD 10 million grant from the Power of Nutrition Trust Fund is stretched over a period of five years. The program will start by scaling up the utilization of a high-impact package of nutrition and health interventions known to reduce stunting – for example, micronutrient supplementation and promotion of breastfeeding.

The priority focus of the program is on delivering a set of high impact nutrition interventions in the first 1,000 days (from conception to two years of age). The right nutrition during the “first 1,000 days” of life has a profound impact on a child’s ability to grow, learn and thrive.


Related information

Improving Nutrition Outcomes using the Multiphase Programmatic Approach Project (World Bank)
• Madagascar Country Profile (2017) – English | Français | Español

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