Health begins with nutrition.

What we do/Nutrition

Malnutrition represents a serious public health problem and a national priority in Madagascar because it compromises children's cognitive abilities and their future.

In 2021, the country ranked 10th in the world for chronic malnutrition and 7th in Africa. About 47% of children under 5 suffer from chronic malnutrition, while 8% are affected by acute malnutrition. *

In addition, it has been demonstrated that chronic malnutrition is a problem that starts as early as pregnancy: about 30% of women of reproductive age at Ampefy do not follow a sufficiently diversified diet and only 50% have changed their diet during pregnancy and during breastfeeding. These deficiencies negatively affect neonatal psycho-physical development**.

*Global Hunger Index, 2021
**Rotella R., Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD-W) tool in breastfeeding mothers in Madagascar, 2024

What did Change do?

In 2016, we established our Nutrition Center, which is located at the Medical Center, but it operates mainly on the field, identifying malnourished or at-risk children between the ages of 6 months and 5 years.

A part of the nutrition team goes daily to the villages of the municipality of Ampefy, according to a well-defined schedule, carrying out Dépistage, distribution of therapeutic flours, culinary demonstrations and mobile clinics.

Medical care and monitoring
In our Center, we offer free pediatric visits to all those in charge, we provide basic medications for the treatment of the most common diseases among malnourished children, and we organize weekly follow-ups to monitor children's growth and evaluate treatment progress.
In addition, we periodically carry out home visits, during which we verify the family's hygiene and food conditions, offering personalized support.
Health education
We train the local population, with particular attention to pregnant women and young mothers, on topics such as: essential food groups, exclusive breastfeeding, newborn nutrition and food hygiene.
Our awareness-raising activities take place both in our Center, through monthly pre-partum courses or personalized advice, and in the villages where we operate.
Dépistage
The Dépistage (or nutritional screening) is carried out daily in villages and consists of detecting the anthropometric parameters of children, such as weight, height and brachial perimeter.
The data collected are compared with the growth standards established by the World Health Organization (WHO) to diagnose any cases of acute or chronic malnutrition.
Distribution of therapeutic foods
To children suffering from acute malnutrition, we distribute therapeutic foods that vary according to the state of malnutrition.
Moderate acute malnutrition: we provide enriched flours produced by a local company based on corn, soy, red rice, peanuts, vitamins, minerals as well as Moringa Oleifera food supplements, produced by us.

Severe acute malnutrition: we distribute Plumpy'nut, a highly energetic type of RUTF (Ready-to-Use Therapeutic Food) that provides about 500 kcal per serving.
Culinary demonstration
Every two weeks we organize culinary demonstrations in the villages in our area of intervention.

With the active involvement of mothers, we teach how to prepare balanced meals using ingredients easily available in local markets, in addition to promoting good hygiene practices and raising awareness of the importance of dietary variety to prevent chronic malnutrition.
Mobile clinic
Every two weeks, our multidisciplinary team, consisting of a pediatrician, midwife or nurse and our nutritional agents, organizes the mobile clinic to reach patients in the most remote villages.

Here we carry out all our diagnosis, treatment and prevention activities.
School canteen
In January 2024, we renovated the canteen at Ampefy's Saint-Therese Primary School.

Currently, about 300 children receive a nutritious lunch everyday. The meal includes animal and vegetable proteins, seasonal vegetables and Moringa Oleifera as a dietary supplement. The project includes periodic nutritional screening activities to monitor the growth and well-being of children.

Moringa plantation

Since 2017, we have been cultivating Moringa Oleifera, also known as a “miracle tree,” on a plot of 1,400 m² on which about 10,000 plants are distributed.

This plant, which is particularly rich in protein, iron, calcium, vitamin A and vitamin C, is a key element of our nutritional initiatives. In fact, it allows us to produce a food supplement with excellent nutritional properties, subject to analysis at the Universities of Pavia and Milan.

Ideas for the future

Production of enriched flours

Our long-term goal is to directly self-produce enriched therapeutic flours, used in the treatment of moderate acute malnutrition. This project could allow us to reduce purchasing costs and create job opportunities for the local community, stimulating the economy.

Cultivation of vegetables for the canteen

We would like to buy land close to the Moringa plantation to grow fresh vegetables, intended for school and hospital canteens. Among the benefits are a greater availability of nutritious foods and a more sustainable local supply chain.

These future projects reflect our commitment to the long-term well-being of local communities, integrating food security with economic development.