Malnutrition in Times of Crisis
When a crisis strikes, it is often already too late to avoid its most devastating consequences. Floods, droughts, cyclones, epidemics, and conflicts are becoming more frequent and more intense, driven by climate change and global instability. These shocks disrupt lives, destroy crops, limit access to water and healthcare, and push already vulnerable communities deeper into poverty.
In these moments, malnutrition does not simply appear overnight. It grows quietly, exacerbated by disrupted food systems, strained health services, and loss of income. Once hunger takes hold, it fuels a vicious cycle of illness, displacement, and long-term vulnerability, especially for children and pregnant or breastfeeding women. Breaking free from this cycle becomes increasingly difficult for communities the more times they are forced to react to emergencies.
But malnutrition in times of crisis is not inevitable. With the right tools, data, and planning, it can be anticipated and prevented.
Fabeha Monir
Action Against Hunger, Bangladesh
This monitor tracks water levels and AI helps predict flooding in Bangladesh.
Acting Before the Crisis Hits
For several years, Action Against Hunger has been testing and refining an approach known as anticipatory action: intervening before predictable shocks occur, based on early warning signs and predefined triggers. Rather than waiting for an emergency to unfold, this approach focuses on preparedness—protecting livelihoods, strengthening health systems, and enabling communities to take action before their situation deteriorates.
In practice, anticipatory action can take many forms. Food and medical supplies may be pre-positioned in areas likely to be cut off by floods. Communities can receive alerts that allow them to protect crops, livestock, and household assets. Cash transfers can give families the means to reinforce their shelters, secure clean water, or seek healthcare before conditions worsen.
This approach is not only more dignified; it is also more effective. A recent study by the Food and Agriculture Organization of the United Nations shows that anticipatory action generates an estimated seven dollars in avoided losses and benefits for every dollar invested. Acting early saves lives, reduces suffering, and lowers the cost of emergency response.
Building on these lessons, Action Against Hunger launched a new pilot project funded by the Swedish International Development Cooperation Agency (SIDA), with a clear objective: to integrate malnutrition prevention and treatment into anticipatory action frameworks.
Putting Nutrition at the Center of Anticipatory Action
While anticipatory approaches have traditionally focused on food security, shelter, and livelihoods, this pilot project explicitly places nutrition at the heart of preparedness. The goal is twofold: to reduce the spikes in malnutrition that typically follow a shock, and to ensure continuity of care for the most vulnerable—even when crises disrupt daily life.
By integrating malnutrition management into early action plans, Action Against Hunger aims to protect nutritional pathways before they break down. This includes maintaining access to screening, treatment, and preventive services for children under five and pregnant or breastfeeding women, who face the highest risks during emergencies.
In Madagascar, an Action Against Hunger staff member uses a Mid-Upper Arm Circumference (MUAC) band to check a child for malnutrition.
The pilot project was implemented in two highly vulnerable contexts: Mali and Madagascar. Though the risks differ, both countries face recurring climate-related shocks that directly threaten food security and access to healthcare.
A Participatory Approach Grounded in Local Realities
Before any action was taken, Action Against Hunger teams conducted an extensive preparatory phase. This included research, risk mapping, and consultations with communities, local authorities, and health and nutrition stakeholders. The objective was to understand how specific hazards affect nutrition in each context and to co-design practical, locally appropriate solutions.
This participatory approach ensured that proposed measures were not only technically sound, but also realistic and accepted by the communities they are meant to serve.
Mali: Anticipating Floods Along the Niger River
In Mali, particularly in the regions of Ségou and Bamako, seasonal flooding of the Niger River poses a major risk. When waters rise, entire neighborhoods can become inaccessible, cutting communities off from health facilities and essential services. For families already living on the edge, these disruptions can quickly lead to malnutrition.
During consultations, community members highlighted the urgent need to maintain access to healthcare during floods. Together with local stakeholders, several anticipatory measures were identified. These include the deployment of mobile clinics to reach isolated populations and the relocation of health centers threatened by rising waters. The creation of safe spaces for women and children was also prioritized, ensuring that nutritional and health services remain accessible during emergencies.
To avoid shortages, stocks of nutritional products, essential medicines, and hygiene kits can be stored in waterproof containers ahead of time, ready for rapid deployment. Early warning systems were also strengthened, with alerts disseminated through radio broadcasts, WhatsApp messages, and even traditional town criers—ensuring that information reaches as many people as possible, regardless of literacy or connectivity.
Action Against Hunger distributes emergency food assistance after flooding in Timbuktu region in 2025.
Madagascar: Preparing for Droughts and Cyclones
In Madagascar, communities face a different but equally challenging set of hazards. Chronic drought in the south and recurrent cyclones across the island regularly disrupt food production, damage infrastructure, and strain health services.
Workshops held in Antananarivo and Ambovombe brought together communities and stakeholders to define anticipatory measures tailored to these risks. Cash transfers emerged as a key tool, allowing families to seek healthcare early, purchase nutritious food, or prepare their homes before a shock occurs. Nutritional supplements for children and pregnant or breastfeeding women were also prioritized as a preventive measure.
Awareness-raising on good dietary practices was incorporated into the plans, alongside strengthened malnutrition screening to enable rapid identification and referral of at-risk children. Evacuation plans and mobile clinics were integrated into preparedness strategies, ensuring continuity of care even during large-scale disruptions.
Community members provide feedback on interventions and needs.
Strengthening Early Warning Systems and Community Capacity
Following these consultations, Action Against Hunger worked closely with partners to improve early warning systems in both countries. Radios were distributed to local committees, and awareness-raising activities were organized to help communities understand alerts and respond effectively.
The aim is empowerment: enabling communities to anticipate shocks, take protective measures, and regain a sense of control over events that once felt unavoidable. Rather than simply enduring crises, families are better equipped to face them.
Through this pilot project, nearly 350,000 people in Mali and Madagascar will be better protected when the next alert or shock occurs. Action Against Hunger teams continue to support and monitor the implementation of these measures, ensuring they are adapted, understood, and used effectively.
Toward a New Standard in Humanitarian Response
The lessons learned from this pilot project will be shared with Action Against Hunger partners and beyond. By further demonstrating that malnutrition can be prevented through anticipatory action, this initiative paves the way for nutrition-sensitive preparedness to become a standard component of risk management and humanitarian response.
In a world where crises are increasingly predictable, waiting is no longer an option.
Anticipating to prevent malnutrition is not just a strategy, it is a commitment to protecting lives before they are put at risk.
