Between May 2025 and April 2026, the acute malnutrition situation in Grand Sud and Ikongo (located in the Fitovinany Region of Grand Sud-Est) is projected to worsen significantly. An estimated 558,000 children under five are either currently suffering or at risk of suffering from acute malnutrition. Of these, approximately 155,600 are expected to face Severe Acute Malnutrition (SAM), while 402,400 are likely to experience Moderate Acute Malnutrition (MAM). In addition, around 38,500 pregnant and breastfeeding women (PBW) are expected to be affected during the same period.
Amboasary and Ikongo districts are already classified as IPC AMN Phase 3 (Severe) between May and September 2025. This severity is expected to intensify, with five additional districts projected to enter Phase 3 between October 2025 and January 2026. Notably, Ikongo could escalate to IPC AMN Phase 4 (Critical) during this period. By February to April 2026, Amboasary is also projected to reach Phase 4. The residual effects of harvests may temporarily obscure the full extent of the crisis between May and September, but underlying vulnerabilities persist.
Key drivers of acute malnutrition include very low food consumption, soaring food prices, limited market access, high child morbidity (notably from diarrhea and malaria), inadequate healthcare practices, and a fragile health system. These factors are compounded by climatic and socioeconomic shocks, deepening household vulnerability. Without urgent intervention, child survival is at serious risk across several districts.

Significant scale-up needed in southern Madagascar to meet large-scale needs through early 2022