UNICEF MADAGASCAR

Newsletter on the Situation of Children and Families in Madagascar

February 2010

INTRODUCTION

Since January 2009, Madagascar has been experiencing a socio-political crisis. During the course of this crisis, a
transition government has been established that is not recognized by the international community. The effects of
this crisis on children and women are serious.

Children and women have been particularly affected by economic instability, acts of violence and the decline in
the functioning of basic social services such as those in the health sector - this in a context where climate change
becomes increasingly tangible in Madagascar considering that the country is being hit by increasingly forceful
cyclones every year and the South is experiencing repetitive spells of drought.

The country has also been affected by the global financial, fuel and food crisis. Each year Madagascar must
import approximately 10 per cent of its rice requirements, all of its oil products, its capital goods, raw materials,
consumer goods, and some of its other food products. In 2008, the decrease in world trade was felt in the
downturn in key export products such as vanilla, clover, pepper, coffee, and shrimps, and a decline in orders for
products produced in the free trade zone, mainly textiles. The country’s key economic sectors have been affected.
After the suspension of Madagascar from the African Growth Opportunity Act (AGOA) in December 2009, lay-offs
and the closing down of companies located in the free trade zone have resulted in job losses contributing to even
higher levels of vulnerability.
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In Madagascar, the majority of the population (68.7 per cent) lives below the poverty line . In this context and in
the face of the current social, political and economic problems, ensuring the basic rights of the population remains
crucial. The situation presents a risk of increasing vulnerability levels even further, particularly those of children
and women,

This newsletter intends to share the latest information UNICEF has gathered on the situation of children and
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women in Madagascar through various studies and surveys that were carried out together with its partners.

EDUCATION

The budget of the Ministry of National Education (MEN) was reduced by at least 20 per cent from the
planned amount for the 2009 financial year, and it is highly likely that the budget reduction will be greater in
2010. The Ministry’s capacity to ensure execution of key activities was seriously diminished. By the end of 2009,
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schools still had not received their budget allocations (school capitation grants ), and children did not have their
school kits for the 2009/2010 school year. Other activities have been equally affected by the crisis: (1) activities
related to quality improvement, including curriculum and school manual development and teacher training (2) the
construction of classrooms, in particular the contract payment of the NGO Aide et Action by the MEN to finalize
400 classrooms, and (3) the Local Catalytic Funds (FCL) intended to reinforce the capacity of the decentralized

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Defined by a food poverty line (2,133 kcal/person/day) and a basic non-food related poverty line.
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Studies and assessments quoted in this newsletter are:
- Multi-cluster Rapid Assessment Mechanism (McRAM) : Evolution of the socio-economic situation of households in the city of
Antananarivo – Madagascar, United Nations System, May/August/November 2009.
- Analysis of the functioning of the health sector in three regions of Madagascar– UNICEF, WHO and UNFPA, May-June 2009
- Situation of households in Nosy Be in the context of the socio-political crisis, November 2009 – UNICEF
- Rapid assessment of the impact of the crisis on 192 fokontanys of Antananarivo, August 2009 – UNICEF
- Study on the impact of the crisis on the water, sanitation and hygiene sector, November 2009 – UNICEF
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The budget allocated per student enrolled.

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entities to reduce vulnerability and disparities. The payment of non-civil servant teachers (FRAM) was
considerably delayed at the end of 2009 – and at the beginning of February 2010, a great number of FRAM
teachers had still not received their subsidies for November/December.

Replacement of key government staff is affecting the sector’s continuity and operations. As of December
2009, the MEN had changed the majority of its technical directors as well as 10 of the 22 National Education
Regional Managers and 63 of the 111 School District (CISCO) Chiefs. These considerable changes are likely to
lead to losses of technical capacity, and threaten the continuity of the sector’s development. Signs of reduced
capacity are already visible. Many teachers, principals, Pedagogic Support Zone Chiefs (Zone d’Appui
Pédagogique, ZAP) and CISCO personnel have expressed confusion in regards which programmes are to be
continued.

Services at the Regional National Education Offices (DREN) and CISCO level have decelerated. In general, the
personnel working in these services have been rendered inactive due to budget constraints. Pedagogic
supervision of teachers has been temporarily suspended in most of schools. The quality of teaching has also
been affected.
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In urban areas education has also been seriously affected. According to the results of the McRAM carried out in
November 2009 in 11 urban areas (fokontanys) of Antananarivo, 52 per cent of parents report that the quality of
teaching has deteriorated during the crisis. Between May and November 2009, school dropout has multiplied by
three. More than three out of four households have difficulties in paying their children’s school fees (for FRAM
contributions, school materials etc.). By comparing types of school in the 2008/2009 and 2009/2010 school years,
in 11 fokontanys, transfers from private to public schools have been twice as high as those from public to private
schools. This new trend towards public school enrolment suggests a parental strategy to reduce school expenses
in a situation of reduced purchasing power.

UNICEF is currently engaged in a study on the impact of the crisis on the education sector at the local level,
focusing on teachers, communities, students and parents. Results will be made available shortly.

HEALTH

For 2009, the budget allocated to the health sector was reduced by around 30 per cent, and the budgetary
execution for the year was only effective as of April 2009. Furthermore, the budget of the cross-functional offices
of the health administration (EPD, DRH, DAF and DRS) was reduced by 10 per cent for each office to benefit the
new Ministry of Population. The areas most affected by the budgetary cuts have been vaccines, fuel and
lubricants for vehicles, fuels for operating power generating units and the cold chain, oxygen for hospitals, water
and electricity, office supplies and IT consumables, the budget for maintenance of vehicles, technical and office
equipment as well as for the maintenance of buildings and the refund for medical expenses.

Supervision of health interventions, which was already weak prior to the crisis, is limited due to
inadequate transport and follow-up. In June 2008, in collaboration with WHO and UNFPA, UNICEF assessed
the functioning of the health system in 3 regions of the country (Analamanga, Boeny and Androy), specifically
examining budget management and the availability of human and logistic resources. The activities found to be
most affected by the crisis are those requiring travel (for supervision, supply of health equipment, budgetary
execution, community-based activities), the consumption of electricity (for the conservation of vaccines, use of
computer equipment, cervix abnormality screening activities, laboratory and dentistry activities), and the use of
office supplies and IT consumables (setting-up and multiplication of management tools and printed activity

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The Multi-cluster Rapid Assessment Mechanism (McRAM) is a method, which has proved itself reliable in emergency evaluations for
humanitarian responses in Sri Lanka and Pakistan. Its approach is multisectoral, inter agency and it is foreseen that the IASC decides jointly
on the objectives, the questionnaires and the methodology. The various sectors which contributed to the McRAM in Madagascar are: health
(WHO), nutrition (UNICEF), water and sanitation (UNICEF), education (UNESCO and UNICEF), protection including children (UNDP, UNFPA
and UNICEF), food safety and urban agriculture (WFP, FAO), habitat (UN-habitat and IFRC). UNICEF, with the technical support of WFP,
coordinated the study. The McRAM covered 11 fokontanys in the Capital city in 2009 in three survey rounds.

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reports). Depending on the local context, various solutions were adopted including negotiations with mayors for
the purchase of fuel, cash support for operating the cold chain, the use of private means for travel, photocopying
and private refrigerators for vaccine conservation, negotiation with communities to ensure transport and vaccine
conservation, use of FANOME funds for the purchase of oxygen at hospitals and the integration of travel with that
of partners.

Immunisation of children and pregnant women has been jeopardized by the crisis. The government
normally contributes up to half of the funds for common vaccines (Polio3, measles, tetanus, BCG), and UNICEF
covers the remainder with its own funds. Until now, UNICEF has not received a clear indication that the
government is committing itself to provide its usual contribution for 2010, while at the same time stocks of
vaccines at central level are empty or only sufficient for the first months of 2010. The stock for the measles
vaccine has been depleted and the polio vaccine is available for a further 2 months only. The anti-tetanus vaccine
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stock will not last for more than 4 months. The GAVI Fund has committed to provide pentavalent vaccines for
Madagascar; however, without any guarantee of an effective cold chain and service delivery system, the value of
these vaccines could be compromised as budgets for transport, storage and administration of vaccines are not
available for 2010. To counteract these problems and support the basic cold chain operating system, throughout
2009 UNICEF used emergency funds to buy kerosene for the refrigerators, to replace 150 broken refrigerators
and to supply missing spare parts.

In view of the funding shortage, UNICEF provided the majority of financial support for the Mother and Child Health
Weeks of April and October 2009, including vaccinations. The implementation of the proposed Mother and Child
Health Weeks for 2010 are heavily jeopardized due to the lack of funding commitments by the government.

If the present situation remains unchanged, 770,000 children under one year old and 870,000 pregnant women
will not be vaccinated on time in 2010. This could lead to serious long-term consequences for children and
pregnant women who have not finished their entire course of vaccinations or who will not be vaccinated during the
coming months.

To ensure access to basic health care to the Malagasy population during the transitional period, including
vaccination and childbirth services alongside essential medicines, UNICEF and its partners estimate that at least
US$ 54 million will be required for 2010. This minimum health package would aim at providing free medicine to all
children under 5 years old and all pregnant women, and highly subsidized medicine to the whole population.

WATER AND SANITATION

In the second half of 2009, a study on the impact of the socio-political crisis on the water, sanitation and hygiene
sector was led by UNICEF at the national level in collaboration with partners at regional and local levels.

The investment in infrastructure has been reduced. The planned amounts for the investment in water and
sanitation covered less than 7 per cent of the total amount necessary to reach the national objectives for 2009. A
further reduction applied in July 2009 reduced the planned amount to nearly 2 per cent of the requirement. In
total, a deficit of approximately US$ 170 million was recorded for 2009 compared to the budget required to
achieve the water and sanitation national objectives. Yet, in spite of the reduced budget covering only a bare
minimum of actual needs, the Ministry of Water could only engage 36 per cent of the allocated amount.
As a consequence, nearly 1,571,700 people (including 282,900 children of under 5 years and 70,700 pregnant
women), i.e. 63 per cent of people who were to be supplied with drinking water in 2009, are still without access
and approximately 322,880 people (including 58,120 children under 5 and 14,530 pregnant women) will remain
without access to latrines. Access to water and sanitation in schools and basic health centres remains of great

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Edits March 2010- Since the publication of the Newsletter challenges remain, however UNICEF Madagascar is doubling
expenditure on vaccines in 2010 to help the authorities meet basic funding requirements for providing routine vaccinations
for children and pregnant mothers. This was done in order to avoid stockout. UNICEF is also providing an intermediate
solution to address the challenges related to the cold chain on the level of the Central Purchasing Office of Essential Drugs
and Medical Equipment - SALAMA.

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concern: only 19 per cent of the primary schools have water points in their compounds and only 30 per cent are
equipped with latrines. Less than 15 per cent of the basic health centres are equipped with drinking water points
and only 40 per cent are equipped with latrines meeting the standards.

Budgetary situation July 2009 - Ministry of Water

Unrequisitioned

Requisition rate
Needed budget

regulation rate

Requisitioned
budget in the
by PNAEPA 6

according to
Accessible
Disbursed
Allocated

budget

budget

budget
budget
PGE

(%)
In thousands of
27,996,000 81,959,866 21,586,882 10,617,941 3,806,714.77 6,811,226.23 35.85
Ariary

In millions of USD 182.22 45.50 11.99 5.89 2.11 3.78 35.85

Drinking water consumption is reported to have decreased. In the localities visited, households declared that
the household budget share allocated to buy water decreased in order to cover other food expenses. The quantity
of water consumed was thus reduced to the bare minimum for cooking and when really necessary, for hygiene. A
total of 60 per cent of households indicated a decline in income and 15 per cent indicated that they had difficulties
in paying for water expenses. The difficulty to pay for water can be attributed to the economic shocks experienced
by households during the crisis.

Capital expenditures to build latrines are not a priority for households. The majority of the surveyed families
use traditional latrines with very poor hygienic standards. The water and sanitation assessment revealed that in
the town of Sambava, the administrative centre of the country’s richest region, Sava, the dina (contract) set up to
oblige households to construct latrines is no more operational since the crisis. Households seem to be waiting for
subsidies and are willing to only contribute a minimum to the construction of latrines.

The number of households practising handwashing with soap has decreased: According to the McRAM
results of November 2009, the use of soap for handwashing in households is not systematic and has decreased
since the beginning of the crisis. To demonstrate this, in May 2009 84 per cent of the households surveyed
reportedly used soap systematically for handwashing, declining to 66 per cent in August 2009 and 63 per cent in
November 2009.

The management of garbage disposal has encountered difficulties. A rapid assessment carried out in the
capital city showed that the collection of waste services has suffered enormously since January 2009 from lack of
funding and materials, reducing the respective public service capacity to 50 per cent of its usual level.

CHILD PROTECTION

Times of crisis are particularly critical for children, particularly for children already at risk, i.e. those living in poor
and vulnerable families. During crises, children are often exposed to violence and security problems, while at the
same time often excluded from basic social services and opportunities (employment, health, water and sanitation,
education etc).

The riots which took place during the crisis disturbed teaching in public and private schools in Antananarivo and
some other big cities in 2009, through the prolonged closure of certain schools, frequent interruptions of courses,
the absence of pupils and/or teachers, and shortened class hours or earlier closing times. Schools situated near
the troubled areas were the direct victims of teargas grenades or of fire weapon noises causing fear and distress.

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Programme National d'Approvisionnement en Eau Potable et d'Assainissement, or National Program for Water Supply and Sanitation.

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In 2010 the disturbances continued but at to a lesser degree. During the first week of February 2010, students at
Antanimbarinandrina school in Tana (near Lac Anosy) became victims of teargas launched by the police force
against the school wall to disperse people assembled outside, also affecting parents of pupils and infants leaving
the school.

Interventions carried out by social workers with 46,436 pupils in 81 schools in the cities of Antananarivo,
Fianarantsoa and Ambositra reported an increase in signs of stress, anguish and troubled psychosocial behaviour
among pupils. This current situation has resulted in the disruption of children’s school life and the non-respect of
their right to study in a serene and protective environment.

In Nosy Be, the socio-political crisis has affected the tourism sector, which is the main source of income for
households. This income reduction has pushed many households to make their children work. Some households
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mentioned sending children under 18 years to work elsewhere . Concerning child protection problems in the
surveyed households and their surroundings, the three most frequently reported issues were: verbal abuse (30
per cent), child abuse (23 per cent) and sexual exploitation/abuse (22 per cent). In addition, 48 per cent of
respondents reported an increase in sexual exploitation observed since the onset of the political and economic
crises, with a marked increase in the urban environment. Though 95 per cent declared that their children were not
approached for sex work, the respondents recognized the existence of under-age sex workers in their
environment. In normal times, households reported that foreign tourists are the first to approach children for sex
work (as per 53 per cent of household responses) in exchange of money or gifts, followed by the national adults
(as per 48 per cent of household respondents). However, the ratio has been reported to have become inverted
since the onset of the crisis.

Concerning violence in the home, still in Nosy Be, an en example, 74 per cent of the households declared the
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existence of violence against women including marital abuse (37 per cent against 45 per cent in Tana ), forced
labour (14 per cent against 4 per cent in Tana), forced prostitution (7 per cent against 4 per cent in Tana), and
psychological harassment (6 per cent against 33 per cent in Tana).

In Antananarivo, inter-family violence, in particular sexual violence, shows alarming signs. According to data
received from the Gynaecology-Obstetrics ward of Befelatanana hospital, 479 cases of rape were listed for the
year 2009. Victims under 10 years old numbered 107, those aged from 10 to 18 were 345 and those over 18
years represented 27. In general, the perpetrators of the sexual abuse are close relations and/or members of the
family. Only in one quarter of the cases could the perpetrators be prosecuted. This is mainly due to the failure of
the legal system (from the police force to the prosecution of the perpetrator) as well as the weakness of the
protection services by the various actors engaged in the social sector.
st th 9
Disappearance of children. In Antananarivo, during the period of 1 January 2009 to 30 January 2010 , a total
of 1,119 children were reported missing, out of which 613 were found again while 503 remain missing. Similarly,
in Nosy Be, households reported disappearances of children during the McRAM investigation in November 2009;
investigations are underway.

HOUSEHOLD VULNERABILITY

Despite an apparent stability in the number

and type of incomes, the economic situation
of households remains vulnerable. In
November 2009, 85 per cent of the households
stated having the same income sources as
before. However, despite this high rate of
unchanged income source, two thirds declared
a decrease in their income itself in November

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McRAM Nosy Be, UNICEF November 2009
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McRAM November 2009 for data of Tana
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Source : SPDTS Report 2010

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2009 compared to August 2009. It appeared that the sources of household income became diversified throughout
the crisis. Households were increasingly working in unstable trades such as the informal sector or temporary
employment, which explains the reduction in income level and the increase in job insecurity over time.

Since January 2009, the average share of the total household income spent on food is high and reached
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68 per cent in October 2009. It was 66 per cent in August and 69 per cent in April 2009 . From the point of view
of food security, this reveals that 2 households out of 5 in the 11-surveyed fokontanys are in a food insecure
situation. There are three households out of ten in the eleven fokontanys surveyed which suffer from severe food
insecurity and approximately one household in ten (11 per cent) which suffer from moderate food insecurity.

The informal social safety network has changed face. Under normal circumstances the social safety network
to help households face difficulties is usually made up of friends and close family members. However, according
to the McRAM, this safety network has changed during 2009 to increasingly include friends, neighbours and even
pawn brokers.

CONTACTS

Bruno Maes
Representative
Tél: (261 20) 23 300 92 /93 /94
Email: bmaes@unicef.org
UNICEF Madagascar

Valérie TATON
Deputy Representative
Tel: (261 20) 23 300 92/93/94
vtaton@unicef.org
UNICEF - Madagascar

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McRAM I, II, III