Crises such as floods, droughts, cyclones, epidemics, and conflicts are becoming more frequent and severe due to climate change and global instability, pushing vulnerable communities deeper into poverty. These shocks disrupt food systems, healthcare access, livelihoods, and water supplies, creating conditions where malnutrition gradually takes hold rather than appearing suddenly. Children and pregnant or breastfeeding women are especially at risk, as hunger fuels cycles of illness, displacement, and long-term vulnerability that become harder to break with each new emergency.
Malnutrition during crises is not inevitable if risks are anticipated and addressed early. Rather than reacting once conditions deteriorate, anticipatory action focuses on preparedness based on early warning signs and predefined triggers. This approach allows communities and humanitarian actors to act before predictable shocks occur, protecting livelihoods, strengthening health systems, and reducing the severity of nutritional impacts. Evidence shows this method is highly effective, with studies indicating that every dollar invested in anticipatory action can generate significant savings in avoided losses while reducing human suffering.
Building on this evidence, Action Against Hunger launched a pilot project supported by the Swedish International Development Cooperation Agency to integrate malnutrition prevention and treatment into anticipatory action frameworks. The initiative places nutrition at the center of preparedness, aiming to prevent spikes in malnutrition following shocks and ensure continuity of care for the most vulnerable groups, even when crises disrupt normal services.
The project was implemented in Mali and Madagascar, two contexts highly exposed to recurring climate-related shocks. Before implementation, extensive research, risk mapping, and consultations were carried out with communities, local authorities, and health and nutrition stakeholders. This participatory process helped identify how specific hazards affect nutrition and ensured that proposed measures were locally appropriate, practical, and widely accepted.
In Mali, seasonal flooding of the Niger River regularly isolates communities and cuts off access to health services, increasing the risk of malnutrition. Anticipatory measures identified included deploying mobile clinics, relocating health facilities threatened by floods, creating safe spaces for women and children, and pre-positioning nutritional supplies, medicines, and hygiene kits in waterproof storage. Early warning systems were strengthened using radio, mobile messaging, and traditional communication methods to ensure timely alerts reached all communities.
In Madagascar, where chronic droughts and frequent cyclones disrupt food production and healthcare, anticipatory actions focused on cash transfers, nutritional supplementation, and strengthened malnutrition screening. Communities were supported to prepare their homes, seek healthcare early, and maintain access to nutritious food. Preparedness plans also incorporated mobile clinics, evacuation strategies, and awareness-raising on dietary practices to ensure continuity of care during large-scale disruptions.
Alongside these measures, early warning systems and community capacity were reinforced through training, radio distribution, and awareness activities. The goal was to empower communities to understand alerts, take protective actions, and respond proactively rather than simply enduring crises. Through this pilot project, nearly 350,000 people in Mali and Madagascar are expected to be better protected against future shocks.
The lessons from this initiative demonstrate that integrating nutrition into anticipatory action can significantly reduce the human cost of crises. By showing that malnutrition can be prevented through early, coordinated action, the project supports a shift toward nutrition-sensitive preparedness as a standard element of humanitarian response. In an increasingly predictable world of recurring crises, anticipating risks and acting early is essential to protecting lives before they are placed in danger.







