Madagascar El Nino Drought Humanitarian Situation Report Focus group with mothers in Sihanamaro, Tsihombe District. UNICEF/January 2017 Highlights Madagascar s forgotten crisis continues. The January 2017 nutrition assessment of children under 59 months indicated a deterioration as compared to the last quarter of 2016, as expected given the current period of the lean season. Current estimates for 2017 are that 35,000 children will suffer from severe acute malnutrition (21,750 alone in the South). A rapid health assessment in four districts of Androy Region indicated that the vulnerability of children under 5, and the overall population in particular is aggravated, the lack of access to quality health care being one of the main unaddressed concerns. Out of the 850,000 people with the most acute needs, 740,000 people (87 per cent) remain without potable water. However, since January 2017, UNICEF has provided 12 per cent of this population, living in the eight most affected districts, with access to sustainable safe potable water and an additional 13 per cent will gain access during the first quarter of 2017. All sectors remain widely underfunded, except Nutrition. Therefore, UNICEF is unable to meet the needs of 391,000 children in need of humanitarian assistance. UNICEF s Response with partners highlights UNICEF UNICEF Cumulative results (#) Cluster Sector/Cluster Cumulative results (#) Children 6-59 months treated for severe acute malnutrition (SAM) 35,000* 1,173 35,000 1,173 Caregivers of children in humanitarian situations 0-23 months 65,000-65,000 - accessing IYCF counselling Children under 5 with pneumonia treated with antibiotics 70,620 - - People in humanitarian situations accessing water for drinking, cooking 850,000 110,250 850,000 114,500 and personal hygiene Children in humanitarian situations accessing psychosocial support 12,600-187,000 - Children aged 5-18 in humanitarian situations access basic education (including through temporary 25,000** 62,000 25,000 62,000 structures) Vulnerable households receive cash transfers 20,000 1,429 122,300*** 122,300 *The estimated caseload of SAM children is calculated for all the country, since SAM is an emergency in itself. Out of the 35,000 national figure, 21,750 are estimated to be in the Southern Regions. **This target will be eventually be revise. ***Cash transfer is not a cluster itself, but rather a modality of intervention. shows the total actors capacity at this stage to reach beneficiaries with cash. s will change provided that new actors intervene through cash transfers. SITUATION IN NUMBERS As of 28 February 2017 391,000 Children in need of immediate humanitarian assistance (46% Total pop in IPC phases 3 & 4) 35,000 Children aged 6 to 59 months in need of treatment for SAM in 2017 (UNICEF estimated caseload 2017 in the Humanitarian Action for children (HAC) appeal) 850,000 People without access to safe water for drinking, cooking and personal hygiene (UNICEF estimated caseload 2017, HAC) UNICEF HAC Appeal 2017 US$ 31.4 million 2017 UNICEF Funding Status Carry forward from 2016: $5.3M Funds received to date: $1.6M 2017 funding requirement: $31.4M Funding gap $24.5M *Funds available includes funding received for the current appeal year as well as the carry-forward from the previous year.
Situation Overview & Humanitarian Needs Tropical Cyclone season has commenced with two tropical storms (Carlos and Dineo) which formed in the Indian Ocean and Mozambique Channel, however due to the trajectory, neither storm made landfall therefore damages were minimal. An Intense Tropical Cyclone, Enawo, struck northeastern Madagascar on the morning of 7 March, travelling at two to three hundred kilometers per hour. On 8 March, Enawo weakened from an intense to a moderate tropical storm, with an average speed of 80km/hour with peaks of 112km/hour. As Enawo moves further inland, the Government s disaster management agency (BNGRC), the United Nations and NGOs are evacuating affected populations, passing on life-saving information to affected communities and responding to growing humanitarian needs. Water remains the key factor in the crisis taking place in the southern region of Madagascar, especially in Taloagnaro where the first rains have not yet fallen. Since mid-december, rain has fallen intermittently throughout Grand Sud, raising hopes that sufficient crops can be harvested by the end of March. However, harvests are still at stake if the pluviometric pattern is not sustained. With the weather patterns changing, the use of surface stagnated water has further increased, while the demand for water trucking has reduced, therefore increasing the threat of higher incidence of malaria and transmissible water borne diseases like acute diarrhoea. Although the rain is welcome, humanitarian assistance delivery has been delayed due to flooding and cut off roads. Local isolated cases of floods in Tulear Fiherenana have been reported and assessed by a joint Mission, with flood response provided by the National Office of Disaster Risk Management (BNGRC) and local authorities. The nutrition situation in the southern regions of the country remains a concern. In January 2017, a widespread nutritional screening took place, using mid upper arm circumference (MUAC) and oedema assessment, and covered 7 of the 8 affected districts. A total of 231,241 children aged 6 to 59 months were assessed, represents 94 per cent of all children in the target area. The results indicate that the proportion of children with MUAC below 115 mm or oedema (severe acute malnutrition or SAM) by district ranged from 0.7 per cent to 1.8 per cent. The proportion of children with MUAC between 115 mm and 125 mm (moderate acute malnutrition or MAM) ranged from 2.7 to 11.8 per cent and Global Acute Malnutrition (GAM), identified through MUAC less than 125 mm or oedema, ranged from 3.4 to 13 per cent. Overall these results indicate that the nutrition situation has deteriorated in January as compared to the last quarter of 2016 (October screening) when SAM rates ranged from 0.5 to 1.2 per cent, and GAM rates between 2.5 and 7.4 per cent. A rapid health assessment addressing morbidity and mortality was carried out by UNICEF and its partner Médecins du Monde in four districts of Androy Region, whose final conclusions were that the vulnerability of the general population and mainly children less than five years of age is far aggravated. Access to quality health care remains one of the top challenges, and only an integrated response combining emergency interventions, capacity building and health system strengthening actions could alleviate the current situation. The school year started on 3 October, but negative coping mechanisms have been employed in some areas such as parents taking their children out of school to look for water, earn money or find food. At the end of 2016 there was a reduction in the number of students attending schools in the nine districts of the south (the most affected by the drought plus Betroka, in Anosy). Between October 2016 and November 2016, there was an average 2.5 per cent increase, however, in December, there was an average 12 per cent decrease, with Androy reaching figures of a 24 per cent decrease. In January 2017, there was a 3 per cent increase 1 in December 2016. Absenteeism remains high in 2017, with the average for the nine districts averaging 15 per cent and particularly high for Anosy at 21 per cent. The region of Atsimo Atsinanana has particularly high rates of absenteeism at 29 per cent, a consequence of the extreme weather conditions affecting this region whereby families have been unable to plant crops due to the lack of rain. Teacher absenteeism is also high despite improvements on 2016. The average is 30 per cent for Androy (44 per cent for female teachers) and 24 per cent for Anosy (29 per cent for female teachers) 2. For protection issues, the vulnerability of population and especially adolescents living in urban areas was regularly underlined. Key informants and protection actors both from rural and urban communities stressed that families who are the most affected by drought were often the ones who were obliged to leave their community and migrate to towns. Once there, they often have no other alternatives than to rely on negative coping mechanisms such as begging or sexual and economic exploitation of their children. 1 All data concerns the 9 target districts: 2/9 in Atsimo Andrefana; 4/4 in Androy and 3/3 in Anosy. The data collection system established, organized by the UNICEF Regional technical Assistants is representative, collects data from 40 schools from each region which have been randomly selected. For the month of January 2017, the data for Androy was only collected in 29 schools and is thus not statistically representative. 2 Data for Atsimo Andrefana is being verified.
Estimated Affected Population Total Male* Female* # of people affected by drought 1,140,000 564,300 575,700 # food insecure (IPC, Oct 2016) 840,000 415,800 424,200 # SAM Children Under-5 in drought affected districts in the south (UNICEF, Malnutrition Screening, 2,466 1,127 1,339 January 2017) # MAM Children Under-5 in the drought affected districts in the south (UNICEF, Malnutrition Screening, 14,918 6,857 8,051 January 2017) # of population without access to safe water 850,000 433,500 416,500 # of women in childbearing age living beyond 5km from health facilities ( 34.000 pregnancies) 178,000 0 178,000 # of children Under 5 living beyond 5km from health facilities 130,990 64,840 66,150 # of people living beyond 5km from health facilities 748,000 370,260 377,740 *Estimated based on sex 49.5% (M) and 50.5% (F). UNICEF. SITAN. 2014 Humanitarian leadership and coordination UNICEF has continued to invest in coordination and supported OCHA in the recruitment of a coordinator in the southern regional capital of Androy. Multi-sectoral Cyclone Preparedness: UNICEF-led clusters (WASH/Nutrition/Education) continue to map the changing needs based on the analyses provided by the meteorological office. Emergency stocks have been prepositioned in UNICEF and partner warehouses for immediate support towards an eventual response. Stocks include water coverage capacity for 215,000 people, sanitation and hygiene supplies, health kits and supplies for 40,000 people, education capacity for 30,000 pupils and protection supplies for 6,000 children as well as nutrition supplies for the diagnosis and treatment of severe-acute malnutrition. As part of the pre-position supplies, UNICEF has also developed and pre-positioned more than 6,000 Information, Education and Communication materials to inform the public of key messages pertaining to cyclone and flood preparedness and response. Lastly, UNICEF also activated the protocol with BNGRC and TELMA to immediately put in place an emergency cash transfer program for 1,600 households. Nutrition Cluster: UNICEF continued to lead the nutrition cluster response at both district and central levels (with the national nutrition Office as co-lead). At each monthly meeting, UNICEF and the Office National de Nutrition (ONN) present the Nutrition screening results and discuss constraints, lessons learned and ways forward for the improved treatment of children with SAM. The first cluster meeting of 2017 was held in February at the national level to prepare for the Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey which will take place during February and March in the south of the country. At the decentralized level (district), 9 sub-cluster coordination meetings were held and focused on the preparation of the January massive screening, as well as identification of the outreach sites within each district for the mobile clinic SAM treatment. WASH Cluster: UNICEF co-leads the cluster response with the Ministry of Water, Sanitation and Hygiene at national and regional levels with a focus on data collection and response interventions. WASH rapid assessments are carried out every two months, with the next one taking place by mid-march. A WASH cluster meeting at the national level took place in February, and WASH sub-clusters meetings in January for Ampanihy and Atsimo Andrefana, and in January for Androy and Anosy. Education Cluster: Towards the end of 2016, together with the other clusters, Madagascar updated its Drought Response Plan for the south, UNICEF organised a training for regional authorities, the Education Regional Technical Assistants and the national cluster members (international and international NGOs, private sector, the MoE) on the role of the cluster, on what education in an emergency situation is and on the responsibility the education actors have to ensure that the school is secure, resilient and ensures social cohesion. Child Protection Area of Responsibility: UNICEF finalized its strategy focusing its interventions in urban areas for adolescent s victims of sexual and economic exploitation, together with local protection actors, local authorities, the Ministry of Population and the Ministry of Youth and partners from the private sector such as mobile phone companies. During the reporting period, additional support through the Child Protection Cluster was also provided to ensure the upcoming multi-sectorial assessment includes Child protection indicators. C4D in emergencies: UNICEF supported the BNGRC to coordinate communication in humanitarian action through the Emergency Communication Network at national level and at regional level for Anosy and Androy Regions.
Emergency Cash Transfer/Social Protection: As co-lead of the cluster, UNICEF has promoted information sharing and coordination among different donors and NGOs that are supporting cash-based interventions. Currently six partners provide support to five types of cash interventions. UNICEF has strengthened national capacity to coordinate emergency cash responses and a specific emergency cash sub-group has been created. A joint communication strategy for emergency cash is being developed to avoid miscommunication to beneficiaries, local and national authorities. Humanitarian Strategy UNICEF s humanitarian strategy includes interventions in the areas of Nutrition: Screening, treatment of SAM, Infant and Young Child Feeding; WASH: Drilling of boreholes, distribution of ceramic filters; water trucking, emergency sanitation and C4D; Health: Distribution of antibiotics, Zinc and Oral Rehydration Salts (ORS); Education: Provision of catch up classes for children who have dropped out of school; provision of teaching and learning materials; Child Protection: Training of social workers to provide psychosocial support to children and their families; strengthening family tracing and reunification interventions for separated/unaccompanied children; and prevention of negative family coping mechanisms through Emergency Cash Transfers. In addition, UNICEF continues to preposition supplies for early response in areas likely to be affected by La Nina and/or seasonal floods and storms. The 2017 approach will be three pronged: i. continue with current activities, ii. Further develop outreach and integrated activities and iii. Strengthen documentation and dissemination of evidencebased analysis in all sectors. The humanitarian strategy encompasses early recovery and resilience building. This includes capacity building of public systems as well as community mobilisation and integrated, complementary interventions that improve resilience, especially considering the extreme poverty and structural vulnerability faced by the populations in the south, which have significant long term negative consequences for children. Local Water carriers. Ambovombe District UNICEF/January 2017 Summary Analysis of Programme response Nutrition: Nutritional screening which took place in January found children with 2,466 SAM and 14,918 children with MAM. Children with SAM were referred for treatment at one of 116 UNICEF-supported treatment facilities. Children with MAM were referred to nutrition treatment sites supported by WFP and the National Community Nutrition Programme. UNICEF s support to SAM treatment includes the provision of Ready to Use Therapeutic Foods (RUTF) and essential drugs, capacity building of the health staff and community workers, reinforced coordination and supervision through six nutrition consultants placed in the affected districts. A total of 5,000, boxes of RUTF were supplied to the treatment facilities at the beginning of 2017. Since this time, 1,173 cases of SAM (48 per cent of the caseload) were admitted to the treatment programme, of which 863 were cured (73.8 per cent), 1.1 per cent died, 5.6 per cent defaulted and 10 per cent did not respond to the treatment. UNICEF, in collaboration with the Ministry of Health at central and district level, has set up five mobile clinics for outreach SAM treatment in three districts (Beloha, Tsihombe, Ambovombe) that showed the lowest coverage in an effort to improve the equity and coverage of the treatment programme. These mobile clinics will be deployed in other districts in case of observed heightened levels of malnutrition. WASH: The result of the WASH rapid assessment carried out in December showed a slight decrease in the percentage of population with access to less than 10 litres/person/day, from 70 to 68.9 per cent. The percentage of the population using stagnant water has increased corresponding to the increased rainfall in the south since the end of December 2016. Over 73.1 per cent of surveyed households in the three regions (Androy, Anosy and Atsimo Andrefana) use non-improved water sources. A significant decrease was noted in the percentage of population resorting to buying water at a tripled price ($US 0.3/20 liters), from 20.5 to 14.3 per cent. Since January 2017, over 114,500 additional people gained access to safe water as a result of ongoing water trucking, rehabilitation of 190 boreholes and construction of three new boreholes (27,300 persons reached by water trucking and 87,200 persons reached by new infrastructures and rehabilitations). The construction of 43 boreholes, four wells and nine mid-level water supply systems remains in progress and will benefit to an estimated additional 33,890 people. An estimated 50,000 more people will benefit from other ongoing activities, including the rehabilitation of 175 water points by UNICEF and 25 wells rehabilitated by ACF. Hydrogeological and geophysical studies of other 50 sites in sedimentary and littoral areas in Androy, Anosy and Atsimo Andrefana regions are currently starting. The new pipeline from Mandrare
River to Sampona, Marolopoty and Maroalomainty, remains in construction, supported by the Ministry of Water, Sanitation and Hygiene and UNICEF, and will result in an estimated 46,000 additional people gaining access to safe water. The water trucking operation, including water vouchers and wash kit distribution are underway. Health: According to the results of a rapid health assessment carried out by UNICEF and Medecins du Monde in November 2016, the situation shows that, even if not featuring all the characteristics of an ongoing health emergency, the vulnerability of general population and mainly children less than 5 years of age is very much aggravated as seen in the following figure: *Extract from Medecins du Monde Evaluation Report. Crude mortality and under five mortality rates are the highest registered for the last 10 years, as per comparison with the three SMART surveys carried out during this period: Various factors were noted with the capacity to affect this increased mortality: o Lack of access to quality health care due mainly to: 1) Cost of the services: financial constraint; 2) Difficult access: the distance families need to go to reach the nearest health facility; 3) general understaffing through all the health facilities, with in many cases only one paramedic rendering all services in one single health center. o These barriers affects not only children under five, but also pregnant, lactating women and newborns, whereby the rate of deliveries in health facilities in Androy is around half the national average; o Community health workers lacking the capacity, equipment and drugs to reinforce the decentralization of healthcare at community level. As of today, emergency response priorities for 2017 focus on the following most urgent needs: provide quality health services at health facility level and through community health workers for 850,000 persons in Integrated Food Security Phase Classification (IPC) Crisis and Emergency, focusing on the most vulnerable people (pregnant and lactating women, children under age five, people living more than 10 km from a health facility). Education: As part of the Drought Response, UNICEF continues to support 5,300 children to access catch-up classes 3 ; 61,820 will benefit from learning and recreational materials which are in the process of being dispatched; and the Education sector is contributing to cash transfers for 600 households in the region of Anosy 4. Absenteeism for students and teachers remains high and it is anticipated that the distribution of teaching and learning materials will improve this situation. In anticipation of a worse than expected rainy season, UNICEF commits to pre-positioning essential education stocks for 50,000 children. Child Protection: The identification of beneficiaries has started and is expected to last until mid-march. Priority will be given to adolescents between 10 and 18 who are victims of sexual and/or economic exploitation, forced to seek food and financial support for survival, unaccompanied adolescents as well as adolescent head of households. The package of services will include non-conditional cash transfer support, life skills training, alphabetisation and catch up education interventions. UNICEF aims to reach at least 15,000 households from the most vulnerable district (urban area) classified IPC 3 and 4. Lack of socio-economic opportunities such as vocational training and tailored educational mechanism for children and adolescent vulnerable in the South has also been highlighted. Several options are currently being discussed with the Ministry of Education and the Ministry of Youth at national and regional level to fill this gap. Emergency Cash Transfer/Social Protection: An emergency national cash program, Fiavota, funded through the World Bank and supported technically by UNICEF, aims to alleviate the situation of affected families in communes with high rates of malnutrition. The programme is implemented by the Development Intervention Fund and the National Nutrition Community Programme in coordination of the Ministry of Social Protection, and targets 68,000 households (4,000 funded through UNICEF) with a monthly unconditional cash transfer, a livelihoods-recovery grant and nutrition services for children. As of January 2017, 8,466 households have been reached, including 1,429 funded specifically through UNICEF. Distribution of water vouchers for 10,000 families in affected districts through CERF and ECHO funds continues. This 3 This figure will be reported once the children and adolescents have completed all the classes. Currently, they are ongoing. 4 Funds suffice for 1,000 but identification of beneficiaries is still underway.
operation improves access to safe water for the targeted families with SAM children, pregnant women and families with mothers who recently gave birth. Communications for Development (C4D) The implementation of the emergency C4D strategy was launched in January 2017 in Androy and Anosy Region and to date, 108 mayors have been trained using Communication for Humanitarian Action Toolkit (CHAT) principles, and oriented with drought key messages. The mayors have committed to mobilise the communities using action plans which they developed during training sessions for their respective localities. Fifty eight coaches or Responsibles of community agents, and 46 Responsibles of volunteers and youth peer educators were trained in interpersonal communication skills. Responsibles were also oriented on key drought-related messages and developed action plans for their respective communities. Eight local radio stations have committed to produce and broadcast emergency communication programs through the media plans developed during their trainings. Supply and Logistics Nutrition: 5,000 boxes of RUTF (US $235,000) have been dispatched for prepositioning into Warehouses of Androy district due to coming malnutrition lean season, as well as Infant and Young Child Feeding (IYCF) and SAM programme management and monitoring tools. Education: 933 school-in-a box and 175 recreational kits and the same number of ECD kits are currently being dispatched to the nine drought affected regions in the south. A replenishment order will be placed as soon as donor-pledged funds arrive. Since the end of November 2016, UNICEF purchased goods valued at more than US $1,096,672 in emergency funding for deliveries in early 2017, $765,000 worth of goods have been delivered to date. The actual prepositioning stock of UNICEF has a value of $516,000 for more than 178 different items. Funding UNICEF Funding Requirements* UNICEF 2017 Requirements* Funds available for UNICEF** Funding gap Appeal Sector US$ % Nutrition 5,700,000 3,142,853 2,557,147 45% WASH 11,200,000 1,366,711 9,833,289 88% Health 5,500,000 803,539 4,696,461 85% Education 3,400,000 0 3,400,000 100% Child Protection 2,100,000 238,446 1,861,554 89% Emergency Cash/Social Protection 3,000,000 714,731 2,285,269 76% Coordination- Cross sectoral 500,000 704,075 (204,075) -41% Total 31,400,000 6,970,355 24,429,645 78% *The Madagascar appeal is broader than the El Nino/drought emergency and funding requirements therefore include estimated funding requirements for the upcoming cyclone season expected to be further aggravated by La Nina. **Funds available includes funding received against current appeal as well as funds carried-forward from the previous year. *** The figures are provisional and subject to change due to the 2016 year-end financial closure in late January. Next SitRep: 30 April 2017 Internet: www.unicef.org/madagascar Facebook: http://www.facebook.com/pages/unicef-madagascar Twitter: http://twitter.com/unicefmada Who to contact for further information: Elke Wisch Representative UNICEF-Madagascar Tel: +261 (0) 321139936 E-mail: ewisch@unicef.org Jean Benoit Manhes Deputy Representative UNICEF-Madagascar Tel: +261 (0) 320541137 E-mail: jmanhes@unicef.org Matthew Conway Media Relations UNICEF-Madagascar Tel: +261 (0) 320341131 E-mail: mconway@unicef.org
Annex A SUMMARY OF 2017 PROGRAMME RESULTS Response Sector/Cluster Cluster 2017 Cluster Total Results UNICEF and IPs UNICEF 2017 UNICEF Total Results NUTRITION Number of children under 5 treated for SAM El Nino 35,000 1,173 35,000 1,173 Floods 125 0 125 0 Number of caregivers of children in humanitarian situations 0-23 El Nino 65,000 0 65,000 0 months accessing IYCF counselling Floods 8,500 0 8,500 0 Number of children 6-59 months that receive deworming and El Nino 324,000 0 324,000 0 Vitamin A supplementation* Floods 14,000 0 14,000 0 HEALTH Number of children under 5 with pneumonia treated with El Nino 66,000 0 antibiotics Floods 4,620 0 Number of children under 5 with diarrhea treated with zinc and El Nino 63,000 0 ORS Floods 4,400 0 Number of basic emergency obstetric care facilities per 100,000 El Nino people 18 0 WATER, SANITATION & HYGIENE Number of people in humanitarian situations accessing water for El Nino drinking, cooking and personal hygiene 1,300,000 114,500 850,000 110,250 Number of internally displaced people and host community Floods members provided with safe water (7.5-15L per person per day) 270,000 0 100,000 0 Number of people in humanitarian situations supported to adopt Floods appropriate hygiene practices 270,000 0 100,000 0 CHILD PROTECTION * Number of children in humanitarian situations accessing El Nino 172,000 0 5,600 0 psychosocial support Floods 15,000 0 7,000 0 Number of children accessing child friendly spaces Floods 7,000 0 7,000 0 Number of children benefiting from family tracing & reunification Floods programmes 1,500 0 1,500 0 SOCIAL PROTECTION Number of vulnerable households receive cash transfers El Nino 15,000 1,429 Floods 5,000 0 EDUCATION Percentage of school-aged children who have dropped out of or who at risk of dropping out of school, including adolescents, completing catch-up classes in affected areas El Nino 50% 10%** 50% 10%** Number of children aged 5-18 in humanitarian situations access Floods 25,000*** 62,000 25,000*** 62,000 basic education (including through temporary structures) *Interventions are currently ongoing, results will be reported in next sitrep. **TBC, estimation is based on administrative data available for the academic years 2014-2015 and 2015-2016, pending availability of administrative data for the academic year 2016-2017). ***This target will be revised in the next HAC revision.
Annex B SUMMARY OF 2016 PROGRAMME RESULTS Sector/Cluster Response UNICEF and IPs NUTRITION Number of children 6-59 months suffer from severe acute malnutrition (SAM) have access to treatment Number of women/caregivers of children less than 24 months who have access to Infant and Young Child (IYCF) counselling HEALTH Number of cases of pneumonia in children under 5 years treated with antibiotics Number of cases of diarrhoea in children under 5 years treated Zinc and oral rehydration salts # basic emergency obstetric care facilities per 100,000 people WATER, SANITATION & HYGIENE Number of people living in the areas most affected by drought provided with safe water CHILD PROTECTION Number of children receive psychosocial support EMERGENCY CASH Number of vulnerable families receive cash transfers EDUCATION % of school-aged children including adolescents completing catch-up classes in the most affected districts of 2016 2016 Total Results Change since last report 2016 Total Results Change since last report 35,291 14,500 2,500 35,291 14,500 2,500 165,000 55,380-165,000 55,380-62,000 8,000-75,000 13,000* - 18 0** - 665,000 372,670 110,250 665,000 376,920 114,500 1,400 321*** 5 153 4,000* 600-70 0**** - *UNICEF used regular resources to achieve these results. **Due to funding shortages these interventions have not begun yet. ***Due to funding shortages these interventions have only reached a small portion of UNICEF s 2016 target. ****Catch up classes for 5,300 children had started in November and continued into 2017. At 31 December 2016, there were no children who had completed classes. 5 Madagascar was hit by two cyclones without major damages and the responses for the South is currently ongoing (at the end of 2016).