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Seasonality matters: how cyclical changes trigger drivers of acute malnutrition in Chad’s Sila Province

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A prevalence of global acute malnutrition (GAM) above 15 percent is one of the main indicators of a humanitarian crisis. Yet GAM rates often persist above this emergency threshold beyond the acute phase of a crisis, even when assistance is provided. A recent adaptation of the UNICEF Conceptual Framework for Acute Malnutrition adapted for dryland environments highlights a key gap in our understanding of the basic drivers: environment and seasonality, systems and institutions, and livelihoods. The study identified "environment and seasonality" as a key trigger of the underlying and immediate drivers, mediated through livelihoods and institutions (see Figure 1).

This briefing paper sets out how seasonal changes in rainfall, temperature, and vegetation, mediated through livelihoods, trigger the underlying and immediate drivers of acute malnutrition in eight villages in the Sila Province of eastern Chad. This research reveals a nuanced and complex seasonal pattern of wasting characterized by two different sized peaks with likely different drivers; a primary and larger peak at the start of the rains and a secondary smaller peak prior to the harvest. As well as exploring the basic, immediate, and underlying drivers of acute malnutrition in Chad's Sila Province, this briefing paper offers recommendations for programming and evaluation that are grounded in a seasonal perspective.

This research was undertaken in collaboration between Tufts University and Concern Worldwide. The data described in this brief comes from a mixed methods study, using both qualitative interviews and quantitative longitudinal data collection. Concern collected data on children 6-59 months across 89 households for 23 months (May 2018 -- March 2020) in the Sila Province of Chad with in-depth qualitative work carried out in August 2018 and May/June 2019. For the full report, detailed description of methods, and instrument please see