MSF CHAD: Tackling malnutrition starts in the community

“Our money comes from what we harvest,” she says, “but over the past two years, we haven’t had much of a harvest.” Fadija is five months pregnant. ​

At Am Timan Hospital, where Médecins Sans Frontières/Doctors Without Borders (MSF) supports treatment for the most severe cases of acute malnutrition, admissions to the inpatient therapeutic feeding unit increased by 77 per cent between January and June 2026. This increase grew particularly pronounced from April onwards, with the start of the lean and rainy seasons – the months when families’ food reserves dwindle while the next harvest is not yet available.

The condition of children treated at facilities in the province sometimes deteriorates severely after spending a few days or weeks at home, health workers say. This is why the response to malnutrition must go beyond the hospital; it must start within communities, through screening, raising awareness among families, and referring children to appropriate health facilities.

Bolstering community-level prevention and healthcare

MSF stepped up its support for early screening of malnutrition in communities. Between April and June 2026, 1,676 children aged 6 to 59 months were screened at MSF-supported community sites. Of these, 4.8 per cent were suffering from severe acute malnutrition and 21.4 per cent from moderate acute malnutrition, highlighting the importance of this prevention strategy.

In Am Timan district, the proximity of care is essential. During the rainy season, roads become impassable, while the Bahr Azoum River can overflow and temporarily cut off some villages. Families sometimes live dozens of kilometres from health facilities, and some cannot afford transportation. ​

To bring healthcare closer to people, MSF opened 10 new community sites for the case management of childhood illnesses, as well as three therapeutic feeding units in Ablelaye and Mina. Located closer to villages, these services combine treatment for common childhood illnesses, including malaria and diarrhoea, with malnutrition screening.

The aim is to identify malnourished children as early as possible within their communities and quickly refer them to appropriate treatment sites before their health deteriorates further.

“By the time a child finally reaches the hospital, their condition may already be very serious,” explains Samoussi Bremali, who works in hygiene and health promotion at Am Timan Hospital.

Children weakened by multiple illnesses

For children with malnutrition, delays in receiving care can be particularly dangerous because malnutrition and illness can exacerbate one another. Malnutrition does not simply mean that a child is not eating enough. When children are already weakened by a lack of food, they also become more vulnerable to disease and may have greater difficulty recovering.

At Am Timan Hospital, children treated for malnutrition often also suffer from malaria, respiratory infections, diarrhoea or measles. These illnesses can, in turn, further worsen their nutritional status.

“In Salamat, we see children whose malnutrition is often associated with other health problems,” says Dr Assoumana Halarou, MSF medical coordinator in Chad. “Our response therefore needs to be comprehensive: We need to treat malnutrition, but also identify and treat illnesses that can further weaken the child.”

MSF has been supporting the health authorities in treating malnutrition in Salamat since August 2025. The most severe cases are admitted to Am Timan Hospital, while children whose condition allows them to be treated without hospitalisation can receive follow-up care at outpatient therapeutic feeding units.

Listening, supporting and building trust

Bringing healthcare closer to communities is not always enough. In nutrition services, teams also need to gain families’ trust, as complications related to malnutrition can require hospitalisation and considerably increase the risk of death.

“Some parents may be afraid of certain treatments, particularly when a child needs oxygen or has to be fed through a tube,” says Katia a health promoter at the therapeutic feeding unit in Am Timan. “We reassure them and explain that the nurses and doctors are there to care for their children.”

This relationship can be crucial in ensuring that a child receives the care they need and remains in hospital until their condition allows them to safely return home.

MSF supports the health authorities in malnutrition screening and treatment, from the community level to the hospital, including through the referral of cases from health centres. This support also includes treatment for malaria and diarrhoea, vaccination, and training for healthcare staff.

By bringing health services closer to communities, teams aim to identify sick children earlier and ensure they receive the care they need before their condition becomes critical. For a child already weakened by malnutrition and illness, a few days can make all the difference.