The Saharan nation of Chad has long dealt with food insecurity, which has been exacerbated by displacement, climate shocks, and economic hardship.
Recent cuts to humanitarian aid funding by the United States and European governments have made the situation worse: The number of people reached with World Food Program assistance dropped from 1 million in 2024 to just 118,000 in 2025.
Today, an estimated 5.7 million people are facing malnutrition in Chad—including 3.6 million who are severely food-insecure. Those most vulnerable are children and pregnant and breastfeeding women. An estimated 1.8 million children under 5 years old suffered from acute malnutrition this year, including over 700,000 severe cases.
In response, Doctors Without Borders/Médecins Sans Frontières (MSF) launched interventions in Salamat, Massakory, and N’Djamena, working with both community members and the Ministry of Health toward a sustainable solution to this chronic health crisis.
Sustainable, community-based ownership of health care
In Bla Kouka, in western Chad’s Hadjer Lamis province, around 20 women gather under a shelter made of wood and canvas, waiting their turn to have their children screened for malnutrition. The screenings are carried out by “MUAC moms” — trained women from the community — using bands that measure mid-upper arm circumference (MUAC). When the band is red, bad news follows: The patient has severe acute malnutrition.
Nine-month-old Adam is one of the patients with severe malnutrition. “Adam was hospitalized in Massakory, three hours from the capital,” says his mother, Zara. “But after we left, I had to come back for screening ... because he fell ill again.” Zara has four other children, including two who also became malnourished.
Reducing malnutrition requires coordinated action starting at the community level — early screening and treatment — and the involvement of all actors to ensure access to food and essential services before the situation becomes critical. An effective approach must include adequate medicines and training for complicated cases.
After his consultation, Adam was put on a regimen of Plumpy’Nut — a nutrient-rich peanut-based ready-to-use therapeutic food used to treat malnutrition — and placed in a community-based care program implemented by MSF, the Ministry of Health, and community members. Through this program, children aged 6 to 59 months old and pregnant and breastfeeding women can receive proper care at 21 community-based care sites in Massakory district. These sites are run by community health workers trained by MSF and the Ministry of Health.
This community-based approach expands access to primary health care (including treatment for malaria, malnutrition, and respiratory infections, as well as vaccination), allows for referrals to hospitals when needed, and ensures the sustainability of the response. By promoting community ownership of health care, these sites will be able to continue operating after MSF’s intervention, as long as they have the supplies they need.
Malnutrition is a recurring and seasonal crisis in Chad
Chad’s malnutrition crisis is chronic, but the situation regularly worsens during critical periods, such as the rainy season, the lean period before harvests, and peaks of diseases like malaria.
“First, when my child fell ill at the beginning of the rainy season, I had to pressure my in-laws to take her to a health center,” says Kadija Mahamad Zen as she holds her 1-year-old daughter, Youssoura. “The health worker told me that her condition was beyond their capabilities, and we were referred to Am Timan Hospital.”
MSF launched an emergency intervention at Am Timan Hospital in August. A massive influx of patients forced staff to put more beds in the hospital, and between September and October, the occupancy rate reached 108 percent, according to MSF supervising nurse Harou Habou Rahamatou. Malnourished patients often have weakened immune systems, which makes them vulnerable to infections and prolongs their hospital stays, adding to the pressure.
Mitigating the long-term effects of malnutrition in N'Djamena
Malnutrition does not end with recovery. The consequences can be physical or cognitive, and long-lasting — especially for children.
At Toukra Hospital on the outskirts of N'Djamena, a pilot program run by the MSF Foundation is attempting to mitigate the long-term effects of malnutrition in urban areas. This program involves recruiting three Chadian physical therapists who are currently being trained by a pediatric rehabilitation specialist, and empowering patients to treat the psychomotor consequences of malnutrition.
"The goal of physical therapy for these patients is to get them moving early on to prevent orthopedic or functional complications in the future," explains Lucie Saint Louis, a clinical specialist in pediatric rehabilitation with the MSF Foundation. Potential complications include no longer being able to walk or use one’s arms, or losing the ability to function in the environment.
After just a few sessions, some children regain their desire to move and make up for the developmental delays caused by malnutrition.
Breaking the cycle of malnutrition
Malnutrition in Chad is not a one-time emergency, it is a decades-long struggle, and the result of deep structural vulnerabilities such as poverty and lack access to food and livelihoods. It is exacerbated by poor harvests due to droughts and delayed rains.
Medical care alone is not enough to break this cycle. It is urgent that the government of Chad, together with humanitarian and development organizations, work to address the root causes and fight malnutrition and food insecurity in the long term. This includes developing resilient agriculture, improving access to water and water management, and strengthening community food storage capacities.
