Given the magnitude and persistence of nutritional problems, their multiple origins, their impacts on various development sectors, it was deemed essential to carry out a Link NCA study in the district of Amboasary in order to seek a programmatic synergy across sectors for better efficiency and sustainability of nutrition interventions.

According to the results of the anthropometric data collection, the rate of global acute malnutrition (GAM) was estimated at 12.3%, which is considered "high" according to the 2018 World Health Organization (WHO) thresholds, with the upper value of the confidence interval above the emergency threshold of 15%. The prevalence of global chronic malnutrition (GCM) was estimated at 44.0%.

The analyses undertaken during this Link NCA study allowed to identify 19 risk factors, believed to have an impact on the incidence of undernutrition in the zone of study. Following a triangulation of data from diverse sources, six (6) risk factors were identified as having a major impact. The six principal risk factors cover each sector and thus underline the multi-sectoral aspect of causal mechanisms of undernutrition. They include:

Poor access to health services,

Poor breastfeeding practices,

Poor access to food,

Poor household coping capacities,

Poor access to water and

Poor nutritional status of women.