ArticleBMC global and public health2026
The role of embedded Non-Governmental Organisations and other stakeholders in building resilience to cyclone-related crises in Madagascar: a qualitative study.
Article in BMC global and public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMadagascar has been seriously affected by climate change with a particular impact on population health, wellbeing, and livelihoods. The country is prone to cyclones with floods as immediate consequences creating a cascade of crises. This study aims to understand how stakeholders (state and Non-Governmental Organisations) engage with communities to respond to cyclone-related shocks, how communities themselves respond, and what factors facilitate or hinder these partnerships.
methodsThis qualitative study collected data though In-Depth Interviews (IDIs) from community members, Key Informant Interviews (KIIs) from stakeholders, and Focus Group Discussions (FGDs) from community members in Ambanja district of Madagascar. Data collection was guided by a realist-informed approach collecting data specific to Context, Mechanisms, and Outcome (CMO) of community engagement and involvement (CEI) for the response to cyclone-related crises. Data were presented as narrative summaries before going thorough framework analysis.
resultsThis study identifies three pathways enabling community resilience. First, timely cyclone early-warning communication from trusted stakeholders from local actors and supporting Non-Governmental Organisations (NGOs) facilitates community involvement and saves lives during cyclone events. Second, embedded NGOs who are committed to working with communities play a pivotal role in building trust and delivering jointly long-term interventions essential for sustained resilience. Third, existing community social capital-including local knowledge, labour and solidarity networks-represents vital yet underutilised resources for effective intervention design. However, two fundamental challenges systematically undermine resilience-building efforts. Most significantly, the predominance of short-term partnerships means that only a few NGOs engage in long-term interventions, leaving substantial community needs unmet and limiting resilience to survival rather than at levels to thrive. Additionally, ignoring local knowledge and social norms leads to waste of resource through non-sustainable interventions, exemplified by water facilities that were rapidly destroyed because stakeholders failed to incorporate community insights about flood-resistant design.
conclusionsWhilst communities possess considerable adaptive capacity, and strong social solidarity, greater resilience requires sustained institutional commitment to longer-term engagement and support to address community needs. This needs a systematic integration of existing community knowledge and networks, rather than continued reliance on short-term, externally designed interventions that neither build upon local strengths nor address underlying vulnerabilities.
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