Increasingly unpredictable shifts in climate are triggering public health crises globally. Southern Madagascar is particularly vulnerable to climate impacts, despite contributing to only 0.2% of global emissions. Though endemic in Madagascar, climate impacts such as below average rainfall have increased the severity of droughts, putting over half of the population in southern regions at risk of being food insecure in 2022. The following review examines: How can interventions surrounding the current food emergency in southern Madagascar center community-based knowledge in their strategies? Through a social-ecological approach, this review aims to holistically discuss the complexity of the climate and food crises in this region, which is a topic that has not been widely covered in published review articles thus far.