|© UNICEF Niger/2010/Pirozzi|
|Access to health services has improved for women and children in rural Niger as a result of a health-post network supported by UNICEF.|
UNICEF’s equity-based approach to achieving the Millennium Development Goals aims to reach the poorest and most vulnerable children and families with cost-effective interventions for sustainable progress. Here is one in a series of stories that make the case for equity.
By Véronique Mistycki
MARADI, Niger, 14 July 2011 – The health post of Sarkin Yamma-Sofoua, a rural village in the Maradi Region of south-east Niger, opened six years ago. Ever since then, every day has been a busy one for Chaïbou Balla, the community health agent in charge of the post.
“I treat almost 100 patients each week,” said Ms. Balla. “This is a good sign. Women have started to pay more attention to their health and to the health of their children.”
On a typical day, a pregnant woman is in labour in the delivery room while a dozen others are waiting outside for consultations. A few years ago, these women and their children had nowhere to go to receive medical attention.
Facilities in remote areas
The health-post network was established 10 years ago, with UNICEF’s support, as part of Niger’s national poverty-reduction strategy. The objective was to bring primary health care to the most difficult-to-reach communities in the country.
The development of local health facilities quickly made a difference in Niger, where more than 80 per cent of the population lives in remote rural areas.
|© UNICEF Niger/2010/Pirozzi|
|The development of Niger's health-post network, especially in remote rural areas, has contributed to a decrease in under-five child mortality.|
“Before the opening of the health post, people in Sarkin Yamma-Sofoua would just have no access to medical care,” recalled Ms. Balla. “There is no other health centre anywhere close, and no one owns a car here. People would have to walk several kilometres to get to a main road and then pay for transportation to get to a health centre.”
‘A huge difference’
But transportation was not the only challenge. In some villages, people would rather go to a traditional healer than see a doctor who is not part of their community.
“Husbands usually don’t give permission to their wives to see a doctor they don’t know. They’re also hesitant to let their wives travel far away to go to a health centre,” explained Sahia Iro, 25, a mother of two who brought her younger son to the Sarkin Yamma-Sofoua health post with a fever.
“Having a health agent who is trusted by the community right in the village has made a huge difference for us,” added Ms. Iro. “Every time I detect a sign such as fever or diarrhoea, I bring my sons here.”
The development of the health-post network has greatly contributed to improving access to treatment for the three main diseases affecting children in Niger: malaria, pneumonia and diarrhoea. The promotion of key family practices has also been quite successful so far, with a sharp increase in the proportion of mothers who have adopted exclusive breastfeeding since 2006.
Progress with equity
Today, there are almost 2,500 health posts in Niger. UNICEF is also supporting an outreach programme that allows health agents to travel to villages that do not have direct access to a health centre.
“It is essential to bring health services closer to rural villages, because this is where the poorest and most vulnerable populations are,” said UNICEF Niger Chief of Health Dr. Khaled Bensaid.
An equity-based approach targeting the most vulnerable populations has proven to be an efficient strategy for Niger, which has seen a striking decrease in mortality among children under the age of five in recent years. In a country where indicators such as child and maternal mortality are among the worst in the world, this is not a small victory.
Toward universal access
Now, the challenge is to extend the health-post network throughout the country and to better equip the existing facilities, most of which offer only a minimum package of services. UNICEF and its partners will, therefore, continue investing in training, equipment and communications – especially in support of pre-natal consultations and assisted deliveries.
There is still a long way to go to ensure universal access to the most basic health services all over Niger. Further development of the health-post network will ensure that the most vulnerable women and children are not left behind.
Equity and the Millennium Development Goals
UNICEF’s equity-based approach to achieving the MDGs aims to reach the poorest and most vulnerable children.
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