NIAMEY, Niger 6 June 2011 - In one of the poorest countries on the globe, reducing child mortality and improving the health of the most vulnerable children is a daunting challenge. However, relentless efforts by the Nigerien Government and its partners have paid off: the number of children dying before the age of five fell to one in eight children in 2010, from one in five in 2005.
A recent survey shows a 34 per cent decline of the under-five mortality rate (U5MR), to 131 in per 1000 live births in 2010, from 198 in 2005. The reduction in U5MR is meaningful in both urban and rural areas and is slightly more important for girls than for boys [why?]. Encouraging results have also been achieved for the maternal mortality rate which has dropped by 14 per cent to 554 deaths per 100,000 live births in 2010, from 648 deaths in 2005.
The much-awaited results of the national survey on maternal and under-five mortality rates were officially announced by Niger’s Minister of Health, Soumana Sanda. The survey was conducted by the National Institute of Statistics to provide the Government of Niger with a concise assessment of the situation and reliable information, as it is about to roll out the first year of its new health sector development plan for 2011-2015.
“If these efforts are sustained, Niger will be on track to reaching the Millennium Development Goal on child survival (MDG-4),” said Sanda. “These figures are proof of the common will of government and partners to meet the challenges that will help improve the health conditions of not only today’s women and children but also of future generations.”
Winning strategies for equity in health
A mix of strategies is being used in Niger to develop the public health system in an equitable way:
The extension of health services to rural areas. Thanks to the creation of 2500 health posts since 2000 and the development of more than 850 integrated health centres and district hospitals, there has been a positive impact on populations’ access to health facilities.
Government-mandated free health care has been in force since 2006 for children under-five, as well as for antenatal care, caesarean sections, and family planning. The lifting of user fees for children under-five has boosted the utilization of health services, particularly in rural areas where the most impoverished and most deprived populations live.
Since 2005, active screening, referral and case management of Severe Acute Malnutrition (SAM) have been scaled up. During the 2010 nutrition crisis, some 330,000 children under five years of age suffering from SAM received treatment in 822 therapeutic feeding centres across the national network of health centres and district hospitals. The total number of children treated in 2010 represents one-fifth of all children treated for SAM worldwide.
Coverage through the Expanded Programme on Immunization (EPI) has improved with 69 per cent of children receiving three doses of combined diphtheria/pertussis/tetanus vaccine (DPT3) in 2010 against 39 per cent in 2006. Vaccination against measles has also increased from 47 per cent to 69 per cent in 2010. Mass vaccination campaigns are coupled with distribution of vitamin A capsules.
The percentage of patients seeking care for malaria has increased from 33 per cent in 2006 to 78 per cent in 2010. Among those who sought care, 60 per cent were treated in health centres in 2010 compared to 51 per cent in 2009. Large-scale distribution of 2.2 million insecticide impregnated bed nets has helped in the prevention of this deadly disease.
Health and nutrition of children and women still critical
While the survey shows important reductions in mortality rates, health conditions for children remain critical in a country prone to recurrent food and nutrition crises. Inadequate dietary intake, micronutrient deficiencies, and poor breastfeeding and care practices are major impediments to children’s good health, growth and development. Chronic malnutrition still affects 47 per cent of all children under the age of five.
Limited access to improved drinking water sources particularly in the rural areas (39%) and to adequate sanitation facilities (only 9% of the total population) further increase the health risk of Nigerien children and women overall.
Maternal mortality rates still too high
“Despite the path being set, more needs to be done to improve maternal and newborn health,” said the UNICEF Representative in Niger, Guido Cornale. “This means extending free health care to include childbirth and postnatal care so that women can deliver in the best possible conditions assisted by qualified health personnel.”
In Niger one woman dies every two hours from complications linked to pregnancy or delivery. “For comparison’s sake,” explained the Minister of Health, “when one western woman dies for reasons linked to childbirth it is equivalent to 240 Nigerien women who die. It is a sad reality then to see a woman die when she is giving birth.”
Such factors as low literacy rates of women in Niger; their poor socio-economic status as a consequence of widespread poverty and social norms; the very high fertility rate (7.1 children per woman) associated with early marriage and teenage pregnancy; the low percentage of births attended by health personnel in health structures (17%) contribute to the high maternal death rate in Niger.
Health system reforms underway
To pursue efforts towards the achievement of the health-related MDGs, the Ministry of Health and partners, including UNICEF, are working on the reforms foreseen in the National Health Plan 2011-2015. This includes the reconfiguration of the health map to eliminate districts covering more than 500,000 inhabitants, the review of the drugs supply and distribution strategy, the review of the Health Information Management System, the Human Resources Development Plan and the National Strategy on Community Case management.
For further information please contact:
Anne Boher, UNICEF Niger, Head of Communication.
Tel.: +227 96 96 21 59;