Niger

Niger, a landlocked West African nation, relies on traditional subsistence farming, herding, trading, seasonal migration, and informal markets to support its people. It is one of the hottest in the world, and only 15% of its land is suitable for livestock and agriculture. Frequent drought, desertification, and unsustainable population growth contribute to economic woes.  Health care services are limited, and majority of women—a full 85%—deliver their babies at home, without skilled medical care, leading to unacceptably high rates of infant and maternal mortality. To counter these trends, EngenderHealth is:

• Making motherhood safer and increasing child survival;
• Expanding contraceptive options;
• Addressing HIV and AIDS with integrated health care;
• Reducing health care costs;
• Advocating for heath care policies.

 
Making Motherhood Safer and Increasing Child Survival
Niger is one of 21 West African countries included in EngenderHealth’s Action for West Africa Region—Reproductive Health (AWARE-RH) Project. Since its launch in 2003, this USAID-funded project has been working in Niger to:

• Train doctors and midwives in basic and emergency obstetric care, including postabortion care;
• Educate health care workers to prevent and treat malaria in pregnancy;
• Prevent and treat obstetric fistula;
• Collaborate with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to reduce infant deaths from acute respiratory infections, malaria, diarrhea, and malnutrition through a “train the trainers” program that teaches community health workers how to manage these common childhood diseases.

 
Expanding Contraceptive Options
A shortage of skilled providers, inadequate supplies, and lack of accurate information about methods have hindered men’s and women’s access to modern contraception in Niger. Through the ACQUIRE Project, funded by USAID, EngenderHealth collaborates with the country's Ministry of Health, Pathfinder International, and other agencies on the following initiatives:

• Promoting the use of Norplant and the intrauterine device (IUD), two low-cost, long-acting contraceptive methods;
• Ensuring the availability of family planning and reproductive health supplies.

 
Addressing HIV and AIDS with Integrated Health Care
Throughout West Africa, EngenderHealth trains peer educators to integrate family planning messages and materials into HIV prevention programs. In Niger we support these activities at the Gaya border crossing, a main transport corridor that links countries in the region. Peer educators provide truckers and residents along this major truck route with information on HIV and refer clients to selected facilities for testing and services.

 
Reducing Health Care Costs
To reduce financial barriers to health care, EngenderHealth launched community-based health financing schemes, known as mutual health organizations (MHOs). MHOs are nonprofit, voluntary groups that pool the community’s savings to ensure financial access to services when one of the members becomes ill. MHOs often negotiate a care package with local providers for their members that can include both preventive and curative care. In Dosso and Maradi EngenderHealth promotes community health financing schemes for access to emergency health care and other health services identified by the communities.

 
Advocating for Health Care Policies
EngenderHealth works with stakeholders such as governments, non-governmental organizations, and civic groups to advocate for appropriate policies and increased funding to improve maternal and neonatal health programs. Efforts include:

• Promoting the use of national health accounts, a tool designed to measure health expenditures, so administrators can better understand how health resources are used;
• Working with Niger’s Ministry of Health to develop a national maternal and newborn health advocacy plan;
• Conducting a training session to strengthen the advocacy skills of key Ministry of Health staff;
• Working with the Parliament of Niger to promote legislative issues regarding reproductive health.