Menus Subscribe Search
(PHOTO: WORLD BANK PHOTO COLLECTION)

(PHOTO: WORLD BANK PHOTO COLLECTION)

How to Save a (Nigerien) Life

• October 17, 2012 • 4:00 AM

(PHOTO: WORLD BANK PHOTO COLLECTION)

The Millennium Development Goals call for an ambitious reduction in child mortality by 2015. In West Africa, Niger is sweeping away the competition. What’s its secret?

Niger doesn’t often make headlines. And when it does, well, the news is rarely uplifting. Perhaps you read about the landlocked West African nation earlier this summer, when a failed harvest and sustained drought plunged more than six million Nigeriens—a third of the population—into a food crisis. Or more recently, when flooding along the Niger River swept away 40,000 homes and claimed 80 lives. The only bit of sunshine to come out of Niger this summer, it seems, was the story of Hamadou Issaka, a swimming pool attendant who took up rowing three months before the London Olympics, trained in an old fishing boat, and finished dead last in the men’s singles sculls wearing an enormous grin on his face.

Yet there may be something else to smile about in Niger. Researchers from Johns Hopkins Bloomberg School of Public Health and UNICEF report in The Lancet that childhood mortality in the deeply impoverished country is on the decline. In fact, it’s plummeting.

Let’s hit the low notes first. Niger ranks 186th out of the 187 countries in the U.N.’s Human Development Index. (Only the Democratic Republic of Congo is in worse shape.) It has faced three “food crises” in the last decade, owing to recurring droughts, and 66 percent of Nigeriens live on less than $1.25 per day. Save the Children estimates that 120,000 kids die annually before the age of five—and half of those deaths are linked to malnutrition. Long-simmering discontent among the desert-dwelling Tuareg, in northern Niger and Mali, led to hostilities in 2007 and recently toppled the latter’s government, leading many to wonder if Niger might be next. Poverty levels and per capita GDP haven’t budged much in the last 10 years, “child brides” are a chronic problem, and fertility rates are some of the highest in the world: an average of 7.1 children per woman.

In other words, Niger has lots of poor, young mothers, and lots of malnourished kids.

The fourth Millennium Development Goal is simply stated: to reduce by two-thirds, between 1990 and 2015, the rate of under-5 child mortality. It is not so simply achieved. But a massive, decade-long effort by the Nigerien Ministry of Public Health to combat childhood diseases is beginning to pay dividends.

As Johns Hopkins’ Agbessi Amouzou illustrates, between 1998 and 2009, Niger accomplished a 43 percent reduction in under-5 childhood mortality—from 226 deaths per 1,000 live births to 128—as well as gains in stunting and wasting. (To put that mortality rate in perspective, here in the United States, eight of every 1,000 newborns die before the age of 5.) It did so by instituting free, universal healthcare for all Nigerien mothers and children; creating a network of community health workers and medical “outposts” in rural areas; and launching mass campaigns that promoted vitamin A supplements, anti-malarial bed nets, and measles vaccination.

Amozou and his collaborators calculate that, owing of such extraordinary efforts, some 59,000 young lives were saved in 2009, half of which could be attributed to bed nets and nutritional supplements alone. Since 1998, they report, the number of mothers with access to skilled antenatal care has climbed dramatically, as have rates of breastfeeding. Far more households are receiving diphtheria, pertussis, and tetanus vaccines, and seeking care for fevers and pneumonia. More than 2,000 “outposts” were built in the last decade, and today, 80 percent of the population lives within five kilometers—easy walking distance—of a clinic. The cadre of paid community health workers went from fewer than 100 to more than 2,300. And in 2006 after medical fees were abolished for women and kids, the death rate from malaria among children dropped by nearly two-thirds.

Compared to its neighbors in the Sahel—Nigeria, Benin, Chad, and Mali—Niger is making enormous strides. Its falling rate of childhood mortality is on track to meet the target set by the fourth Millennium Development Goal. It’s only a start, of course: Amozou found that the rate of infant mortality has stagnated in recent years, even as maternal healthcare has improved, and as long as food security plagues the country, stunting and wasting will remain massive problems.

But it’s nice to know that change can, and will, come. In 1990, Niger had the highest child mortality rate of any country on in the world. It wears that badge no longer.

Kevin Charles Redmon
Kevin Charles Redmon is a journalist and critic. He lives in Washington, D.C.

More From Kevin Charles Redmon

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

September 2 • 10:00 AM

SWAT Pranks and SWAT Mistakes

The proliferation of risky police raids over the decades.


September 2 • 9:12 AM

Conference Call: The Graphic Novel


September 2 • 8:00 AM

Why We’re Not Holding State Legislators Accountable

The way we vote means that the political fortunes of state legislators hinge on events outside of their state and their control.


September 2 • 7:00 AM

When Men Who Abstain From Premarital Sex Get Married

Young men who take abstinence pledges have trouble adjusting to sexual norms when they become husbands.


September 2 • 6:00 AM

The Rise of Biblical Counseling

For millions of Christians, biblical counselors have replaced psychologists. Some think it’s time to reverse course.


September 2 • 5:12 AM

No Innovation Without Migration

People bring their ideas with them when they move from place to place.


September 2 • 4:00 AM

Why Middle School Doesn’t Have to Suck

Some people suspect the troubles of middle school are a matter of age. Middle schoolers, they think, are simply too moody, pimply, and cliquish to be easily educable. But these five studies might convince you otherwise.


September 2 • 3:13 AM

Coming Soon: When Robots Lie


September 2 • 2:00 AM

Introducing the New Issue of ‘Pacific Standard’

The science of self-control, the rise of biblical counseling, why middle school doesn’t have to suck, and more in our September/October 2014 print issue.


September 1 • 1:00 PM

Television and Overeating: What We Watch Matters

New research finds fast-moving programming leads to mindless overeating.



September 1 • 6:00 AM

Why Someone Named Monty Iceman Sold Doogie Howser’s Estate

How unusual names, under certain circumstances, can lead to success.



August 29 • 4:00 PM

The Hidden Costs of Tobacco Debt

Even when taxpayers aren’t explicitly on the hook, tobacco bonds can cost states and local governments money. Here’s how.


August 29 • 2:00 PM

Why Don’t Men and Women Wear the Same Gender-Neutral Bathing Suits?

They used to in the 1920s.


August 29 • 11:48 AM

Your Brain Decides Whether to Trust Someone in Milliseconds

We can determine trustworthiness even when we’re only subliminally aware of the other person.


August 29 • 10:00 AM

True Darwinism Is All About Chance

Though the rich sometimes forget, Darwin knew that nature frequently rolls the dice.


August 29 • 8:00 AM

Why Our Molecular Make-Up Can’t Explain Who We Are

Our genes only tell a portion of the story.


August 29 • 6:00 AM

Strange Situations: Attachment Theory and Sexual Assault on College Campuses

When college women leave home, does attachment behavior make them more vulnerable to campus rape?


August 29 • 4:00 AM

Forgive Your Philandering Partner—and Pay the Price

New research finds people who forgive an unfaithful romantic partner are considered weaker and less competent than those who ended the relationship.


August 28 • 4:00 PM

Some Natural-Looking Zoo Exhibits May Be Even Worse Than the Old Concrete Ones

They’re often designed for you, the paying visitor, and not the animals who have to inhabit them.


August 28 • 2:00 PM

What I Learned From Debating Science With Trolls

“Don’t feed the trolls” is sound advice, but occasionally ignoring it can lead to rewards.


August 28 • 12:00 PM

The Ice Bucket Challenge’s Meme Money

The ALS Association has raised nearly $100 million over the past month, 50 times what it raised in the same period last year. How will that money be spent, and how can non-profit executives make a windfall last?


August 28 • 11:56 AM

Outlawing Water Conflict: California Legislators Confront Risky Groundwater Loophole

California, where ambitious agriculture sucks up 80 percent of the state’s developed water, is no stranger to water wrangles. Now one of the worst droughts in state history is pushing legislators to reckon with its unwieldy water laws, especially one major oversight: California has been the only Western state without groundwater regulation—but now that looks set to change.


August 28 • 11:38 AM

Young, Undocumented, and Invisible

While young migrant workers struggle under poor working conditions, U.S. policy has done little to help.


Follow us


Subscribe Now

When Men Who Abstain From Premarital Sex Get Married

Young men who take abstinence pledges have trouble adjusting to sexual norms when they become husbands.

Your Brain Decides Whether to Trust Someone in Milliseconds

We can determine trustworthiness even when we’re only subliminally aware of the other person.

Young, Undocumented, and Invisible

While young migrant workers struggle under poor working conditions, U.S. policy has done little to help.

Education, Interrupted

When it comes to educational access, young Syrian refugees are becoming a “lost generation.”

No, Smartphone-Loss Anxiety Disorder Isn’t Real

But people are anxious about losing their phones, even if they don’t do much to protect them.

The Big One

One third of the United States federal budget for fighting wildfires goes toward one percent of such fires. September/October 2014 big-one-fires-final

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.