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

July 29 • 11:23 AM

Where Should You Go to College?


July 29 • 10:29 AM

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.


July 29 • 10:00 AM

The Monolingual American: Why Are Those Outside of the U.S. Encouraging It?

If you are an American trying to learn German in a large German town or city, you will mostly hear English in return, even when you give sprechen your best shot.


July 29 • 8:00 AM

The Elusive Link Between Casinos and Crime

With a study of the impact of Philadelphia’s SugarHouse Casino, a heated debate gets fresh ammunition.


July 29 • 6:00 AM

What Are the Benefits of Locking Yourself in a Tank and Floating in Room-Temperature Saltwater?

After three sessions in an isolation tank, the answer’s still not quite clear.


July 29 • 4:00 AM

Harry Potter and the Battle Against Bigotry

Kids who identify with the hero of J.K. Rowling’s popular fantasy novels hold more open-minded attitudes toward immigrants and gays.


July 29 • 2:00 AM

Geographic Scale and Talent Migration: Washington, D.C.’s New Silver Line

Around the country, suburbs are fighting with the urban core over jobs and employees.


July 28 • 4:00 PM

Border Fences Make Unequal Neighbors and Enforce Social Inequality

What would it look like if you combined Israel, the West Bank, and Gaza, demographically speaking? What about the United States and Guatemala?


July 28 • 2:00 PM

Are Patient Privacy Laws Being Misused to Protect Medical Centers?

A 1996 law known as HIPAA has been cited to scold a mom taking a picture of her son in a hospital, to keep information away from police investigating a possible rape at a nursing home, and to threaten VA whistleblowers.


July 28 • 12:00 PM

Does Internet Addiction Excuse the Death of an Infant?

In Love Child, documentary filmmaker Valerie Veatch explores how virtual worlds encourage us to erase the boundary between digital and real, no matter the consequences.


July 28 • 11:11 AM

NASA Could Build Entire Spacecrafts in Space Using 3-D Printers

This year NASA will experiment with 3-D printing small objects in space. That could mark the beginning of a gravity-free manufacturing revolution.


July 28 • 10:00 AM

Hell Isn’t for Real

You may have seen pictures of the massive crater in Siberia. It unfortunately—or fortunately—does not lead to the netherworld.


July 28 • 8:00 AM

Why Isn’t Obama More Popular?

It takes a while for people to notice that things are going well, particularly when they’ve been bad for so long.


July 28 • 7:45 AM

The Most Popular Ways to Share Good and Bad Personal News

Researchers rank the popularity of all of the different methods we have for telling people about our lives, from Facebook to face-to-face.


July 28 • 6:00 AM

Hams Without Ends and Cats Tied to Trees: How We Create Traditions With Dubious Origins

Does it really matter if the reason for why you give money to newlyweds is based on a skewed version of a story your parents once told you?


July 28 • 4:00 AM

A Belief in ‘Oneness’ Is Equated With Pro-Environment Behavior

New research finds a link between concern for the environment and belief in the concept of universal interconnectedness.


July 25 • 4:00 PM

Flying Blind: The View From 30,000 Feet Puts Everything in Perspective

Next time you find yourself in an airplane, consider keeping your phone turned off and the window open.


July 25 • 2:00 PM

Trophy Scarves: Race, Gender, and the Woman-as-Prop Trope

Social inequality unapologetically laid bare.


July 25 • 1:51 PM

Confusing Population Change With Migration

A lot of population change is baked into a region from migration that happened decades ago.


July 25 • 1:37 PM

Do Not Tell Your Kids That Eating Vegetables Will Make Them Stronger

Instead, hand them over in silence. Or, market them as the most delicious snack known to mankind.



July 25 • 11:07 AM

The West’s Groundwater Is Being Sucked Dry

Scientists were stunned to discover just how much groundwater has been lost from beneath the Colorado River over the past 10 years.


July 25 • 10:00 AM

Shelf Help: New Book Reviews in 100 Words or Less

What you need to know about Bad Feminist, XL Love, and The Birth of Korean Cool.



July 25 • 8:00 AM

The Consequences of Curing Childhood Cancer

The majority of American children with cancer will be cured, but it may leave them unable to have children of their own. Should preserving fertility in cancer survivors be a research priority?


Follow us


Subscribe Now

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.

NASA Could Build Entire Spacecrafts in Space Using 3-D Printers

This year NASA will experiment with 3-D printing small objects in space. That could mark the beginning of a gravity-free manufacturing revolution.

The Most Popular Ways to Share Good and Bad Personal News

Researchers rank the popularity of all of the different methods we have for telling people about our lives, from Facebook to face-to-face.

Do Not Tell Your Kids That Eating Vegetables Will Make Them Stronger

Instead, hand them over in silence. Or, market them as the most delicious snack known to mankind.

The West’s Groundwater Is Being Sucked Dry

Scientists were stunned to discover just how much groundwater has been lost from beneath the Colorado River over the past 10 years.

The Big One

One in two full-time American fast-food workers' families are enrolled in public assistance programs, at a cost of $7 billion per year. July/August 2014

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