Countdown to 2030 is working in Niger through two funding mechanisms, the Global Financing Facility (GFF) and Exemplars in Global Health. For both projects, the partnership includes the National Institute of Statistics (INS), the Ministry of Health (MOH), UNFPA, UNICEF, WHO, GFF, and Johns Hopkins University. The GFF collaboration will strengthen country evidence and analytical capacity to inform Niger’s annual and midterm reviews of health progress and performance, with a focus on women’s, children’s and adolescents’ health. The Exemplar study will seek investigate why Niger's reductions in neonatal mortality outperformed other countries in the region. All Exemplar studies employ a mixed methods study design.
Niger is a landlocked, low-income country in West Africa with an estimated population of 24 million in 2020. One of the poorest countries in the world, ranked last on the Human Development Index, Niger faces a continuous harsh environment and poor economic conditions. However, the country has made substantial strides in reducing mortality among children under-five to a level comparable to other countries within the region, and it was the only country within West Africa that achieved the Millenium Development Goal for child survival by 2015. Since 2000, under-five mortality has reduced by two-thirds, from 225 to 80 deaths per 1000 live births, an average annual reduction of 5.4%. Neonatal mortality reduced by 3% per year from 43 deaths per 1000 in 2000 to 25 in 2018. Estimates of maternal mortality showed a reduction of 2.7% per year from 813 deaths per 100,000 live births in 2000 to 509 in 2017. This progress was guided by the persistent effort from the government and its partners, laid out in the five-years health, economic and social development plans .
Niger is currently implementing the Plan de Developpement Sanitaire (PDS) (2017-2021), its fourth health development plan, aimed at reaching the Sustainable Development Goal for health (SDG 3) and nine other SDG goals indirectly related to health. The overall objective of the PDS is to promote the social well-being of the population to reach the SDGs, targeting the six WHO health system building blocks: 1) improve governance and leadership, 2) increase service provision and quality of care, 3) develop human resources, 4) ensure sustained health financing, 5) implement an appropriate management of infrastructure and commodities, and 6) enhance health system information integrated with new information technologies.
In July 2019 Niger began receiving GFF support to assist with progress toward universal health coverage by 2030 for women, children and adolescents. A focal point from the Niger government has been appointed (the Secretary General for Health) and a liaison officer recruited by the World Bank. A national technical working group has been established to develop an investment case, with support from UNICEF’s consultants. The development of the investment case was scheduled for mid-2020 but has been delayed by the COVID-19 pandemic.
For Countdown country collaboration through GFF, a series of quantitative assessments and analyses will be carried out with the INS and the MOH, based on the country’s already established monitoring and evaluation plan to describe the current level of RMNCH and nutrition indicators, the past performance in these indicators, and the ability to reach targets set in the plan. Analytical priorities will be cross-linked with priorities defined in the GFF investment case in order to also support progress assessment on selected GFF-funded activities within the national health plan.
Countdown is also conducting an in-depth case study to understand drivers of maternal and neonatal mortality reduction as part of the Exemplar in Global Health initiative developed and funded by the Gates Ventures. Niger is one of the two countries – along with Senegal – that has been selected as a focus country for analysis within the West Africa region. Analyses related to the country collaboration and the Exemplar study are therefore integrated.
Outputs, Products, Programs
- At least one annual or mid-term or final review report to inform progress and performance of the country RMNCAH+N plan and investment case during the two years, in close collaboration with the Ministry of Health
- Basic report with regional progress analyses based on surveys, health facility data, administrative data, focusing on recent trends and inequalities; informs annual reviews
- Comprehensive, in-depth analysis of progress and performance at national and subnational levels (up to district level based on available data), including long term perspective
- Special analytical studies as requested in the context of the investment case and national plans, such as district-level progress and performance assessment, special target populations such as urban poor or adolescents, or special subject areas such as quality of care or results-based funding
- At least one peer-reviewed publication on the country work
- Systematic archiving of data and methods (e.g., statistical code) linked to country repositories