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Field article
Article de terrain
Background
National nutrition and health situation
Niger is a land-locked Sahelian country with a population of over 15
million people, of which approximately 50 per cent are children under 15
years of age. Niger ranks 173rd out of 177 countries according to the 2010
UNDP 1 Human Development Index. Millenium Development Goal
(MDG) indicators, such as child mortality and maternal mortality rate, are
among the worst in the world. The maternal mortality rate has stalled
over the past ten years and in 2010, was still 554 per 100,000 live births.
Moreover, one child out of five still dies before the age of five in Niger. 2
Malaria, respiratory infections, and diarrhoea are the main direct causes
of under-five mortality. Acute malnutrition is directly or indirectly
responsible for 50 to 60 per cent of under-five deaths.
For years, Niger has been confronted with chronic food insecurity and
high levels of maternal and child malnutrition, common to the Sahel region.
National nutrition surveys carried out over the past five years all point to
the conclusion that the nutritional status of young children in Niger
remains a matter of great concern. Even in good harvest years, child malnutrition
remains high. Since 2005, the prevalence of acute malnutrition
among children in Niger has always been above the alert level of 10 per
cent, with a few regions exceeding the emergency level threshold (15 per
cent) (see Figure 1). The latest national nutrition survey (June 2011) revealed
a national average of global acute malnutrition (GAM) of 12.3% with a
prevalence of severe acute malnutrition (SAM) of 1.9%. The situation is of
great concern among children aged 6–23 months. The prevalence of GAM
in this age group is 20.2% according to the latest national nutrition survey.
A high prevalence of chronic malnutrition is also a major problem of
public health importance as every other child aged 6 – 59 months is
stunted, and there is very little variation over the years (see Figure 2).
In Niger, only 46 per cent of the population has access to safe water.
The regions of Zinder, Maradi, Tahoua and Agadez, in particular, face
limited access to drinking water, low sanitation coverage, and poor
hygiene practices, especially among the poor. In a context of high food
and nutrition insecurity, the lack of appropriate hygiene, drinking water
and proper sanitation increases the incidence of water-related diseases,
including diarrhoea, which is a major underlying cause of malnutrition.
The health system in Niger is well structured and quite decentralised.
However, it is confronted with a serious issue of staffing.
1
United Nations Development Programme
2
Multiple Indicator Cluster Survey on Population and Health in Niger (EDSN – MICS), 2006
Figure 1: Prevalence of acute malnutrition among children aged 6-59 month in Niger
Figure 1 : Prévalence de la malnutrition aiguë chez les enfants âgés de 6 à 59 mois au
Niger
Prevalence (%)
Prévalence (%)
18
16
14
12
10
8
6
4
2
0
2005 2006 2007 2008 2009 2010 2011
GAM: global acute malnutrition. SAM: severe acute malnutrition
MAG: malnutrition aiguë globale. MAS: malnutrition aiguë sévère
Figure 2: Prevalence of severe chronic malnutrition among children aged 6-59
month in Niger
Figure 2 : Prévalence de la malnutrition chronique sévère chez les enfants âgés de 6 à
59 mois au Niger
Severe chronic malnutrition: (Z score height for age