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There are now an estimated 287,000 maternal deaths per year, according to UN partners/AFP-File

Kenya

$20 billion for women, children’s health

Niger: A success story
Countdown to 2015 papers included in The Lancet special issue also show far greater reductions in child mortality in Niger than in its neighbouring West African countries. Because Niger is one of the world’s poorest countries, beset by malnutrition, lack of education and hostile geography, Countdown wanted to find out why.

The Niger case study, led by a team of researchers including Agbessi Amouzou of The Johns Hopkins University in the US, shows that under-5 mortality rates dropped from 226 per 1,000 births in 1995 to 128 in 2009. Wasting declined by about half, mostly in children under two.

During the same period, coverage for most child survival interventions increased. In 2009, an estimated 56,000 children under five were saved, 25 percent attributable to the introduction of bed nets treated with insecticides against mosquitoes which carry malaria; 22 percent to the correct care and treatment of diarrhoea, malaria and pneumonia; 19 percent to better nutrition; 9 percent to vitamin A supplementation; and 12 percent to vaccination.

Government policies supporting free care for children and pregnant women, and decentralized nutrition programs have also been key to Niger’s success.

The study provides invaluable evidence for other low-income countries as to how child health can be improved in a comparatively short space of time, at relatively low cost. According to author Agbessi Amouzou: “This study codifies, for the first time, policies, programmatic strategies, and what was actually done on the ground in Niger to achieve the dramatic reductions in child mortality and wasting that we’ve seen there in the last 10 years.”

Writing in a linked Comment in The Lancet, Niger’s Minister of Health, Soumana Sanda, says: “These results are a source of enormous pride on the part of the Government of Niger, and especially the Ministry of Health, for having moved Niger from its position in 1990, when the country had the highest child mortality rate in the world, to where we are today. Our success provides evidence that it is possible to reduce child mortality substantially in an incredibly hard socioeconomic context.”

“Niger shows what can be achieved,” says Dr. Chopra, who also contributed to two UNICEF-led studies on equity and child survival in this special issue of The Lancet. “Just getting simple things to poor people can save a lot of lives. Niger shows how global activism and national leadership can actually make a difference.”

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