During Fall 2014, IPD’s Global Health Team was tasked with working on maternal and child health donor briefs for various countries around the world. I was assigned Niger. Before this project, the only thing I knew about Niger was that it was a country in Africa. To be completely honest, I didn’t even know how to pronounce it correctly. Listen to the correct pronunciation here.
Through my research for the brief, I learned that Niger has a poverty rate of 56 percent, ranking it last among all countries worldwide in the 2012 Human Development Index. According to the World Bank’s 2013 Country Partnership Strategy Report for Niger, the Niger government remains highly committed to achieving the Millennium Development Goals, though progress is slow. One particular area of concern in Niger is its high maternal mortality rate (MMR) (590 per 100,000 live births).
The most recent related project in Niger was funded by the World Bank in 2007, under the auspices of the Bank’s Reproductive, Maternal and Child Health sector for the Multi-Sector Demographic Project. This $10 million government-sector project ended in March 2013 and was successful in meeting its target goals. By the end of the project, one of the three primary goals was exceeded (increased contraceptive use among women aged 20-24), one was met (number of work plans prepared and adopted), and one was missed by 0.7 percentage points (off a targeted 28 percent gain in contraceptive knowledge among women).1
The graph above allows for some further understanding of the situation in Niger. It has one of the highest maternal mortality rates among countries with the highest total fertility rate. That means that it has one of the highest percentages of women dying when they give birth. According to a 2010 report from the World Health Organization, 79 percent of the reason why Niger citizens die is because of the transfer of communicable diseases, the most for any any African country. Additionally, there are only about 0.5 doctors and 3 hospital beds for every 10,000 people in Niger, meaning even if you get sick, there is a huge lack of infrastructure to treat you. It also doesn’t help that 66 percent of the Niger population is living under $1, furthering their lack of access to adequate health care.
In 2010, the World Bank launched its Reproductive Health Action Plan (RHAP) with the primary objective of helping client countries improve reproductive health outcomes, focusing on alleviating poverty and strengthening health systems. Considering Niger’s strong performance on the 2007 World Bank project, its high maternal mortality rate and total fertility rate, the government’s commitment to development, Niger is an ideal candidate for support under the RHAP, which strives to help the higher burdened countries. Why then has it been largely ignored, with just one relatively low funded project throughout the five year Action Plan and no additional funds approved during the Action Plan timeframe? It appears as though the World Bank has missed an opportunity in Niger and unfortunately, many women are losing their lives because of it.
Saumya Wali is pursuing her BA in Public Relations and a Business Foundation Certificate at UT Austin. She has been a member of IPD since Fall 2014.