Niger is a landlocked West African nation that relies on oil production, extractive industries and agriculture. Terrorist attacks from Boko Haram continue to threaten the country, and combined with low rainfall, impede the country’s economic wellness. Health care access is limited outside Niamey, the capital, and there are high rates of malaria transmission, meningococcal meningitis and HIV infection. In 2016, Niger had the largest unmet need for family planning with the highest total fertility rate in the world at 7.6 children per woman.sol
PSI/Niger was founded in 2013 to address the high burden of disease in the country. Programming began with reproductive health education, contraceptive distribution and child survival. The following year, PSI/Niger added projects addressing water, sanitation and hygiene improvement, and HIV prevention, including testing and referral for treatment. By 2015, PSI/Niger incorporated projects addressing gender equity and expanding family planning work. In 2016, PSI began projects aimed at women’s empowerment and gender equity; family planning access including long term methods; harm reduction and post-abortion care, and nutrition. PSI/Niger is a committed partner of the Nigerian Ministry of Public Health, and also collaborates with the private and public sectors.
Family Planning
Niger has an exceptionally high need for expanded access to family planning services. The country has a rapidly increasing population and a contraception prevalence rate of only 12.5%. Women marry at a median age of 15.7 years, and by the age of 19, three-quarters of girls have already had their first child or are pregnant. Fortunately, the Government of Niger is dedicated to reversing this trend and is engaged in many efforts, including the FP2020 Partnership.
In 2016, PSI/Niger started a project to support women in planning the families they desire, and to reduce harm to women due to unsafe abortions by providing harm reduction counseling, safe abortion where legally indicated and post-abortion care. The project also works to increase access to and demand for long-acting reversible contraceptives (LARCs), especially the intrauterine device (IUD) and hormonal implants.
In 2016, PSI/Niger launched a research project to capitalize on a growing gardening movement. The project’s objectives are to improve gender equity, increase access to family planning, and help address malnutrition in Niger. The project aims to engage women with family planning and nutrition methods at women-run gardens. The project will also engage with male partners of women-gardeners through religious leaders and community outreach.
HIV/AIDS
In 2015, PSI/Niger began a program with the military to support and strengthen HIV prevention, testing, referral for treatment, and strategic information activities in collaboration with the Government of Niger. This program complements regional HIV activities targeting national security forces.
PSI/Niger contributes to the goal of reducing HIV incidence among Niger’s armed forces by:
- Increasing access to and demand for HIV prevention, testing and counseling, care and treatment services.
- Improving quality of HIV prevention, testing, counseling, and treatment services.
Gender Equity
In Niger, 76% of married women report that husbands alone make healthcare decisions for them. Thus, improving gender equity will impact a woman’s access to healthcare, including her ability to plan the family she desires. In 2016, PSI/Niger completed a program that partnered with local NGOs to improve gender equity through a multi-faceted approach. Strategies included:
- Supporting income-generating activities, including distribution of sheep, goats, mills, sewing materials, and other investment capital.
- Capacity building of local organizations through trainings and supportive supervision
- Training municipal government members on awareness of gender inequity issues, and integrating gender equity into their programming.
- Improving literacy of young girls.
Donors
- Anonymous donor
- U.S. Agency for International Development (USAID)
- U.S. Department of Defense
- U.S. President’s Malaria Initiative – IMPACT Malaria
- U.S. President’s Malaria Initiative – VectorLink
Partners
- Ministry of Public Health of the Republic of Niger
- Local and international NGOs
- Mobile Outreach for Family Planning in Rural Niger
This program brief demonstrates how a High Impact Practice can support access to voluntary family planning in fragile and hard-to-reach settings, like rural Niger. It also explores how proven service delivery models can be rolled out and adapted to these contexts. - Transforming Mobile Outreach for Voluntary Family Planning in Rural Niger
Poster presented at the 8th Annual Ouagadougou Partnership Meeting in Cotonou, Benin, December 2019.
- Transform/PHARE: Examining Male and Female Family Planning Attitudes and Behaviors in Niger
- SARARI Video
- Strategies, Approaches and Tools Used to Introduce Next Generation Injectable Contraceptives in Resource Poor Settings
This workshop set out to identify different service delivery models share strategies and best practice, explore how DMPA-SC is being used within the wider method mix, and ultimately develop action plans for strengthening high quality DMPA-SC programming and implementation in participants’ respective countries. - Outil de formation financiere
A simple exercise that helps youth estimate the costs and financial burden involved in having a large family. - Argumentaire Coranique
A booklet for Religious Leaders that compiles Coran verses in 9 themes, to help them discuss family health and family planning. - Niger Male Segmentation Analysis
Quantitative analysis of men’s attitudes and behaviors related to contraception and family planning leading to behavioral/-attitudinal segmentation in Niger - IVR Pretesting
Interactive Voice Response (IVR) used to pre-test and iterate messages to increase demand for FP. - Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market.