Republic of the Niger
The Republic of the Niger is a vast landlocked country of the Sahel, two-thirds of which are desert. The population is very young and a large majority is rural. A large part of the active population is employed in the agropastoral and agricultural sectors, mainly in small-scale family farms, practicing subsistence agriculture and rearing livestock. This sector, which is the foundation of the economy, is highly sensitive to the harsh climatic conditions which include recurrent periods of drought.
Poverty is widespread and severe, with more than 60% of the population below the poverty line. Structural poverty, coupled with persistent food production shortages, results in high vulnerability of the population to climatic and economic shocks, which can lead to severe food crises, as occurred in 2005.
Health indicators show an alarming situation, characterised by very limited access to essential health care, low immunization coverage and precarious living conditions that strongly impact young child and maternal mortality rates, which remain at very high levels although a decline in infant and under-five mortality rates has been observed. Geographic dispersion of the population is an added constraint to the development of accessible health services. Moreover, due to a low level of funding of health care there is an important lack of trained health personnel.
The diet is largely based on cereals, mainly millet and sorghum, with some starchy roots (essentially cassava). In rural areas, the diet is complemented with pulses, while in urban areas it is more often complemented with vegetables. Consumption of foods of animal origin, and of fruit and vegetables, foods that are rich in micronutrients, remains low. Consumption of milk, a tradition in the agropastoral population, is declining because of the reduction in the number of cattle due to drought and to the degradation of the terms of trade of cattle against cereals. The dietary supply, comprised mainly of cereals, is barely sufficient to meet the population energy requirements at national level and, due to an unequal distribution within the population, undernourishment affects 29% of the population.
The nutritional situation of the young children of Niger is alarming. Half of the children under five years of age are stunted, i.e. are affected by chronic undernutrition. The prevalence of this form of malnutrition has been increasing significantly in the rural sector for the last 15 years. This trend is due to increasing rural poverty, lack of access to health care, a low level of environmental hygiene and a food supply lacking essential micronutrients. Women of childbearing age are also highly affected by chronic undernutrition in the rural sector, while overweight and obesity are emerging in the urban sector.
Prolonged breastfeeding is a universal practice in Niger, but early initiation after birth and exclusive breastfeeding for the first six months are not widely practiced, although some progress has been observed. Complementary feeding is inadequate, lacking diversity.
The high prevalence of malnutrition is associated with severe micronutrient deficiencies. Iodine deficiency disorders, which were endemic in the country in the past, have regressed due to the introduction of universal salt iodization but this strategy must be reinforced and new prevalence data are needed to assess its impact. Vitamin A deficiency is also a major public health problem, for which a national supplementation programme has been implemented. Supplementation coverage is relatively large among young children but remains limited among mothers. Prevalence of anemia is very high in the most vulnerable groups, and among these groups iron supplementation must be strongly reinforced. As anemia is affecting all population groups, more comprehensive measures, such as deworming, are also needed.
The rural population suffers disproportionately from poverty, food insecurity and nutritional deficiencies. Major efforts are needed on the part of the government and international actors to help the country improve its situation in a sustainable way.