TY - JOUR
T1 - Reduction in child mortality in Niger
T2 - A Countdown to 2015 country case study
AU - Amouzou, Agbessi
AU - Habi, Oumarou
AU - Bensaïd, Khaled
N1 - Funding Information:
The case study was supported through Countdown to 2015 for Maternal and Child Survival by the Bill & Melinda Gates Foundation, the World Bank, and the Governments of Australia, Canada, Norway, Sweden, and the UK. Mortality analyses were supported by the Canadian International Development Agency through the Real-Time Results Tracking project, implemented by the Institute for International Programs at The Johns Hopkins Bloomberg School of Public Health. The application of the Lives Saved Tool (LiST) was supported through the Child Health Epidemiology Reference Group (CHERG) by the Bill & Melinda Gates Foundation. We thank the Government of Niger and especially the Ministry of Health for their assistance in compiling, reviewing, and interpreting the data presented here. The work could not have been done without the full support of the Niger National Institute of Statistics and its Director-General; of UNICEF-Niger, its Country Representative (Guido Cornale) and Deputy Representative (Isselmou Boukhari). UNICEF-Niger provided technical inputs and essential support on the ground for this effort. Catherine Pitt helped us with the estimates of official development assistance. WHO and the Health Systems and Policy Working Group of the Countdown to 2015 provided feedback on the case study design, and Bernadette Daelmans assisted in the identification of the programme documentation consultants.
PY - 2012/9
Y1 - 2012/9
N2 - Background The Millennium Development Goal 4 (MDG 4) is to reduce by two-thirds the mortality rate of children younger than 5 years, between 1990 and 2015. The 2012 Countdown profile shows that Niger has achieved far greater reductions in child mortality and gains in coverage for interventions in child survival than neighbouring countries in west Africa. Countdown therefore invited Niger to do an in-depth analysis of their child survival programme between 1998 and 2009. Methods We developed new estimates of child and neonatal mortality for 1998-2009 using a 2010 household survey. We recalculated coverage indicators using eight nationally-representative surveys for that period, and documented maternal, newborn, and child health programmes and policies since 1995. We used the Lives Saved Tool (LiST) to estimate the child lives saved in 2009. Findings The mortality rate in children younger than 5 years declined significantly from 226 deaths per 1000 livebirths (95% CI 207-246) in 1998 to 128 deaths (117-140) in 2009, an annual rate of decline of 5•1%. Stunting prevalence decreased slightly in children aged 24-35 months, and wasting declined by about 50% with the largest decreases in children younger than 2 years. Coverage increased greatly for most child survival interventions in this period. Results from LiST show that about 59 000 lives were saved in children younger than 5 years in 2009, attributable to the introduction of insecticide-treated bednets (25%); improvements in nutritional status (19%); vitamin A supplementation (9%); treatment of diarrhoea with oral rehydration salts and zinc, and careseeking for fever, malaria, or childhood pneumonia (22%); and vaccinations (11%). Interpretation Government policies supporting universal access, provision of free health care for pregnant women and children, and decentralised nutrition programmes permitted Niger to decrease child mortality at a pace that exceeds that needed to meet the MDG 4. Funding Bill &Melinda Gates Foundation; World Bank; Governments of Australia, Canada, Norway, Sweden, and the UK; and UNICEF.
AB - Background The Millennium Development Goal 4 (MDG 4) is to reduce by two-thirds the mortality rate of children younger than 5 years, between 1990 and 2015. The 2012 Countdown profile shows that Niger has achieved far greater reductions in child mortality and gains in coverage for interventions in child survival than neighbouring countries in west Africa. Countdown therefore invited Niger to do an in-depth analysis of their child survival programme between 1998 and 2009. Methods We developed new estimates of child and neonatal mortality for 1998-2009 using a 2010 household survey. We recalculated coverage indicators using eight nationally-representative surveys for that period, and documented maternal, newborn, and child health programmes and policies since 1995. We used the Lives Saved Tool (LiST) to estimate the child lives saved in 2009. Findings The mortality rate in children younger than 5 years declined significantly from 226 deaths per 1000 livebirths (95% CI 207-246) in 1998 to 128 deaths (117-140) in 2009, an annual rate of decline of 5•1%. Stunting prevalence decreased slightly in children aged 24-35 months, and wasting declined by about 50% with the largest decreases in children younger than 2 years. Coverage increased greatly for most child survival interventions in this period. Results from LiST show that about 59 000 lives were saved in children younger than 5 years in 2009, attributable to the introduction of insecticide-treated bednets (25%); improvements in nutritional status (19%); vitamin A supplementation (9%); treatment of diarrhoea with oral rehydration salts and zinc, and careseeking for fever, malaria, or childhood pneumonia (22%); and vaccinations (11%). Interpretation Government policies supporting universal access, provision of free health care for pregnant women and children, and decentralised nutrition programmes permitted Niger to decrease child mortality at a pace that exceeds that needed to meet the MDG 4. Funding Bill &Melinda Gates Foundation; World Bank; Governments of Australia, Canada, Norway, Sweden, and the UK; and UNICEF.
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U2 - 10.1016/S0140-6736(12)61376-2
DO - 10.1016/S0140-6736(12)61376-2
M3 - Article
C2 - 22999428
AN - SCOPUS:84866654193
SN - 0140-6736
VL - 380
SP - 1169
EP - 1178
JO - The Lancet
JF - The Lancet
IS - 9848
ER -