After a COVID-19 related growth slowdown in 2020, Niger’s economic recovery was hit by a series of climate and security shocks in 2021 that deteriorated many economic and social indicators. As a result, GDP growth decelerated to 1.4 percent in 2021, which translated into a per capita GDP contraction of 2.3 percent.
Reestablishing public health priorities and resuming economic growth are essential prerequisites to sustainably fund an increase in health spending for better health outcomes. The 2020 World Bank Public Expenditure Review estimated that greater efficiency in the use of the resources spent on health care could increase life expectancy by 4 years. One source of inefficiency stems from the imbalance between the human resources and infrastructure: the density of qualified practitioners is at the very bottom of the international ranking, while in terms of beds per capita, Niger has twice the LIC average, though they are under-used. The geographical imbalance also has efficiency consequences: health providers in hospitals see very few patients, while health post and health center staff have a much larger caseload. Overall, redirecting health financing towards improvement of the primary health care and human resources could bring large gains in health and service coverage within the same budgetary envelope. However, the prioritization and efficiency of health expenditures are key strategies, but with finite possibilities. In the long run, only economic growth can enlarge these possibilities provided that major growth bottlenecks (such as informality, gender gaps, weak business environment) are tackled and that the resilience to shocks is enhanced.