National UHC Dynamics Card Niger

Flag Niger

General Information

The Niger’s health situation remains characterised by high levels of maternal and child mortality and the double burden of communicable and noncommunicable diseases. Unhealthy conditions, environmental degradation, poor hygiene and sanitation, climate change and problems with the supply of drinking water are also factors limiting the government’s and partners’ efforts to promote sustainable development.

Map of Niger
THE COUNTRY

The Niger, a landlocked country located in West Africa, covers an area of 1,266,491 km2. Its population is mainly young (51% under 15 years of age) and in 2017 was estimated to be 21,5 million. Its intercensal annual growth rate of 3.9% is one of the highest in the world. This strong population growth rate is corroborated, among other factors, by a high fertility rate (total fertility rate of 7.6 in 2012), which contributes to the population doubling every 18 years.

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Niger can be found in the attached print version of the card.

 
 

POST-INDEPENDANCE IN 1960

After the independence of the country in 1960, Niger’s health policy focused mainly on individual curative medicine. The essential elements of this policy were free healthcare, the low participation of communities in the management and financing of actions affecting their health, the predominance of curative medicine and the concentration of health infrastructures in cities and large conurbations.

1974-1995

PRIMARY HEALTH CARE STRATEGY
1974-1978
Signup of a number of regional and international declarations including the 1978 Alma-Ata Declaration which adopted a Primary Health Care Strategy.

Emphasis was placed on mass medicine that was preventive and mobile and incorporated the curative aspect of care much more clearly.

1980-1987
The Primary Health Care Strategy became increasingly structured following the implementation of the ‘self-managed health care’ policy throughout the country.

This strategy focused on having village health care teams treat health problems in rural areas, supervised by staff from health centers.

1995
Adoption of the Health Sector Policy Declaration as part of the comprehensive framework for decentralisation and following on from the national pharmaceutical policy.
 

2005-2015

FREE HEALTH CARE POLICY
2005
Introduction of free health care policy.

Adoption of a legal text which guarantees free health care for some population groups.

Free health care began with the provision of care for women with children under the age of five.

 
2011
National social protection policy

It provides for the creation of a Special Fund for Social Protection (FSPS) based on a share of the national budget representing at least 1% of GDP’.

 
 
Adoption of the Constitution of the Seventh Republic.

The Constitution of the Seventh Republic provides for the right to health care and social protection.

 
2012
Elaboration of the National health financing strategy by the Ministry of Public Health.

It aimed at universal health coverage in the Niger as part of the implementation of the National Social Protection Policy.

 
2015
47.83%

Household OOP remain the main means of health financing, constituting 47.83% of current expenditure on health.

 
 

"The State will continue to prioritise preventive health care, to promote universal health coverage and to strengthen the management of the health system."

Extracted from: The National Health Policy

2018-2019

ACCELERATION IN THE REFLEXION ON UHC
 
2018

• July: P4H (AFD-WHO-World Bank associating GAVI-GFTAMKfW-USAID-ILO) mission states: «Niger needs to focus on improving the exemption fee mechanism»

• July: WHO fee exemption mechanism new study states the «need to profesionnalize the 1/3 party payment»

 
2019

• June: WHO scoping mission on UHC suggests that « conceptsneed to be clarified and people sensitized on UHC »

• July: participation of a team of 10 high level people from different Ministries in the P4H Leadership for UHC programme

• July & September: study of the options to profesionnalize the 1/3 party payment for the fee exemption mechanism

• September: arrival of a P4H country Focal Point in Niger (AFD funded, Expertise France contracted)

• September-December: study of fee exemption mechanism and PFM (payment mechanism)

• August-October: development of a draft UHC strategy

• October: National Forum on UHC

 
 
PRIVATE INSURANCE
0.4%
In total, six private insurance companies operate in the Niger and cover 0.4% of the country’s population.

However, this insurance is only available to organised groups (e.g. projects,businesses, companies) and not to individuals, families or even groups of families.

NATIONAL HEALTH EXPENDITURE (In Milliards CFA)
 
CHANGES IN THE NIGER’S HEALTH BUDGET FROM 2003 TO 2015
 
NATIONAL SOCIAL SECURITY FUND (CNSS).

Adoption of the National Social Security Fund (CNSS) was 1965.

CNSS PROVIDES:

• family benefits

• maternity benefits

• assistance in the event of workplace accidents or occupational diseases

• assistance for the elderly

• disability benefits

• survivors’ benefits in the event of death

• medical care benefits.

CURRENT HEALTH EXPENDITURE ACCORDING TO FINANCING SOURCES 2017 IN U.S. $
 
THE SERVICES COVERED BY THE FREE HEALTH CARE POLICY INCLUDE:

Vaccinations; ante-natal check-ups; caesarean sections; contraceptive provision; HIV, tuberculosis and women’s cancer care; preventive and curative health care for children under five, etc.

 

Source references

• Déclaration de Politique Générale (DPG) 2017-2021. Niger.

• Institut National de la Statistique (n.d.) : Comptes rapides 2015. Niger

• La Constitution de la septième République de Niger (2011). Niger.

• Ministère du Plan de l’Aménagement du Territoire et du Développement Communautaire (2017) : Plan de Développement Economique et Social (PDES) 2017-2021. Niger.

• Ministère de la Santé Publique (2017) : Politique Nationale de Santé. Niger.

• Ministère de la Santé Publique (2017) : Rapports des Comptes nationaux de la santé NS 2015-2017. Niger.

• Ministère de la Santé Publique (2011) : Plan de Développement Sanitaire (PDS) 2011-2015. Niger.

• Ministère de la Santé Publique (2017) : Plan de Développement Sanitaire (PDS) 2017-2021. Niger.

• Ministère du Plan (2017) : Niger 2035 : Un pays et un peuple prospères. Tome – II : Scénarii, Vision et Orientations Stratégiques. Stratégie de Développement Durable et de Croissance Inclusive. Niger.

• Ministère de la Population de la Femme et de la Protection de l’Enfant (2011) : Politique Nationale de protection Sociale. Niger.

• Ministère du Plan, Institut national de Statistique (n.d.) : Etude sur la Gratuité des soins de santé au Niger. Niger.

• Ministère de la Santé Publique (2012) : Plan stratégique du Système National d’Information Sanitaire 2013-2022 du SNIS. Niger.

• Ministère de la Santé Publique (n.d.) : Rapport d’Analyse de situation et Diagnostic, mission d’audit organisationnel et fonctionnel du MSP du Niger. Niger.

• Ministère de la Santé Publique (1995) : Déclaration de Politique Sectorielle de Santé. Niger.

• Ministère de la Santé Publique (2002) : Politique sanitaire 2002-2011. Niger.

• Ministère de la Santé Publique (2012) : Stratégie nationale de financement de la santé en vue de la couverture universelle en santé au Niger. Niger.

• Ministère de la Santé Publique (n.d.) Rapport d’étude pour déterminer les acquis de la gratuité des soins et des mécanismes assurantiels en vigueur au Niger dans la perspective de la mise en place d’une Couverture Universelle du Risque Maladie. Niger.

• Programme de Renaissance du Président de la République acte II 2016-2021. Niger.

• United Nations (n.d.) : Plan Cadre des Nations Unies pour l’Aide au Développement (UNDAF) 2014-2018.

 

This card was created in friendly collaboration with Dr. Hassane ADAMOU – Public Health Consultant, Niger.

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Niger can be found in the attached print version of the card.