Médecins Sans Frontières (MSF) continued to improve and expand integrated health programmes to reduce child suffering and death in Niger.
Niger is affected by child malnutrition of epidemic proportions, which peaks during the ‘hunger gap’, a period between harvests in May and September when household food stocks become depleted and are insufficient to meet nutritional needs. The hunger gap coincides with the rainy season and a proliferation of malaria-transmitting mosquitoes, a lethal combination for young children: a malnourished child is more vulnerable to diseases such as malaria and a sick child is more likely to become malnourished.
MSF collaborates with national authorities and NGOs (FORSANI, Befem/Alima) to reduce under-five mortality in several regions of the country, with a particular focus on the management of children with severe malnutrition and malaria. In 2014, MSF supported six inpatient and several outpatient centres in Madarounfa and Guidan Roumdjii (Maradi region), Bouza and Madaoua (Tahoua region), and Magaria (Zinder region).
Aiming to complement treatment with prevention, MSF also conducted a seasonal malaria chemoprevention (SMC) campaign in the Sahel region (Tahoua, Zinder and Maradi) for the second year running, reaching a total of 447,500 people. SMC involves the administration of antimalarial treatment. It is used alongside common methods of mosquito bite prevention such as nets and has been proven to significantly reduce the incidence of malaria in children under the age of five.
In 2014, MSF continued a programme of medical and nutritional care for children under the age of five in Magaria, Zinder. The programme focused on the paediatric unit of Magaria hospital, as well as seven health centres and 21 health posts during the peak in malnutrition. In 2014, more than 65,000 children were targeted for Plumpy’Doz (supplementary food) distributions.
In Madarounfa, MSF runs two outpatient and one inpatient feeding centre to treat children with severe acute malnutrition and supervises four outpatient facilities managed by the national NGO Niger Health Forum (FORSANI). Over 137,000 children were screened for malnutrition and 14,500 were admitted for treatment. MSF also supports the Ministry of Health in Madarounfa hospital’s paediatric unit and provided additional support to 11 health centres during the annual malaria peak in 2014. Preventive activities included SMC, providing 54,400 vaccinations and distributing 7,850 mosquito nets. A temporary respite care unit in Dan Issa relieves the pressure on the Madarounfa centres during the malnutrition peak and cares for the most severely ill children.
MSF supports five health centres in Guidan Roumdji, where outpatient consultations and vaccinations are available for children up to the age of five. Those that are severely malnourished are screened and treated in ambulatory therapeutic feeding centres, and the ones with medical complications or associated diseases are admitted to the paediatric ward of the MSF-supported district hospital. In 2014, over 125,800 children were treated in the outpatient facilities and approximately 10,000 were hospitalised. During the period of high malaria transmission from June to December, MSF supports six additional health centres by providing drugs, training staff and supervising medical activities. Nearly 9,300 paediatric cases of malaria were treated and SMC was provided to over 67,000 children aged between three and 59 months.
In Madaoua district, MSF supports six integrated health centres to provide treatment of childhood illnesses and severe acute malnutrition throughout the year. More than 4,800 children with acute malnutrition were admitted to inpatient programmes and over 13,660 received treatment as outpatients in 2014. Psychosocial activities are also being implemented to ensure healthy development and recovery from malnutrition. A visiting MSF psychologist carried out more than 2,000 consultations, supporting mothers and children by introducing developmental activities to help with psychosocial and psychomotor (the relationship between cognitive function and physical movement) development, and conducting group and individual counselling sessions.
In Bouza district, MSF provides paediatric and nutritional care for children under five in the hospital in Bouza town and the area’s six health centres. There is also a programme that decentralises essential healthcare in three of the project’s health areas; children and pregnant women can be treated at the health posts and only need to attend the hospital if referred.
MSF is also beginning to work with children with HIV and tuberculosis in Madaoua and Bouza. In Bouza, basic training of hospital staff on HIV was undertaken with the aim of reducing stigmatisation.
MSF expanded its SMC campaign in the two districts, covering all the health areas and treating 237,000 children aged between three and 59 months.
Aiding refugees from Nigeria
The violent activity of Boko Haram in Borno state, Nigeria, caused people to flee their villages and cross into neighbouring countries, including the Diffa region of southeast Niger. Responding to the influx of refugees, mainly women, children and elderly people, MSF began supporting health centres in N’Garwa and Gueskerou at the beginning of December, providing free access to healthcare and distributing relief kits to new arrivals. MSF also responded to a cholera outbreak among refugees and the host population in Diffa, after cases were recognised in Diffa city and Chatimari. Teams set up cholera treatment sites and oral rehydration points. MSF also trained local health centre staff to chlorinate water at the rehydration points.
In September, MSF worked with the Ministry of Health to respond to an outbreak of cholera affecting Tamaske, Madaoua, Bouza, Tahoua, Maradi and Madarounfa. Emergency teams treated some 1,000 patients within a few weeks. This was one of the interventions carried by EMUSa, an MSF emergency medical response team for the Sahel, which is based in Niger and aims to create better surveillance and respond more rapidly to emergencies.
Tillabéri project handover
The healthcare programme for Malian refugees and the host community in Abala, Tillabéri region, was handed over to the Qatari Red Crescent in June. A total of 20,777 consultations had been provided.
No. staff in 2014: 1,866 | Expenditure: €23.5 million | Year MSF first worked in the country: 1985 | msf.org/niger