Health in Niger

The Ministère de la Santé et de l’Hygiène Publique sets national standards and coordinates the health system. Regional health directorates coordinate services in the regions, while health districts organize local delivery and referrals. Community health committees, management committees, associations and mutual organizations support local participation. WHO, UNICEF, Gavi and other partners provide support but do not replace Nigerien public authorities as the primary responsibility holders. Niger has three main service levels. National care includes three national hospitals and the national reference maternity hospital. Regional care includes eight regional health directorates, six regional hospitals and seven mother-and-child health centres, of which six were reported as functional. Peripheral care includes 71 health districts, 883 integrated health centres, 2,501 health huts and 33 district hospitals. Of these, 44 districts, 881 integrated health centres and 2,458 health huts were reported as functional; 27 district hospitals had functional operating theatres. The private sector additionally included 288 facilities: 36 clinics or polyclinics, 257 medical practices or treatment rooms, five private non-profit hospitals and one specialized private eye centre. Functioning can change, so the local status should be checked before relying on a facility. A common care sequence begins with a community health hut or integrated health centre, continues to a district hospital when more capacity is needed, and may proceed to a regional hospital or mother-and-child health centre and then to a national hospital or the national reference maternity hospital. The actual referral depends on available staff, equipment, opening hours, transport, security and the facility's current operating status. A single nationwide emergency telephone or ambulance pathway was not verified. Prevention includes routine and campaign vaccination, mobile vaccination, cold-chain management, vitamin A, deworming and nutrition programs, reproductive health, family planning, antenatal and postpartum care, prevention of mother-to-child transmission, youth-friendly centres, sexual health education, malaria, tuberculosis and HIV prevention, screening for malnutrition, insecticide-treated mosquito nets and preventive malaria treatment during pregnancy. Community health workers, community relays, integrated community case management and integrated management of childhood illness extend services beyond fixed facilities. Traditional medicine can provide an informal complement, but its regulation and quality integration remain uneven. Health facilities provide basic clinical care, maternity services, vaccinations, laboratory testing, medicines, child illness management, community malaria, tuberculosis and HIV care, and nutrition treatment. Emergency, trauma and obstetric referral services exist but do not cover all needs; older UNICEF evidence indicated that less than 20% of basic maternal and newborn emergency need was covered. Services for non-communicable diseases and mental health, as well as rehabilitation, remain uneven and may be limited to selected facilities or community programs. The National Essential Medicines List 2025 guides medicine selection. The Ministry and WHO support regulation, procurement and quality oversight, but a medicine's presence on the list does not prove that it is in stock locally. The reported national medicine stockout rate was 3.70% in 2022, while product-quality and supply-chain risks continued. Check the medicine, price and current stock at the facility or an authorized provider. Follow-up may include postpartum family planning, vaccination appointments, HIV, tuberculosis or malaria monitoring, nutrition review, long-term care for non-communicable or mental health conditions, rehabilitation and community follow-up by relays or mobile teams. Health information is reported through DHIS-2, a digital health information and monitoring system. A uniform national patient record and appointment system was not established in the available evidence. The health system gives programmatic priority to equitable access for women, children, adolescents, migrants, displaced people, refugees and people with disabilities. Some services are free or subsidized under specific programs or groups. The Institut National d’Assistance Médicale supports free-care arrangements within the CSU framework, but Niger does not have a uniform zero-cost system for all care. Households paid more than 40.72% of health expenditure in 2021, and actual fees, co-payments and medicine prices depend on the program, facility and treatment. Verify the price and eligibility at the point of care. Niger's health burden includes malaria, malnutrition, vaccine-preventable diseases, HIV, tuberculosis, non-communicable diseases and mental health needs. Maternal mortality was 441 per 100,000 live births in 2020, under-five mortality was 123 per 1,000 live births in 2021, and 72% of confirmed malaria cases were treated according to guidelines in 2021. Maternal, newborn and child mortality has declined but remains high. These national figures do not describe every region or facility. General program commitments refer to access to essential quality services regardless of sex, age or disability, but a nationwide patient charter and complaint pathway were not verified. General formal patient duties were also not established; following treatment, vaccination, prevention and follow-up recommendations remains practically necessary.