Influence of weather shocks and coping strategies on food consumption: Evidence from rural Niger

Weather is an important determinant of household well-being in rural Sub-Saharan Africa. This paper explores the relationship between novel measures of cropping-season weather conditions and household food consumption in rural Niger, and how household coping mechanisms mediate that relationship. We employ a panel logit model to show that the normalised difference vegetation index (NDVI) and extreme heat degree day (EHDD) measures are associated with subjective self-reporting of drought in a panel dataset of 2 264 households. We then show, with a household fixed-effects panel model, that low NDVI and high EHDD measures are associated with significant decreases in household per capita food consumption. Household coping strategies, such as the disbursement of savings, temporary migration of a family member, and the adoption of heat-resistant agricultural technologies, are found to partially mitigate, but not fully alleviate, the negative effects of weather shocks on consumption. More comprehensive coping mechanisms are needed to improve household resilience to weather shocks.

Exploring the relationships between wasting and stunting among a cohort of children under two years of age in Niger

Background Wasting and stunting, physical growth manifestations of child undernutrition, have historically been considered separately with distinct interventions at the program, policy, and financing levels despite similar risk factors, overlapping burdens and multiplicative risk of death when the conditions are concurrent. The aim of this study was to elucidate shared risk factors and the temporal relationship between wasting and stunting among children under 2 years of age in rural Niger. Methods From August 2014 to December 2019, anthropometric data were collected every 4 weeks from 6 to 8 weeks to 24 months of age for 6567 children comprising 139,529 visits in Madarounfa, Niger. Children were defined as wasted if they had a weight-for-length Z-score < − 2 and stunted if they had a length-for-age Z-score < − 2 using the 2006 World Health Organization child growth standards. Parental, child, and socioeconomic risk factors for wasting and stunting at 6 and 24 months of age and the relationship between episodes of wasting, stunting and concurrent wasting-stunting were assessed using general estimating equations. Results Half of children (50%) were female, and 8.3% were born low birthweight (< 2500 g). Overall, at 24 months of age, 14% of children were wasted, 80% were stunted and 12% were concurrently wasted-stunted. We found that maternal short stature, male sex, and low birthweight were risk factors for wasting and stunting at 6 and 24 months, whereas higher maternal body mass index and household wealth were protective factors. Wasting at 6 and 24 months was predicted by a prior episodes of wasting, stunting, and concurrent wasting-stunting. Stunting at 6 and 24 months was similarly predicted by prior episodes of stunting and concurrent wasting-stunting at any prior age but only by prior episodes of wasting after 6 months of age. Conclusions These data support a complex and dynamic bi-directional relationship between wasting and stunting in young children in rural Niger and an important burden of concurrent wasting-stunting in this setting. Further research to better understand the inter-relationships and mechanisms between these two conditions is needed in order to develop and target interventions to promote child growth. Trial registration ClinicalTrials.gov Identifier: NCT02145000.

Costs of Implementing an Integrated Package of Maternal and Pediatric Interventions Including SQ-LNS in Rural Niger

Background: In January 2015, the Alliance for International Medical Action and Bien Être de la Femme et de l’Enfant au Niger launched the 1000 Days Program in Mirriah District, Niger, to provide an integrated package of maternal and pediatric preventive and curative interventions. A new component of the package was the provision of small-quantity lipid-based nutritional supplements (SQ-LNS) for children 6 to 23 months. Objective: The objective of this study was to estimate the costs associated with providing the 1000 days package. Methods: Activity-based costing was used to estimate the total costs of the 10 activities included in the 1000 days package and also the incremental costs of new interventions, those beyond the standard of care. Results: The total cost of the 1000 Days Program was US$2.31 million for 9000 mother–child pairs. The average cost per pair was US$257 or US$103 per year. Incremental costs for new interventions accounted for 56% of program costs. Small-quantity lipid-based nutritional supplement represented 30% of incremental costs. A combination of efficiency measures could lower program costs by 15%. Conclusions: This study is the first to estimate the costs of an integrated, preventative–curative package of maternal–child health interventions with SQ-LNS. Implementing the 1000 days package across Niger will be challenging with only the country’s domestic health resources. Efficiency measures and creative financing arrangements, including support from external partners, should be explored. The approach and results described can inform future resource mobilization, financing, and budgeting efforts to scale the 1000 days or similar programs.

Childhood Disability in Rural Niger: A Population-based Assessment Using the Key Informant Method

Background: Data on childhood disability is essential for planning health, education and other services. However, information is lacking in many low- and middle-income countries, including Niger. This study uses the Key Informant Method, an innovative and cost-effective strategy for generation population-based estimates of childhood disability, to estimate the prevalence and causes of moderate/severe impairments and disabling health conditions in children of school-going age (7-16 years) in the Kollo department of western Niger. Methods: Community-based key informants were trained to identify children who were suspected of having the impairment types/health conditions included in this study. Children identified by key informants were visited by paediatricians and underwent an assessment for moderate/severe vision, hearing, physical and intellectual impairments, as well as epilepsy, albinism and emotional distress. Results: 2,561 children were identified by key informants, of whom 2191 were visited by paediatricians (response rate = 85.6%). Overall, 597 children were determined to have an impairment/health condition, giving a prevalence of disability of 11.4 per 1000 children (10.6- 12.2). Intellectual impairment was most common (4.9 per 1000), followed by physical (4.9 per 1000) and hearing impairments (4.7 per 1000). Many children had never sought medical attention for their impairment/health condition, with health seeking ranging from 40.0% of children with visual impairment to 67.2% for children with physical impairments. Conclusion: The Key Informant Method enabled the identification of a large number of children with disabling impairments and health conditions in rural Niger, many of whom have unmet needs for health and other services.

Experiences and Employability of Nigerien Migrants in Algeria and Libya

There is a growing number of people from the rural Niger to migrate to some North Africa countries such as Libya and Algeria due to the economic opportunities those countries provide for migrants. In this chapter, the researchers attempts not only to shed light on the real motives behind these young men and women's rush to mainly Algeria and Libya, but also to report on their job searching activities, and the challenges migration candidates face on their way to and from host countries. A three-axis methodological approach (bibliographic research, survey questionnaire, and focus group discussions) was used to find the answers to three coarse questions about this border crossing activity. The results revealed the existence of various causes of migration such as failure of local production systems, poverty, search for better living conditions, and insecurity.