Niger Country Health Statistical Report

Publication date: 2010

USAID Country Health Statistical Report Niger January 2011 Table of Contents 1. About the Report 2. Country Profile I. Statistical Overview • Demographic Indicators • Socioeconomic Indicators • Family Planning Indicators • Maternal Health Indicators • Child Survival Indicators • HIV/AIDS Prevention Indicators • Infectious Diseases Control Indicators II. Trends in Health Indicators • Current and Projected Population by Age and Sex (Figure 1 and Table 1.1) • Population Estimates and Projections (Table 1.2) • Estimated Total Fertility Rate per Woman (Figure 2 and Table 2) • Infant Mortality Rates / Under-5 Mortality Rates (Figure 3 and Table 3) • Vaccination Coverage (DPT3) Trends (Figure 4 and Table 4) • Contraceptive Prevalence Rates - Married Women (Figure 5 and Table 5) 3. Data Notes 4. Sources About the Report Released January 2011 This report is one of a series of Country Health Statistical Reports produced on behalf of the United States Agency for International Development (USAID) by the Analysis, Information Management and Communication Activity (AIM) Project. Each profile contains statistical data on current health conditions, population dynamics, health and family planning behavior, and health and population trends in a given developing country. Information is compiled from AIM's health statistics database, which draws data from a diverse range of sources listed at the end of this profile. Hard copy editions of USAID's profiles are available from AIM'S publications department. Reports are available on the USAID Global Health Web site in Portable Document Format (pdf). Any feedback you have on the content or presentation of this report would be greatly appreciated. We would also appreciate receiving any more recent, more accurate, or more representative information. Contact us at the following: Analysis, Information Management & Communications Activity (AIM) 655 15th Street, NW, Suite 450 Washington, DC 20005 Phone: 202-661-8600 Fax: 202-661-8601 E-mail: dolphn@aimglobalhealth.org The Analysis, Information Management & Communications (AIM) Activity, a USAID contract managed by MasiMax Resources, Inc, with John Snow, Inc., ORC Macro, and Insight Systems Corporation prepared this document under task order number GPO-M-00-05- 00043-00, with the Bureau for Global Health, USAID. I. Statistical Overview *see data notes Demographic Indicators Indicator Value Data Unit Year Source Total Population 15,878,271 2010 BUCEN-IDB-2010 Population Growth Rate 3.7 % 2010 BUCEN-IDB-2010 Percent Urban 23 % 2004 World Bank/WDI-2006 Women, 15-19 800,307 2010 BUCEN-IDB-2010 Women, 15-49 3,328,182 2010 BUCEN-IDB-2010 Life Expectancy at Birth 53 2010 BUCEN-IDB-2010 Crude Birth Rate 51.1 per 1,000 2010 BUCEN-IDB-2010 Crude Death Rate 14.5 per 1,000 2010 BUCEN-IDB-2010 Number of Live Births 811,062 2010 BUCEN-IDB-2010 Healthy Life Expectancy: Female 35 2002 WHO Global Health Atlas-2008 Healthy Life Expectancy: Male 36 2002 WHO Global Health Atlas-2008 Population: Percent < Age 15 49.7 % 2010 BUCEN-IDB-2010 Socioeconomic Indicators Indicator Value Data Unit Year Source GNI per Capita (PPP) 800 1 $ 2005 World Bank/WDI-2006 Health Expenditure as Percentage of GDP 4.7 % 2003 World Bank/WDI-2006 Physicians per 1,000 People 0.03 per 1,000 2002 World Bank/WDI-2005 Adult Literacy Rate 28.7 % 2004 World Bank/WDI Database-2007 Adult Literacy Rate, Female 9 2 % 2002 World Bank/WDI-2006 Adult Literacy Rate, Male 20 3 % 2002 World Bank/WDI-2006 Gross Enrollment Ratio - Primary School 53.3 % 2007 UNESCO Global Monitoring Report-2010 Gender Parity Index - Net Enrollment Ratio 0.75 2007 UNESCO Global Monitoring Report-2010 Access to an Improved Water Source (Rural) 36 % 2002 World Bank/WDI-2005 Access to an Improved Water Source (Urban) 80 % 2002 World Bank/WDI-2005 Access to Improved Sanitation Facilities (Rural) 4 % 2002 World Bank/WDI-2005 Access to Improved Sanitation Facilities (Urban) 43 % 2002 World Bank/WDI-2005 Population Living Below $1 a Day 60.6 % 1990-2005 Human Development Report - 2007/2008- 2008 Human Development Index 0.37 2005 Human Development Report - 2007/2008- 2008 Population Below Poverty Line 63 % 1993 CIA World Factbook-2009 Real GDP (Growth) Rate 2 % 2009 CIA World Factbook-2010 Income Inequality (Gini index) 50.5 1995 CIA World Factbook-2009 Unemployment Rate Data Not Available Inflation Rate 0.1 % 2007 CIA World Factbook-2009 Airports 27 2010 CIA World Factbook-2010 Airports with paved runways 10 2010 CIA World Factbook-2010 1 Estimate is based on regression; other PPP figures are extrapolated from the latest International Comparison Programme benchmark estimates. 2 Based on census data 3 Based on census data Family Planning Indicators Indicator Value Data Unit Year Source Total Fertility Rate (BUCEN) 7.7 2010 BUCEN-IDB-2010 Total Fertility Rate (DHS) 7.1 2006 Niger DHS-2006 Contraceptive Prevalence Rate, Modern Methods, All Women 4.5 % 2006 Niger DHS-2006 Contraceptive Prevalence Rate, Modern Methods, Married Women 5 % 2006 Niger DHS-2006 Median Age of Sexual Debut Among Women, Ages 25-49 15.8 2006 Niger DHS-2006 Mean Ideal Family Size 8.8 2006 Niger DHS-2006 Women 20-24 Who Gave Birth Before Age 20 72.2 % 2006 Niger DHS-2006 Total Fertility Rate, Rural 7.3 2006 DHS STATcompiler as of September 2008-2008 Unmet Need for Family Planning: Rural 14.4 % 2006 DHS STATcompiler as of September 2008-2008 Unmet Need for Family Planning: Urban 23.7 % 2006 DHS STATcompiler as of September 2008-2008 Contraceptive Prevalence Rate, All Methods 11.2 % 2006 DHS STATcompiler as of September 2008-2008 Equity in use of modern contraception 0.15 Ratio 2006 Niger DHS-2006 Percent of need satisfied by modern methods of family planning 18.5 % 2006 Niger DHS-2006 Maternal Health Indicators Indicator Value Data Unit Year Source Maternal Mortality Ratio (WHO/Hill) 1,800 Per 100,000 live births 2005 WHO/Hill-2005 Maternal Mortality Ratio (DHS) 648 Per 100,000 live births 2006 Niger DHS-2006 Antenatal Care (at least 1 visit) 47 % 2006 Niger DHS-2006 Antenatal Care (2+ visits) 41.5 % 2006 Niger DHS-2006 Antenatal Care (4+ visits) 14.9 % 2006 Niger DHS-2006 Assisted Delivery by a Health Professional 17.7 % 2006 Niger DHS-2006 Assisted Delivery by Doctor 0.5 % 2006 Niger DHS-2006 Assisted Delivery by Other Health Professional 17.2 % 2006 Niger DHS-2006 Anemia prevalence among women of reproductive age 45.6 % 2006 Niger DHS-2006 Equity in skilled attendance at delivery 0.09 Ratio 2006 Niger DHS-2006 Child Survival Indicators Indicator Value Data Unit Year Source Acute Respiratory Infection (ARI) and Oral Rehydration Therapy (ORT) ARI Care Seeking - Children Under 5 47.1 % 2006 Niger DHS-2006 ORT Use Rate (ORS, RHS, or Increased Fluids) 52.9 % 2006 Niger DHS-2006 Mortality Indicators Infant Mortality Rate (BUCEN) 114.5 per 1,000 live births 2010 BUCEN-IDB-2010 Infant Mortality Rate (UNICEF) 79 2008 UNICEF-2010 Infant Mortality Rate (DHS) 81 per 1,000 live births 2006 Niger DHS-2006 Infant Mortality Rate, Females (BUCEN) 109.3 per 1,000 live births 2010 BUCEN-IDB-2010 Infant Mortality Rate, Males (BUCEN) 119.5 per 1,000 live births 2010 BUCEN-IDB-2010 Under-5 Mortality Rate (BUCEN) 244.8 per 1,000 live births 2010 BUCEN-IDB-2006 Neonatal Mortality Rate 33 per 1000 2006 DHS STATcompiler as of September 2008- 2008 Under-5 Mortality Rate (UNICEF) 167 per 1,000 live births 2008 UNICEF-2010 Under-5 Mortality Rate (DHS) 198 per 1,000 live births 2006 Niger DHS-2006 Nutrition Indicators Exclusive Breastfeeding (under 4 mos.) 15.9 % 2006 Niger DHS-2006 Exclusive Breastfeeding (under 6 mos.) 13.5 % 2006 Niger DHS-2006 Stunted (height-for-age) 50 % 2006 Niger DHS-2006 Underweight (weight-for-age) 44.4 % 2006 Niger DHS-2006 Wasted (weight-for-height) 10.3 % 2006 Niger DHS-2006 Vaccination Coverage DPT3 Vaccination Rate (DHS) 39.3 % 2006 Niger DHS-2006 DPT3 Vaccination Rate (WHO) 93 % 2009 WHO: Global Summary-2009 Measles Vaccination Rate (DHS) 47 % 2006 Niger DHS-2006 Measles Vaccination Rate (WHO) 87 % 2009 WHO: Global Summary-2009 Polio Vaccination Rate (DHS) 54.6 % 2006 Niger DHS-2006 Polio Vaccination Rate (WHO) 88 % 2009 WHO: Global Summary-2009 Tetanus Toxoid Vaccination 23 1 % 2006 Niger DHS-2006 Equity in DPT3 coverage (DHS) 0.49 Ratio 2006 Niger DHS-2006 Improved sanitation/hygiene practices Data Not Available Vitamin A supplementation coverage among children 6-59 months Data Not Available 1 This data reflects the five-year period preceding the survey. HIV/AIDS Prevention Indicators Indicator Value Data Unit Year Source HIV Prevalence proportion: Adults (15–49 years) 0.8 % 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Adults and Children 60,000 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Women (15+ years) 17,000 2007 UNAIDS 2008-2008 Estimated number of people living with HIV: Children (0–14 years) 3,200 2007 UNAIDS 2008-2008 Males Reporting Condom Use With Last Non-Regular Partner Data Not Available Females Reporting Condom Use With Last Non-Regular Partner Data Not Available Infectious Diseases Control Indicators Indicator Value Data Unit Year Source TB Estimated Number of Cases 24,802 2007 WHO: Global Atlas-2009 TB Case Detection Rate 35 % 2007 Global Atlas-2010 TB (DOTS) Treatment Success Rate 77 % 2006 WHO: Global Atlas-2009 Malaria Cases per 100,000 4,884 1 per 100,000 2002 WHO Global Health Atlas-2008 DOTS Coverage 100 % 2007 WHO: Global Atlas-2009 HIV-Infected with Active TB 9.4 % 2007 WHO: Global Atlas-2009 Avian Influenza: Cumulative Number of Confirmed Human Cases Data Not Available Avian Influenza: Cumulative Number of Confirmed Human Deaths Data Not Available Child Sleeps Under Insecticide-Treated Net 7.4 % 2006 UNICEF Global Database-2009 Equity in Bednet (ITN) Ownership 1.1 Ratio 2006 Niger DHS-2006 1 Calculated using (100,000/WHO population)xMalaria Reported # of Cases II. Trends in Health Indicators Figure 1: Current and Projected Population by Age and Sex (in thousands) Table 1.1: Current and Projected Population by Age and Sex Source: BUCEN-IDB Age Group Male - 2000 Male - 2020 Female - 2000 Female - 2020 0-4 1,141,280 2,211,884 1,116,334 2,169,183 5-9 854,104 1,814,159 823,616 1,780,217 10-14 702,064 1,534,782 666,256 1,505,565 15-19 596,949 1,269,459 560,270 1,244,274 20-24 496,735 1,018,058 466,812 996,120 25-29 380,183 797,207 377,901 772,736 30-34 284,751 647,675 313,935 619,319 35-39 226,293 541,792 264,109 513,792 40-44 188,587 444,626 220,214 423,237 45-49 159,153 333,939 181,978 338,516 50-54 130,754 242,056 148,962 276,072 55-59 104,180 182,445 119,798 225,017 60-64 79,149 139,690 92,330 177,096 65-69 56,292 103,033 65,305 131,367 70-74 35,965 67,921 40,263 88,683 75-79 19,019 37,302 19,908 50,874 80-84 7,122 15,428 7,082 22,535 85-89 1,681 4,354 1,633 6,846 90-94 220 736 212 1,238 95-99 15 67 14 118 99+ 0 3 0 5 TABLE 1.2: Population Estimates and Projections Source: BUCEN-IDB 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 3,912,663 4,840,501 6,093,469 7,841,730 10,951,428 15,878,271 22,749,426 31,945,796 43,077,923 55,304,449 Figure 2: Estimated Total Fertility Rate per Woman Table 2: Estimated Total Fertility Rate per Woman Source: BUCEN-IDB 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 8.0 8.0 8.0 8.0 8.0 8.0 7.7 7.3 6.8 6.2 5.6 5.0 4.5 3.9 3.5 Figure 3: Infant Mortality Rates / Under-5 Mortality Rates Table 3: Infant Mortality Rates / Under-5 Mortality Rates Source: BUCEN-IDB 2010 Indicator 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 Infant Mortality Rate (BUCEN) 186.3 186.3 180.1 163.5 139.2 125.7 114.5 103.5 92.9 82.6 73.0 63.9 55.5 47.9 41.1 Under-5 Mortality Rate (BUCEN) 313.2 295.1 276.4 260.2 244.8 224.5 203.8 183.0 162.4 142.4 123.3 105.6 89.6 Figure 4: Vaccination Coverage (DPT3) Trends Table 4: Vaccination Coverage (DPT3) Trends Source: WHO/Global Summary WHO: Global Summary 1985 1990 1995 2000 2005 4.0 22.0 23.0 31.0 89.0 Figure 5: Contraceptive Prevalence Rates, Modern Methods, Married Women Table 5: Contraceptive Prevalence Rates, Modern Methods, Married Women Source: Niger DHS 1992 1998 2006 2.3 4.6 5.0 Data Notes *Indicator definitions that differ from those in the data notes section are identified by footnotes accompanying the indicator tables. Demographic Indicators Total Population The number of people in a given area (i.e., country) in a particular time period (usually a midyear estimate). Population Growth Rate The average annual growth rate is the rate of natural increase in a population plus the net migration rate. The rate of natural increase is the difference between the birth rate and the death rate, but it is conventionally measured in percentage terms (per hundred rather than per thousand). Percent Urban The percentage of the midyear population living in areas defined as urban in each country and reported to the United Nations. Women, 15-19 The number of women between the ages of 15-19 in the midyear population. Women, 15-49 The number of women between the ages of 15-49 in the midyear population. Life Expectancy at Birth The average number of years that a person at age 0 will live if age-specific death rates remain constant. Life expectancy at birth is highly affected by rates of infant and child death. Crude Birth Rate The number of births per thousand of the population. The product of the number of live births, divided by the midpoint population, multiplied by 1,000. Crude Death Rate The number of deaths per thousand of the population. The product of the number of deaths divided by the midpoint population, multiplied by 1,000. Number of Live Births The number of live births, annually, within a country. Healthy Life Expectancy: Female The number of years of in full health that a female newborn can expect to live based on current rates of ill-health and mortality. HALE is based on life expectancy at birth but includes an adjustment for time spent in poor health. Healthy Life Expectancy: Male The number of years of in full health that a male newborn can expect to live based on current rates of ill- health and mortality. HALE is based on life expectancy at birth but includes an adjustment for time spent in poor health. Population: Percent < Age 15 Percent of population less than 15 years of age. Socioeconomic Indicators GNI per Capita (PPP) The gross national income (GNI) converted to international dollars using purchasing power parity (PPP) rates. An international dollar has the same purchasing power over GNI as a U.S. dollar has in the United States. Health Expenditure as Percentage of GDP Total health expenditures is the sum of public and private health expenditures figured as a percentage of a country's gross domestic product (GDP). It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation. Physicians per 1,000 People Physicians are defined as graduates of any faculty or school of medicine who are working in the country in any medical field (practice, teaching, research). Adult Literacy Rate The percentage of people ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Adult Literacy Rate, Female The percentage of women ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Adult Literacy Rate, Male The percentage of men ages 15 and over who can, with understanding, read and write a short, simple statement about their everyday life. Gross Enrollment Ratio - Primary School Total enrolment in primary level of education, regardless of age, expressed as a percentage of the population in the official age group corresponding to primary level of education. The GER can exceed 100% due to late entry or/and repetition. Gender Parity Index - Net Enrollment Ratio The ratio of the female-to-male values (or male to female, in certain cases) of net primary school enrollment rates (NER). NER measures the number of pupils in the official age group for a given level of ecudation, expressed as a percentage of the population in that age group. Access to an Improved Water Source (Rural) Access to an improved water source in rural areas. Refers to the percentage of the rural population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, or rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Access to an Improved Water Source (Urban) Access to an improved water source in urban areas. Refers to the percentage of the urban population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, or rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Access to Improved Sanitation Facilities (Rural) Access to improved sanitation facilities in rural areas. Refers to the percentage of the rural population with access to at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Access to Improved Sanitation Facilities (Urban) Access to improved sanitation facilities in urban areas. Refers to the percentage of the urban population with access to at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Population Living Below $1 a Day The percentage of the population living below the specified poverty line of $1 a day at 1985 international prices (equivalent to $1.08 at 1993 international prices), adjusted for purchasing power parity. Human Development Index The HDI is a composite index that measures the average achievements in a country in three basic dimensions of human development: a long and healthy life, as measured by life expectancy at birth; knowledge, as measured by the adult literacy rate and the combined gross enrollment ratio for primary, secondary, and tertiary schools; and a decent standard of living, as measured by gross domestic product (GDP) per capita in purchasing power parity (PPP) US dollars. Population Below Poverty Line National estimates of the percentage of the population falling below the poverty line are based on surveys of sub-groups, with the results weighted by the number of people in each group. Definitions of poverty vary considerably among nations. For example, rich nations generally employ more generous standards of poverty than poor nations. Real GDP (Growth) Rate This entry gives the gross domestic product (GDP) growth on an annual basis adjusted for inflation and expressed as a percent. Income Inequality (Gini index) This index measures the degree of inequality in the distribution of family income in a country. It is calculated from the Lorenz curve, in which cumulative family income is plotted against the number of families arranged from the poorest to the richest. The index is the ratio of (a) the area between a country's Lorenz curve and the 45 degree helping line to (b) the entire triangular area under the 45 degree line. The more nearly equal a country's income distribution, the closer its Lorenz curve to the 45 degree line and the lower its Gini index, e.g., a Scandinavian country with an index of 25. The more unequal a country's income distribution, the higher its Gini index, e.g., a Sub-Saharan country with an index of 50. If income were distributed with perfect equality, the index would be zero; if income were distributed with perfect inequality, the index would be 100. Unemployment Rate This entry contains the percent of the labor force that is without jobs. Substantial underemployment might be noted. Inflation Rate This entry furnishes the annual percent change in consumer prices compared with the previous year's consumer prices. Airports This entry gives the total number of airports or airfields recognizable from the air. The runway(s) may be paved (concrete or asphalt surfaces) or unpaved (grass, earth, sand, or gravel surfaces) but may include closed or abandoned installations. Airports or airfields that are no longer recognizable (overgrown, no facilities, etc.) are not included. Note that not all airports have accomodations for refueling, maintenance, or air traffic control. Airports with paved runways This entry gives the total number of airports with paved runways (concrete or asphalt surfaces) by length. For airports with more than one runway, only the longest runway is included according to the following five groups - (1) over 3,047 m, (2) 2,438 to 3,047 m, (3) 1,524 to 2,437 m, (4) 914 to 1,523 m, and (5) under 914 m. Only airports with usable runways are included in this listing. Not all airports have facilities for refueling, maintenance, or air traffic control. Family Planning Indicators Total Fertility Rate (BUCEN) The number of children a woman between ages 15-49 would have during her reproductive life, if, for all of her childbearing years she were to experience the age-specific birth rates for that given year. Total Fertility Rate (DHS) The number of children a woman between ages 15-49 would have during her lifetime if she were to bear children at the currently observed rates. Contraceptive Prevalence Rate, Modern Methods, All Women Percentage of all women ages 15-49 currently using a modern method of contraception. Modern methods include oral contraceptives, IUDs, injectables, female and male sterilization, all emergency contraception, and barrier methods (diaphragm, foam, jelly, male and female condom). Contraceptive Prevalence Rate, Modern Methods, Married Women Percent of currently married women ages 15-49 currently using a modern method of contraception. Modern methods include oral contraceptives, IUDs, injectables, female and male sterilization, all emergency contraception, and barrier methods (diaphragm, foam, jelly, male and female condom). Median Age of Sexual Debut Among Women, Ages 25-49 Median age of first sexual intercourse for women ages 25-49. Mean Ideal Family Size Mean ideal number of children for all women, according to number of living children. Women 20-24 Who Gave Birth Before Age 20 Percentage of women ages 20-24 who have given birth before age 20. Total Fertility Rate, Rural In rural areas only, the number of children a woman between ages 15-49 would have during her lifetime if she were to bear children at the currently observed rates. Unmet Need for Family Planning: Rural In rural areas, percentage of married women ages 15-49 with unmet need for family planning. Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family planning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want no more children. Unmet Need for Family Planning: Urban In urban areas, percentage of married women ages 15-49 with unmet need for family planning. Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family planning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want no more children. Contraceptive Prevalence Rate, All Methods Percentage of currently married women ages 15-49 currently using ANY method of contraception. Equity in use of modern contraception Contraceptive prevalence rate in the lowest wealth quintile/contraceptive prevalence rate in the highest wealth quintile. Percent of need satisfied by modern methods of family planning Number of women in union who are fecund and are currently using modern contraceptive methods to stop or postpone the next pregnancy/number of women in union who are fecund and who desire to either terminate childbearing or to postpone their next birth for 2 years or more. Maternal Health Indicators Maternal Mortality Ratio (WHO/Hill) The estimated number of women who die as a result of pregnancy or childbirth per 100,000 live births arrived through Hill et al., adjustment procedure depending on the nature of data used. The margins of uncertainty associated with the estimated maternal mortality ratios are very large and the estimates should not be used to monitor trends in the short term (including comparisons between 1995 and 2000 estimates). In addition, cross-country comparisons should be treated with considerable circumspection because different strategies are used to derive the estimates for different countries rendering comparisons fraught with difficulty. For further information please refer to the source. Maternal Mortality Ratio (DHS) The estimated number of women who die as a result of pregnancy or childbirth per 100,000 live births, arrived mostly through the "sisterhood method". The data are aggregated based on different time periods ranging from four to ten years preceding the survey. Thus, the data may not be suitable for trend analysis due to over-lapping year ranges of estimates. For further information on methodology please refer to: Stanton, Cynthia, Noureddine Abderrahim, and Kenneth Hill. 1997. DHS Maternal Mortality Indicators: An assessment of Data Quality and Implications for Data Use. Calverton: Macro International Inc., or individual country DHS reports. Antenatal Care (at least 1 visit) Percentage of women of reproductive age (15-49) who receive at least one antenatal care visit during pregnancy (in the three-year period preceding the survey). Antenatal Care (2+ visits) Percentage of women of reproductive age (15-49) who receive at least two antenatal care visits during pregnancy (in the three-year period preceding the survey). Antenatal Care (4+ visits) Percentage of women of reproductive age (15-49) who receive four or more antenatal care visits during pregnancy (in the three-year period preceding the survey). Assisted Delivery by a Health Professional The percentage of births/deliveries that occur with the assistance of any trained health professional during the five-year period preceding the survey. May include doctors, nurses, or midwives. Assisted Delivery by Doctor The percentage of live births/deliveries that occur with the assistance of a doctor during the five-year period preceding the survey. Assisted Delivery by Other Health Professional The percentage of live births/deliveries that occur with the assistance of a nurse or midwife during the five-year period preceding the survey. Anemia prevalence among women of reproductive age Number of women of reproductive age (15-49 years) with anemia/number of women of reproductive age (15-49 years). Equity in skilled attendance at delivery Percentage of births in the lowest wealth quintile attended by a doctor, nurse, or trained midwife/ percentage of births in the highest wealth quintile attended by a doctor, nurse, or trained midwife. Child Survival Indicators ARI Care Seeking - Children Under 5 Percentage of children under five years who were ill with an acute respiratory infection (ARI), which is associated with cough, rapid breathing and a high fever, during the two weeks preceding the survey, for whom care was sought from a health facility or provider. ORT Use Rate (ORS, RHS, or Increased Fluids) Oral Rehydration Therapy (ORT). Percentage of children under age 5 with diarrhea two weeks prior to survey who received increased fluids, oral rehydration solution (ORS) or recommended home solution (RHS). Infant Mortality Rate (BUCEN) The estimated annual number of deaths of infants under 12 months in a given year per 1,000 live births in that same year. Infant Mortality Rate (UNICEF) The under five mortality rate is the probability (as expressed as a rate per 1,000 live births)of a child born in a specified year dying before reaching the age of one if subject to current age-specific mortality rates. Infant Mortality Rate (DHS) The estimated annual number of deaths of infants under 12 months in a given year per 1,000 live births in that same year (five-year period preceding survey). Infant Mortality Rate, Females (BUCEN) The estimated annual number of deaths of female infants under 12 months in a given year per 1,000 live births in that same year. Infant Mortality Rate, Males (BUCEN) The estimated annual number of male infants under 12 months in a given year per 1,000 live births in that same year. Under-5 Mortality Rate (BUCEN) Annual number of deaths that occur in children 0-4 years old per 1,000 births. Neonatal Mortality Rate The estimated number of infant deaths in the first month of life per 1,000 live births in the five-year period preceding the survey. Under-5 Mortality Rate (UNICEF) Annual number of deaths that occur in children 0-4 years old per 1,000 births (five-year period preceding survey). Under-5 Mortality Rate (DHS) Annual number of deaths that occur in children 0-4 years old per 1,000 births (five-year period preceding survey). Exclusive Breastfeeding (under 4 mos.) Percentage of children under 4 months exclusively breastfed. Exclusive breastfeeding is defined as providing no food or liquid other than breast milk to the child during the 24-hour period before the survey. Exclusive Breastfeeding (under 6 mos.) Percentage of children under 6 months exclusively breastfed. Exclusive breastfeeding is defined as providing no food or liquid other than breast milk to the child during the 24-hour period before the survey. Stunted (height-for-age) Percentage of children under age five whose height-for-age is below minus-two standard deviations from the median of the reference population. Underweight (weight-for- age) Percentage of children under age five whose weight-for-age is below minus-two standard deviations from the median of the reference population. Wasted (weight-for- height) Percentage of children under age five whose weight-for-height is below minus-two standard deviations from the median of the reference population. DPT3 Vaccination Rate (DHS) Proportion of living children 12-23 months old who have received three complete doses of vaccines against diphtheria, pertussis, and tetanus. DPT3 Vaccination Rate (WHO) Proportion of living children 12-23 months old who have received three complete doses of vaccines aginst diphtheria, pertussis, and tetanus. Measles Vaccination Rate (DHS) Percentage of living children 12-23 months old who have received one dose of Measles Containing Vaccince. Measles Vaccination Rate (WHO) Percentage of living children 12-23 months old who have received one dose of Measles Containing Vaccince. Polio Vaccination Rate (DHS) Proportion of living children 12-23 months who have received three doses of polio vaccine. Polio Vaccination Rate (WHO) Proportion of living children 12-23 months who have received three doses of polio vaccine. Tetanus Toxoid Vaccination Percentage of pregnant women receiving two (or more) doses of tetanus toxoid (three-year period preceding survey). Equity in DPT3 coverage (DHS) DPT3 coverage in the lowest wealth quintile/DPT3 coverage in the highest wealth quintile. Improved sanitation/ hygiene practices Number of households with child under 5 years of age whose youngest child’s feces was safely disposed of the last time he/she passed stool/total number of households with a child under 5 years of age. Vitamin A supplementation coverage among children 6-59 months Number of children aged 6-59 months who received a vitamin A supplement in the last 6 months/total number of children aged 6-59 months surveyed. HIV/AIDS Prevention Indicators HIV Prevalence proportion: Adults (15–49 years) The adult HIV prevalence proportion is the estimated number of adults living with HIV divided by the adult population (aged 15–49). Estimated number of people living with HIV: Adults and Children Estimated number of adults and children living with HIV. Adults are 15 years and over. Children are defined as those aged 0–14 years. Estimated number of people living with HIV: Women (15+ years) Estimated number of women (aged 15 and over) living with HIV. Estimated number of people living with HIV: Children (0–14 years) Estimated number of children under age 15 living with HIV. Males Reporting Condom Use With Last Non- Regular Partner Among men who have had high risk sex in the last year, percentage who used condoms during their last sexual intercourse with a non-regular partner/non-cohabitating partner. Females Reporting Condom Use With Last Non-Regular Partner Among women who have had high risk sex in the last year, percentage who used condoms during their last sexual intercourse with a non-regular partner/non-cohabitating partner. Infectious Diseases Control Indicators TB Estimated Number of Cases The estimated number of cases (all forms). TB Case Detection Rate TB Case Detection Rate is defined as the percentage of the annual new smear-positive notifications of the estimated annual new smear-positive incidence. TB (DOTS) Treatment Success Rate The proportion of smear-positive patients who were cured plus the proportion who completed treatment. Malaria Cases per 100,000 Number of malaria cases per 100,000 of the population during the year for which data was reported. DOTS Coverage The percentage of the national population living in areas where health services have adopted DOTS. "Areas" are the lowest administrative or management units in the country (townships, districts, counties, etc). If an area is considered a DOTS area, then all cases registered and reported in that area are considered DOTS cases and the population living within the boundaries of that area counts toward national DOTS coverage. As a measure of patient access to diagnosis and treatment under DOTS, coverage is an approximation, and usually an overestimate. HIV-Infected with Active TB The TB incidence rate in HIV-infected people 15-49 divided by the incidence rate in HIV-uninfected people 15-49. Avian Influenza: Cumulative Number of Confirmed Human Cases The cumulative number of confirmed human cases of Avian Influenza A/(H5N1) reported to WHO. The total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. Avian Influenza: Cumulative Number of Confirmed Human Deaths The cumulative number of confirmed human deaths from Avian Influenza A/(H5N1) reported to WHO. WHO reports only laboratory-confirmed cases and deaths. Child Sleeps Under Insecticide-Treated Net Percentage of children under five years of age who slept under an Insecticde Treated Net (ITN) the night before the survey. An ITN is (1) a permanent net that does not require any treatment, or (2) a pretreated net obtained within the last six months, or (3) a net that has been soaked with insecticide within the past six months. Equity in Bednet (ITN) Ownership Proportion of households in the lowest income quintile with an ITN / proportion of households in the highest income quintile with an ITN. Statistical Sources For Niger BUCEN-IDB 2006 United States Census Bureau (BUCEN), International Programs Center. International Database. August 2006. BUCEN-IDB 2009 United States Census Bureau (BUCEN), International Programs Center. International Database. November 2009. BUCEN-IDB 2010 United States Census Bureau (BUCEN), International Programs Center. International Database. April 2010. CIA World Factbook 2009 CIA World Factbook 2009 https://www.cia.gov/library/publications/the-world-factbook/ index.html CIA World Factbook 2009 CIA World Factbook, 2008 https://www.cia.gov/library/publications/the-world-factbook/ index.html. Last accessed April, 2009. CIA World Factbook 2010 CIA World Factbook 2010 https://www.cia.gov/library/publications/the-world-factbook/ index.html CIA World Factbook 2010 CIA World Factbook November 2010 https://www.cia.gov/library/publications/the-world- factbook/index.html DHS STATcompiler as of September 2008 2008 DHS STATcompiler as of September 2008 http://www.statcompiler.com Global Atlas 2010 WHO Global Health Atlas: http://apps.who.int/globalatlas/dataQuery/default.asp Human Development Report - 2007/2008 2008 Human Development Report 2007/2008. Fighting climate change: Human solidarity in a divided world. Published for the United Nations Development Programme (UNDP) Niger DHS 1992 Direction de la Satistique et des Comptes Nationaux, Direction General du Plan, Ministere des Finances et du Plan and Macro International Inc. Niger: Enquete Demographique et de Sante, 1992. Columbia, MD: Macro International Inc., Sept. 1993. Niger DHS 1998 CARE International/Niger and Macro International Inc. "Niger Enquete Demographique et de Sante, 1998." Macro Internatiol Inc., Calverton, MD 1998 Niger DHS 2006 Institut National de la Statistique (INS) et Macro International Inc. 2007. Enquête Démographique et de Santé et à Indicateurs Multiples du Niger 2006. Calverton, Maryland, USA : INS et Macro International Inc. UNAIDS 2008 2008 2008 Report on the Global AIDS Epidemic. Geneva: UNAIDS, 2008 UNESCO Global Monitoring Report 2010 EFA Global Monitoring Report April 2010 UNICEF 2010 UNICEF Global Database/Child Mortality UNICEF Global Database 2009 UNICEF Global Database/Child Health Malaria: http://www.childinfo.org/statistical_tables. html WHO Global Health Atlas 2008 Accessed March of 2008 WHO Global Health Atlas 2008 WHO Website: http://apps.who.int/globalatlas/dataQuery/default.asp WHO/Global Summary 2002 WHO Vaccine-Preventable Diseases Monitoring System. 2002 Global Summary. World Health Organization, Geneva. WHO/Global Summary 2008 Immunization surveillance, assessment and monitoring section of the WHO website: http://www.who.int/immunization_monitoring/en/globalsummary/timeseries/ tscoveragedtp3.htm WHO/Hill 2005 Maternal Mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA and The World Bank WHO: Global Atlas 2009 WHO Global Health Atlas: http://apps.who.int/globalatlas/dataQuery/default.asp WHO: Global Summary 2009 WHO Global Summary Vaccine: http://www.who.int/immunization_monitoring/en/ globalsummary/timeseries/tscoveragemcv.htm World Bank/WDI 2005 World Bank Development Indicators 2005, CD-Rom. Washington, DC: The World Bank, 2005. World Bank/WDI 2006 World Bank Development Indicators 2006. Washington, DC: The World Bank, 2005. Available at: http://devdata.worldbank.org/wdi2006/contents/index2.htm. Last accessed April, 2007. World Bank/WDI Database 2007 World Bank Development Indicators Database 2007. Washington, DC: The World Bank, 2007. Available at: http://devdata.worldbank.org/data-query/. Last accessed April, 2007. aimglobalhealth.org DOLPHN - Report

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