Investor Presentaiton
A positive feature in 2018 was the spirit of partnership that prevailed among technical and
financial partners in some key sectors. With the common goal to strengthen government
ownership and capacities, and ensure efficient use of funds, donors continued to support
sector-wide approaches. The Health Basket Fund is well-established and recognized as the
preferred financing mechanism for several bilateral and multilateral entities, including the
United Nations, and other sectors, and provides an avenue for UNICEF to advocate on
strategic issues. This basket fund helps to strengthen equity in access to services, as the fund
cover all the country, compared with donor-supported programmes that tend to target specific
geographic areas. Nonetheless, the health sector remains under-funded with only 5.58%
allocated to the total national budget in 2018.
Aiming at greater budget effectiveness and efficiency, the financial reform initiated by the
Ministry of Finance in 2017 foresaw the creation of a centralized bank account for all public
institutions, including the Ministry of Health. However, this reform entailed the sudden closure
of Government entities commercial bank accounts, without transition measures in place, which
severely hindered implementation.
The current decentralization process, with health one of the four initial sectors to be transferred
to decentralized levels, offers important opportunities. Decentralization in the health sector
focuses on improving physical assets management, human resources management, and
access to healthcare. However, the reform is at an early stage of implementation, with capacity
building and resource transfer as key pre-requisites.
In 2018, Niger faced health epidemics including a large-scale cholera outbreak (3,822 cases
and 78 deaths in 4 regions), measles (4,607 cases and 20 deaths nationwide), meningitis
(1,496 cases and 115 deaths nationwide), and a circulating vaccine-derived poliovirus (13
cases and 1 death in 2 regions). In addition, floods affected over 200,000 people nationwide,
among them over 120,000 people living in Dosso and Agadez regions. In addition, armed
conflict and population movements affected three of Niger's eight regions (Diffa, Tillabery and
Tahoua regions), disrupting access to essential health services.
Several constraints continued to impact activities in the health sector in 2018, including:
•
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Inadequate neonatal services (insufficient human resources, underfunding,
inadequate service delivery conditions);
Failure to pay incentive fees for community volunteers on time, therefore threatening
the sustainability of interventions;
Insufficient funding and delay in disbursement of State funds for the purchase of
vaccines;
Shortage of vaccines for the response to measles outbreaks;
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The existence of several parallel supply chains;
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Weak management of the Free Health Care Policy;
•
Insufficient early diagnosis of HIV in young infants.
IV. Results Achieved in the Sector
In 2018, UNICEF continued to support Government efforts to reduce maternal and child
mortality, in alignment with the Health Sector Development Plan (2017-2021) and with
outcome 3 of the United Nations Development Framework for 2014-2018.
UNICEF worked with several partners for maternal, neonatal and child health interventions:
other UN agencies, the Global Fund, the President Malaria Initiative, the World Bank, the
mechanism of the French Muskoka Fund, GAVI, John Snow International (JSI), the Bill and
Melinda Gate Foundation, and Rotary International. Various funding sources were used to
implement the UNICEF/Government of Niger cooperation programme, including health
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