• Blog post
    Caya is “one size fits most,” eliminating the need for a visit to a health facility.

    The Caya diaphragm is “one size fits most,” eliminating the need for a visit to a health facility. Photo: (c)PSI/Alexandra Angel

    This piece was originally published on PSI's blog, Impact.

    “How can I, as a medical professional, speak with confidence to clients if I am scared of the product myself?”

    In Niamey, Niger, on the edge of the Sahara Desert, a room of community health workers hushed as Mariam* began her story.

    “So, I decided to try it last night!”

  • Blog post
    A woman with her 11th child in Niger, the country with the highest total fertility rate in the world.

    A woman with her 11th child in Niger, the country with the highest total fertility rate in the world. © 2013 Alison Heller/Washington University in Saint Louis, Courtesy of Photoshare

    This piece was originally published on the Health Policy Plus blog, Viewpoints.

    Earlier this year I traveled to Niger to support the Ministry of Health in refining the country's Costed Implementation Plan (CIP) for family planning. While there, I worked with a dedicated group—ministry staff, implementing partners, representatives from the religious community, and youth advocates—to agree on priorities that could accelerate progress on Niger's ambitious goal to increase its modern contraceptive prevalence rate (mCPR) from 13 percent (or 14.4% for married women) to 50 percent by 2020. We spent 3.5 days combing through the results of their mid-term review of Niger's CIP to set priorities and identify which population groups, in addition to women, we should focus on reaching: youth (what age range?), men (which men: community leaders? partners?), religious leaders? At the end of the workshop, we felt a sense of accomplishment in our priorities going forward, which included establishing how the government can extend services throughout the large Sahelian country using community health workers, mobile clinics, and strategies to improve data collection. Another important priority we agreed on was a focus on educating youth on the socioeconomic benefits of family planning.

  • West African Health Organization KM Assessment


    Although each country faces unique challenges in meeting the health needs of its population, within a geographic region, governments, civil society organizations, and donors can benefit from learning from the experiences of their counterparts in other countries. K4Health has partnered with two regional bodies to improve health in West Africa through strengthened collaboration, coordination, and knowledge management (KM).

  • Blog post
    Leyla is now 21, with a four-year-old son named Salim.

    Leyla is now 21, with a four-year-old son named Salim. Photo by Mina Kaci.

    She was like an earthquake: shaking everyone around her to the core, exposing their fault lines, damaging their usual demeanor, and challenging their beliefs in what should be the order of things. Unlike other huge natural phenomena like typhoons and hurricanes, earthquakes don’t have names—but this one did, because it was a positive earthquake. It was called Leyla.

    Leyla is the new normal for girls in Niger. A girl of 18 who spoke her mind, she was at the youth center to talk about how she benefited from an eight-month empowerment program for adolescent girls to reduce child marriage and teen pregnancy. Leyla had been chosen to speak because she had completed a program called Illimin, which in Houasa means “the knowledge.” Developed by UNFPA, Illimin has since become the flagship program of the government of Niger and is a successful model of what works in adolescent empowerment and child marriage and teen pregnancy reduction.

  • Blog post
    Hospital staff in Niger prepare a woman for fistula repair surgery.

    Hospital staff in Niger prepare a woman for fistula repair surgery. © 2015 Cambey Mikush, Courtesy of Photoshare

    Former UNFPA representative Monique Clesca had a tough job: trying to prevent adolescent pregnancy in Niger, the country with the highest rates of child marriage in the world. Earlier this year when I interviewed her for Family Planning Voices, Clesca, who has since retired, told me about a program whose goal was to reach Niger’s hardest-to-reach adolescent girls, 77% of whom are married by the time they’re 18. Program staff find the girls by going door to door. Without this painstaking effort, she lamented, too many adolescent girls will fall through the cracks.

  • Blog post
    Change in modern method use (2010-2014)

    Change in modern method use (2010-2014)

    New family planning data from Niamey, Niger, by the Performance Monitoring and Accountability 2020 (PMA2020) project were presented during a dissemination event in Niamey on December 4, 2015, by the Institut National de la Statistique de Niger (INS-Niger) in partnership with Niger’s Ministry of Public Health.

  • Blog post

    This post originally appeared on Ms. magazine's blog.

    In the mid-1990s, I served as a Peace Corps volunteer in a village in Niger, a West African country consistently ranked as one of the poorest in the world. I lived in a mud hut, learned a local language, made lasting friendships and did interesting work. Nearly 20 years later, two memories stand out from those years: It was incessantly hot, and I went to a lot of baptisms.

  • Blog post

    Dr. Karimou Sani, former USAID-HCI Advisor Tahoua, Niger; Dr Ekoye Saidou, Director General MOH Niger; Mr. Sabou Djibrina, UASID – HCI Niger; and Lauren Crigler, USAID HCI Bethesda, USA contributed to this blog post.

    Faced by a severe shortage of health care professionals throughout Niger, the country’s Ministry of Public Health requested assistance from USAID’s Health Care Improvement Project (HCI) in 2009 to implement a program to address the health workforce crisis within the country.  In response, my team and I recognized this has an exceptional opportunity to implement a program to improve the management of human resources in selected facilities and management offices within the Tahoua Region.

    As a part of the collaborative approach we adopted, quality improvement (QI) teams tested and implemented changes within their own facilities, while simultaneously monitoring performance with QI advisors and coaches from both HCI and the Ministry of Public Health. 

    Applying improvement methods to HR performance management

    Applying quality improvement methods to HR performance management

    As Quality Improvement Advisors, we recognized the importance of supporting the facility teams in strengthening their ability to recognize where they needed to improve their performance and helping them to have confidence in managing the quality of that service within their team. In order to address areas that were in need of improvement, we determined the variables that were adversely impacting health worker performance, engagement, and productivity.  The steps we undertook to address these areas are displayed in the diagram to the right. We began by aligning and clarifying tasks, and we measured progress in performance by tracking clinical indicators.