A study by researchers at the Johns Hopkins Bloomberg School of Public Health and the Niger Countdown Case Study Working Group found that child mortality in Niger - one of the world's poorest countries - declined nearly 50 percent over the last decade. According to the authors, the advances in survival made in Niger far outpaced other nations in the West Africa region. The study appears in a special issue of The Lancet examining the United Nations Millennium Challenge Goals for 2015.

For the study, researchers analyzed changes in child mortality and child health in Niger from 1998 to 2009. For children ages five and younger, they found deaths dropped from 226 deaths per 1,000 live births in 1998 to 128 deaths per 1,000 live births in 2009. In addition, they found severe wasting from under nutrition - a key contributor of mortality - also declined during the decade. The largest decrease was among children 6 to 11 months of age, which dropped from 15.8 percent in 1998 to 6.3 percent in 2009.

"This study codifies, for the first time, policies, programmatic strategies, and what was actually done on the ground in Niger to achieve the dramatic reductions in child mortality and wasting that we've seen there in the last 10 years," said Agbessi Amouzou, PhD, MHS, lead author of the study and scientist with the Bloomberg School's Department of International Health.

The study authors attribute the increased child survival to the Niger government's supportive policies including universal access to health care - which is free for pregnant women and children - and a rapid nationwide scale-up of cost-effective life-saving interventions such as insecticide treated bed nets, vitamin A supplementation and community-based treatment of diseases that are responsible for the most child deaths (i.e., pneumonia, malaria and diarrhea).

"The Niger success story demonstrates the power of evidence-based planning. Other countries in the region should especially examine how Niger was able to quickly scale up cost-effective interventions using community-based solutions," said Jennifer Bryce, EdD, co-author of the study and scientist with the Bloomberg School's Department of International Health.