Birth control in Niger

Population explosion
Runaway birth rates are a disaster

Aug 16th 2014 | MARADI | From the print edition

HAOWA was already struggling to feed five children before she gave birth to triplets in the Gabi
region of southern Niger 19 months ago. Now, when her babies scream for food she often finds
herself helpless. If they cry and I have nothing to give them, then I must let them cry, she says,
cradling two infants who bear the hallmarks of malnutrition. Their hair is yellowing, their bellies
are distended and their expressions glazed. They lack the energy to shake the flies from their
faces. It is a dismal but depressingly common picture in west Africas largest country.
Niger is, by the reckoning of the UNs Human Development Index, the poorest place on earth.
Most of its inhabitants eke out a living growing subsistence crops on small plots of dusty, infertile
land. Despite this agricultural bias, the drought-stricken country cannot feed itself, even in good
years. An estimated 2.5m people out of a total of 17m have no secure source of food. When
harvests fail, which they do almost annually, that number shoots up. In 2012, when the worst of
the recent food crises ravaged the Sahel region, almost a quarter of Nigers population was said
to be going hungry, prompting desperate relief campaigns by international donors.
This perpetual food crisis is compounded by doggedly high fertility rates. With an average of 7.6
children per woman, Niger has the worlds highest rates. Poverty, ignorance and poor access to
contraception are contributing factors, as are cultural issues like competition between wives. Men
in Niger tend to be polygamous, and local doctors note that their spouses often try to prove their
value by outdoing each other in child births. This contributes to Niger having the highest
population growth rate on earth. At current projections, the number of inhabitants will more than
triple between now and 2050 to 55m.
In such circumstances, demographers mostly agree, family planning is key. Two years ago, only
12% of women in Niger professed to use modern contraceptive methods. That is a reasonable
increase on rates of 5% in 2005 but dismally low by global standards. About 50% of women of
child-bearing age use modern contraceptives in Rwanda and Zimbabwe.

The improvements that have been registered are, in large part, the work of donors. Across the
country, foreign-funded health centres are promoting long-term options like contraceptive
implants; local health workers are being trained to distribute other prophylactics. At present the
United Nations Population Fund (UNFPA) is the only importer of contraceptives, flying in millions
of dollars worth this year. It runs a school for husbands which teaches men, who traditionally
tended to obstruct women seeking birth control, about family planning. The schools hope to
dispel wild rumours about contraception. One woman living outside of Zinder, the countrys
second-biggest city, used to believe the pill would cause haemorrhages or make her unborn child
anaemic. I was scared for the first two months, she says.
The political will to improve things is weak: the government professes support but allocates only
a tiny proportion of its budget to family planning. And the appetite for change among the
population is limited. Only about a quarter of women express any desire to space out their births,
let alone reduce their number. More than 20 years ago Niger identified population control as a
priority in the fight against poverty. But birth rates are still rising.
From the print edition: Middle East and Africa
The Economist