Niamey – When 19-year-old Aichatou, from Birni in the Dosso region, found out she was pregnant with her first child in 2023, her hope was for a smooth pregnancy and safe delivery. But she was reluctant to visit a health centre. “My sisters told me the staff don’t pay enough attention to women during antenatal checkups, and that the care is often slow,” she says. 

Niger continues to face high rates of maternal and neonatal mortality. In 2020, maternal mortality was estimated at 441 deaths per 100 000 live births. Neonatal mortality rose from 24 to 43 deaths per 1000 live births between 2012 and 2021. In 2021, only 43% of births were attended by skilled health personnel, underlining the urgent need to expand access to quality care.

According to the 2023 Perinatal Maternal Death Surveillance and Response (PMDSR) report, the leading direct causes of maternal death in Niger are haemorrhage (34%), hypertensive disorders (28%), infections (24%) and obstructed labour (3%). While these causes are largely preventable, many women continue to give birth at home, far from health facilities. This is compounded by low health coverage – just 55.45% in 2023, according to the 2023 National Health Information System (SNIS).

In response, the Ministry of Public Health, Population and Social Affairs, in collaboration with World Health Organisation (WHO) in the African Region and with support from the Muskoka Fund, launched the Integrated Essential Obstetric and Neonatal Care Promotion Project (SONNE) in 2023. The project, implemented by the NGO Action for Well-being (APBE), aims to improve maternal and newborn health in the Dosso and Zinder regions.

The SONNE project is active in four health facilities per region, including two integrated health centres, a district hospital, and a mother-and-child health centre. To expand access, 22 maternal and neonatal health professionals and 100 community relays have been trained. These community relays, tasked with raising awareness about reproductive health, especially among women of child-bearing age, play a vital role in encouraging antenatal visits. They go door-to-door to identify pregnant women and motivate them to give birth in health facilities, with skilled support. 

“Before the SONNE programme, many women gave birth at home, without medical assistance,” explains Hadiza, a community relay in Dosso. “Now, I encourage them to attend regular check-ups from the start of their pregnancy, and to deliver in a health centre. Thanks to awareness-raising, women are taking more responsibility for their own health, and that of their children.”

As a result of these community efforts, the number of women using maternal services in Dosso’s intervention areas increased by 40% between 2022 and 2023.

“Since receiving the training, we have improved the quality of the care we provide. Mothers now visit more regularly, and they’re better informed about the importance of safe childbirth,” says Boubacar Halima, head of the Birni Integrated Health Centre. «It’s a shift in mindset that’s paying off; we’re seeing more babies born in good health.” 

WHO and its partners continue to support the strengthening of maternal and neonatal health services. Under the SONNE project, health centres have been equipped with essential tools for newborn care, such as heating tables and kangaroo care wraps, vital for preventing hypothermia in premature and low birth-weight babies. 

The programme has also introduced a maternal and neonatal deaths surveillance system, enabling speedy reporting, deeper understanding of causes, and the implementation of corrective actions to improve care.

“Auditing maternal deaths helps reduce mortality by continuously improving services,” explains Dr Laouali Aissatou, head of the maternal and neonatal health programme at WHO Niger. “With this surveillance system, WHO is helping Niger track mortality trends and refine health policies to save more lives.”

The SONNE project marks a crucial step towards better health care for mothers and newborns in Niger. Through quality care, expanded community awareness and ongoing monitoring, the programme is already making a life-saving difference.

Today, the picture is changing. Aichatou, supported by Hadiza, received prenatal consultations, attentive follow-up and a safe delivery. “Everyone listened to me,” she says. «I went to all my check-ups and it was nothing like what I had been told. The midwives were kind and my delivery went well. I would advise all pregnant women not to give birth at home. With the right support, you leave the health centre feeling great, with a healthy baby – and that's what really matters.”