Unicef Programs

Promoting basic health practices to save young lives in Niger's remote villages

© UNICEF Niger/2008/Bisin

Community facilitator Bassira Rabey illustrates proper handwashing with soap in Oumba village, southern Niger.

In the run-up to the 20th anniversary of the Convention on the Rights of the Child – a landmark international agreement on the basic human rights of all children – UNICEF is featuring a series of stories about progress made and challenges that remain. Here is one of those stories.

By Sandra Bisin

OUMBA VILLAGE, Niger, 21 July 2009 – Bassira Rabey is a community facilitator who goes from door-to-door in her rural village to make sure that families, especially women, are maintaining a proper environment to improve their children’s health.

Ms. Rabey is part of a network of 101 facilitators who have been trained to promote essential family practices for child care within their communities. This initiative is at the forefront of UNICEF’s strategy to contribute to improving child survival rates in Niger by 2013.

Benefits for child health

“Since I started these activities in the village, I have already seen major changes in behaviours," said Ms. Rabey. “When I first visit them and tell them about these practices, they do not always cooperate. But after a couple of visits, they start understanding and seeing the benefits for their children’s health.”

The community facilitators focus on four major health interventions: exclusive breastfeeding up to six months of age; the use of insecticide-treated bed nets by pregnant women, and by children under the age of five; the use of oral rehydration salts to manage diarrhoeal dehydration; and regular handwashing with soap.

The challenges are vast. One in five children in Niger dies before reaching his or her fifth birthday. Only 9 per cent of women practice exclusive breastfeeding for the first six months, most children under five do not sleep under insecticide-treated bed nets and only 7 per cent of households have improved sanitation facilities.

© UNICEF Niger/2008/Bisin

Bassira Rabey demonstrates the proper position for breastfeeding to Zina Hamidou, 20, in Oumba village.

One household at a time

As part of her community work, Ms. Rabey visited the home of 40-year-old Hadiza Hamidou and her two daughters. She looked around the home and pointed out places where the family could practice better hygiene. Then she demonstrated the correct procedure for handwashing with soap to the family as well as neighbours who had gathered around the home.

Pointing at two traditional clay water containers, Ms. Rabey told the family: “You should keep them covered all the time or else dirt and dust will get in there and spoil the water. Unsafe water will, in turn, cause diarrhoea and lots of other diseases among your children.”

Ms. Hamidou’s daughter Zina, 20, was trying to breastfeed her infant daughter, but the baby was constantly crying. Ms. Rabey knelt towards Zina and took the baby in her arms, modelling the correct horizontal position for effective breastfeeding.

“I wish I had known all this before,” said Ms. Hamidou. “Rabey has really opened my eyes on these issues. I want my daughter’s children to be in good health, and I will now pay more attention to keeping our environment hygienic.”

A multi-pronged approach

The health-practices programme is currently being piloted in the region of Maradi, in southern Niger, and will progressively be scaled up to the whole country.

In addition to making door-to-door visits, the facilitators organize group discussions that involve community and religious leaders. Also in place is an itinerant cinema showing films that promote essential family practices.

“Through this approach, which uses interpersonal communication, community mobilization as well as the communication by proximity media – such as community radio stations – and advocacy at the community level, we are aiming to create an environment that encourages the adoption of these essential practices,” said UNICEF Niger Communication Officer Violeta Cojocaru. “Families have an essential role to play if we want to win this battle for child survival.”