The West African country of Niger has the highest fertility rate in the world, with an average of 7.6 children per woman. Despite this, as well as having high maternal and infant mortality rates, both men and women want more children than they currently have. Men want to have 11.5 children, and women 9.2 children.
The William & Flora Hewlett Foundation engaged Camber to provide a strategic analysis of the demand landscape in Niger, relying on in-depth qualitative research and a national survey, and complemented by a robust supply analysis. The work’s objective was to provide a common fact base that Niger’s family planning community—including Government and international donors—could use to drive decision-making, as well as to highlight gaps between supply and demand.
A nuanced picture of family planning in Niger emerged from this work. While there have been notable strides in contraceptive supply, the demand picture remains challenging, and will likely take significantly more time and resources to resolve. We found that many women in Niger do not believe that they have control over their own fertility decisions (they believe that Allah or their husbands have control), or they believe they have control, but want many children nevertheless.
Within this broad demand landscape, we found significant variation in women’s demand for family planning. Using advanced statistical analyses, we derived five segments of women with discrete family planning needs, attitudes, and behaviors—representing the first segmentation of its kind (predictive of human behavior) to be developed in reproductive health services in Africa. In Niger’s resource constrained environment, the segmentation allows Government, donors, and NGOs to focus on segments with the highest potential for contraceptive uptake, or to take different segments’ needs into account when defining policy and programming.
We are currently working with a range of partners, including the Ministry of Health, Animas-Sutura, Pathfinder, EngenderHealth, and Population Services International, to integrate this work’s findings into family planning programming and communications in Niger. We are also expanding our insights and strategy work into Burkina Faso, Côte D’Ivoire, Mauritania and Togo.