Fraser, NicoleCheikh, NejmaHaacker, MarkusMasaki, EmikoKaramoko, DjibrillaGorgens, MarelizeKerr, CliffGray, RichardShattock, AndrewWilson, DavidFrescura, LuisaKonan, ClaudeAlhousseini, ZeinabouHarouna, Zakou2014-12-022014-12-022014-06https://hdl.handle.net/10986/20600The main objective of the study is to provide a comprehensive analysis of HIV and health financing needs, investment opportunities, and health system development in the context of the Government of Niger's HIV National Strategic Plan (NSP) 2013-17. The analysis provides support for HIV policy decision-making, investment scenarios and programmatic targeting and prioritization. In addition, the analysis helps Niger build the case for HIV and health impact investment including delivering estimates of health care savings as a result of these investments. The analysis was implemented by the World Bank in collaboration with UNAIDS from a request for analytical support from the Government of Niger. The study involved a desk review of HIV- and health-related evidence, epidemic trends and financial modeling. The Optima model (formerly Prevtool) was used to estimate optimal resource allocation during the NSP, and the impact and cost-effectiveness of past HIV investments. A financial commitment framework was used to estimate longer-term costs and savings of the HIV program and the fiscal dimension of HIV in Niger.Le Niger a fait des progrès significatifs en termes de développement économique et de réduction du niveau d’extrême pauvreté. La croissance économique a été supérieure à 11% en 2012, grâce aux revenus du pétrole, de l’uranium et de la production agricole. Le pourcentage de la population vivant avec moins de $1.25/jour est passée de 66% en 2005 à 44% en 2008, ce qui place le Niger au-dessus de la moyenne Sub-saharienne de 49% en 2008. Malgré ces statistiques encourageantes, les conditions de vie de la population restent difficiles. L’insécurité alimentaire persiste y compris les années ou la production agricole est en surplus. La fourniture de services de santé est dominée par le secteur public et en 2011, les dépenses de santé ont atteint 5.1% du PNB (225 million euro, ou 303 million de USD). Au moment où le Niger progresse sur le chemin du développement, il est opportun de revoir l’ampleur et la trajectoire de l’épidémie de VIH, ainsi que les investissements nécessaires pour répondre aux coûts actuels et futurs de la morbidité engendrée par le VIH/SIDA. Il est particulièrement important d’analyser comment le Niger peut s’assurer que ses investissements sont pérennes et ont un fort impact, et comment ils peuvent soutenir au mieux le système de santé global et les priorités de développements. L’objectif premier de cette analyse est de fournir aux autorités nigériennes des données complètes concernant les besoins et les possibilités d’investissement pour la lutte contre le VIH dans le contexte du Plan stratégique national de lutte contre le VIH-sida 2013-2017 (PSN), du financement de la santé et du développement du système sanitaire. Une telle analyse éclaire les décisions relatives aux options de politique et aux scénarios d’investissement, au ciblage et à la priorisation des programmes relatifs au VIH.en-USCC BY 3.0 IGOADULT POPULATIONAGE GROUPSAGEDAGRICULTURAL PRODUCTIONAIDAIDS CAREAIDS DEATHSAIDS MORBIDITYAIDS MORTALITYAIDS SPENDINGANEMIAANTENATAL CAREANTENATAL SERVICESBABYBEHAVIOR CHANGEBIOLOGICAL VULNERABILITYBISEXUALBLEEDINGBREASTFEEDINGBURDEN OF DISEASEC SECTIONCAPACITY BUILDINGCELL COUNTCHILD HEALTHCHILD-TRANSMISSIONCIRCUMCISIONCLINICSCOMMUNICABLE DISEASESCOMMUNITY HEALTHCONDOMCONDOM PROMOTIONCONDOMSCULTURAL PRACTICEDEMOGRAPHIC GROWTHDEVELOPING COUNTRIESDEVELOPMENT POLICYDIARRHEADIARRHEAL DISEASESDISABILITYDISCRIMINATIONDISEASE BURDENDRINKING WATERDRUG ADHERENCEDRUG COSTSDRUGSECONOMIC GROWTHECONOMIC OPPORTUNITIESEFFECTIVE USEEPIDEMICEPIDEMICSEPIDEMIOLOGICAL DATAEPIDEMIOLOGYFAMILIESFAMILY PLANNINGFAMILY SUPPORTFEMALEFEMALE SEX WORKERSFEMALESFERTILITYFEWER BIRTHSFINANCIAL COMMITMENTFIRST CHILDFOOD INSECURITYFOOD SECURITYFOOD SHORTAGESGENITAL MUTILATIONGLOBAL HEALTHGROSS DOMESTIC PRODUCTGROSS NATIONAL INCOMEGROSS NATIONAL PRODUCTHEALTH CAREHEALTH CARE PROVIDERSHEALTH FACILITIESHEALTH INITIATIVESHEALTH INTERVENTIONSHEALTH OUTCOMESHEALTH PROFESSIONALHEALTH PROVIDERSHEALTH SECTORHEALTH SERVICEHEALTH SERVICESHEALTH SYSTEMHEALTH SYSTEMSHEALTH WORKERSHEALTH-SEEKING BEHAVIORHEAVILY INDEBTED POOR COUNTRIES INITIATIVEHERPESHIVHIV INFECTIONHIV INFECTIONSHIV POSITIVEHIV PREVENTIONHIV TESTINGHIV/AIDSHOSPITALSHUMAN DEVELOPMENTHYGIENEINFANTINFANT HEALTHINFECTIOUS DISEASESINFORMED CONSENTINFRASTRUCTURE CONSTRUCTIONINFRASTRUCTURE DEVELOPMENTINTERNATIONAL EFFORTSINTERVENTIONIRONLABOR MIGRANTSLEADING CAUSESLIFE EXPECTANCYLITERACY RATESLIVING CONDITIONSMALARIAMALE CIRCUMCISIONMALE SEXMALNUTRITIONMATERNAL CAUSESMATERNAL HEALTHMEASLESMEDICAL RECORDMENINGITISMIGRANTMIGRANTSMIGRATIONMILLENNIUM DEVELOPMENT GOALMORBIDITYMORBIDITY AND MORTALITYMORTALITYMOTHERMOTHER-TO-CHILDMOTHER-TO-CHILD HIV TRANSMISSIONMOTHER-TO-CHILD TRANSMISSIONNATIONAL AIDSNATIONAL DEVELOPMENTNATIONAL PRIORITIESNEONATAL HEALTHNEW INFECTIONSNEWBORNNUMBER OF AIDS DEATHSNUMBER OF PEOPLENUTRITIONOFFICIAL DEVELOPMENT ASSISTANCEORPHANOUTREACH ACTIVITIESPATIENTPATIENTSPOLICY BRIEFPOLITICAL PARTIESPOOR HEALTHPOPULATION GROUPSPOPULATION GROWTHPOST-EXPOSURE PROPHYLAXISPREGNANCYPREGNANT MOTHERSPREGNANT WOMENPREVALENCEPREVENTION EFFORTSPREVENTION OF MOTHER-TO-CHILD TRANSMISSIONPRISONSPROGRESSPROSTITUTIONPUBLIC HEALTHPUBLIC HEALTH PROBLEMPURCHASING POWERPURCHASING POWER PARITYQUALITY SERVICESRADIORATES OF INFECTIONREAGENTSREPRODUCTIVE HEALTHREPRODUCTIVE HEALTH INTERVENTIONSRESOURCE ALLOCATIONRESOURCE ALLOCATIONSRESOURCE NEEDSRESOURCE STREAMSRISK BEHAVIORSRISK FACTORSRISK POPULATIONSRURAL AREASRURAL DEVELOPMENTRURAL WOMENSANITATIONSCHOOL ENROLMENTSCREENINGSECONDARY EDUCATIONSECONDARY SCHOOLSERVICE AREASSERVICE PROVISIONSEXSEX INDUSTRYSEX WITH MENSEX WORKSEX WORKERSEX WORKERSSEXUAL BEHAVIORSEXUAL NETWORKSSEXUAL RISKSEXUAL RISK BEHAVIORSSEXUAL VIOLENCESEXUALLY TRANSMITTED INFECTIONSMSOCIAL DEVELOPMENTSOCIAL HEALTH INSURANCESOCIAL MARKETINGSOCIAL SECTORSPECIALISTSPOUSESSUSTAINABLE ACCESSSUSTAINABLE DEVELOPMENTTBTELEVISIONTETANUSTHERAPYTREATMENTTUBERCULOSISUNAIDSUNPROTECTED SEXUAL ACTSURBAN AREASURBAN CENTERSURBAN DEVELOPMENTURBAN POPULATIONURBAN POPULATIONSURBAN WOMENURBANIZATIONVERTICAL TRANSMISSIONVICIOUS CYCLEVIOLENCEVIRAL LOADVULNERABILITYVULNERABLE CHILDRENWASTEWOMANWORKERSWORKING CONDITIONSWORKPLACEWORLD HEALTH ORGANIZATION10.1596/20600