ArticleThe Pan African medical journal2026
[Effect of economic sanctions on the quality of hospital management of severe acute malnutrition in Niger: a multicenter retrospective study].
Article in The Pan African medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: in 2023, Niger was subjected to international economic sanctions following political instability, resulting in major disruptions to supply chains and continuity of health services. This study aimed to assess the effect of these sanctions on the quality of hospital management of severe acute malnutrition (SAM) in therapeutic centres across the country. Methods: this multicenter retrospective study was conducted from January 2022 to December 2023 in seven intensive nutritional rehabilitation centres (CRENI) located in six regions of Niger (Dosso, Maradi, Niamey, Tahoua, Tillabéry, and Zinder). Data was extracted from hospital registers using a standardised tool. Quality-of-care indicators (admission rate, recovery rate, mortality rate, average length of stay, and default rate) were compared before and after the imposition of sanctions. Qualitative interviews with health staff were also conducted to explore operational challenges and supply chain disruptions. Results: a total of 6,354 SAM cases were admitted during the study period. Compared with 2022, the year 2023 recorded a 22% increase in admissions, a decrease in the recovery rate (from 83.4% to 74.6%), and an increase in mortality (from 9.1% to 14.3%). Marked regional disparities were observed: urban CRENIs (Niamey, Maradi) were more resilient to disruptions than those in peripheral areas (Tahoua, Tillabery, Zinder), which were more severely affected by stockouts and staff shortages. Conclusion: economic sanctions significantly disrupted the nutritional care system, undermining the quality of services and exacerbating regional inequalities. Strengthening logistical resilience and safeguarding essential health services are critical to preserving child survival in crisis contexts.
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