Niger’s service delivery shift: reduced stockouts, faster financing, and improved staffing

In Dan Gaourou, a village in Niger's Maradi region some 600 kilometers from the capital Niamey, Salamatou Hassan remembers what it used to mean to have a sick child.

"In the past, our children suffered from many diseases whose causes we often did not know," she recalls. "We tried to see the doctor at the health center, but sometimes the center had no staff or medicines. Our children stayed unwell, and sadness filled our homes."

Salamatou is a mother of three who farms and raises small livestock-three rams and two goats-and, like most families in her community, her household's wellbeing depends on reliable access to basic services. For years, that reliability was absent: health centers ran out of essential medicines, schools opened without exercise books, textbooks, or pencils, and teachers and health workers were in short supply, often reluctant to be posted in remote areas far from the capital.

For families like Salamatou's, accessing basic social services can be a daily struggle, as health centers and schools frequently lack essentials partly due to late or insufficient funding and complex purchasing procedures.

The impact is immediate: when essential medicines are out of stock, seeking treatment becomes extremely difficult, especially in areas with too few health workers. In education, overcrowded classrooms and limited learning materials mean children share what they can, and teachers work with fewer tools than they need.

Medicine delivery truck. Credit: World Bank/Niger.

A Different Way of Spending

To address these challenges, the Government of Niger, with financial and technical support from the World Bank, launched the Public Sector Management for Resilience and Service Delivery Program in 2022. Rather than simply directing funds toward inputs, the program takes a Program-for-Results (PforR) approach: financing is tied to concrete, verifiable achievements on the ground, and relies on national systems and processes.

Budget releases to the Ministries of Health and Education are no longer "on paper" allocations - they translate into purchasing large quantities of supplies in facilities, staff where they are needed, and clearer visibility for local offices on their budgets and work plans.

The results, measured over three years, are striking.

Average stockout days for essential medicines in health centers fell from 16 days in 2022 to just 5 days in 2025. The quantity of school supplies procured rose from 839 tons in 2023 to 2,031 tons in 2025 - a 142% increase. For families like Salamatou's, these are not statistics. They are the difference between a child who recovers at the local clinic and one who is carried for hours to a distant facility, or between a student who has a textbook and one who does not.

"When the health center has what our children need," Salamatou says, "we can focus on our work - and our children can recover faster and return to school."

Getting Supplies There - and Creating Jobs Along the Way

Procuring medicines and school materials is only part of the challenge. In a country as vast and geographically dispersed as Niger, getting those supplies to remote communities requires people: workers to load, transport, and unload goods during the intense surges of vaccination drives and back-to-school seasons.

"The country did not experience any shortage of medicine in 2023 or vaccine, despite the challenges, thanks to the project," said Dr. Hassan Abdoul Nasser, Immunization Director. Credit: World Bank/Niger.

Since 2022, the program has mobilized an estimated 5,958 temporary workers across Niger for exactly this purpose, rising from 1,248 in 2022 to 1,770 in 2025. In the Maradi region alone, the estimated workforce mobilized for unloading medicines and vaccines reached 340 people in 2025. These are short-term, surge-support roles-but they highlight how strengthening public systems can create immediate local employment while improving the reliability of essential services that underpin productivity and human capital.

For the World Bank Group, this dimension of the program reflects a core conviction: that investing in the systems that deliver health and education is not just about services. It is about building economic conditions in which more and better jobs can take root. With over 1.2 billion young people set to enter the workforce in developing countries over the next decade, embedding job creation into every layer of development programming - including supply chains - is essential.

Bringing Teachers and Health Workers to Where They Are Needed

Beyond supplies, service delivery depends on people. The Program also supports better management of staff deployment, including clearer and more transparent mobility criteria for teachers, an important step toward ensuring that underserved areas are not left behind.

The Larger Vision

For Salamatou and her family, the change is felt in ordinary moments: a child treated promptly, a school year that begins with pencils in hand, an afternoon spent tending livestock rather than searching for care. These moments, multiplied across thousands of communities, are the foundation on which human capital is built - and on which Niger's future workforce will depend.