Niger

This landlocked west African nation gained its independence from France in 1960, and has a population of 13.3 million. Its female life expectancy is 43.7 years, among the lowest in the world. The birth rate is 50.7 per 1,000, and the fertility rate is 7.3 births per woman (2008), the second highest in the world; only Mali has a higher fertility rate.

During the French colonial period, little was done for the country's health care system except in Niamey, the capital, where a small hospital was built for the European population and the local elite. After independence, the health care system was improved and extended, but the country is desperately poor, and foreign aid groups pay for much of the medical care. There are only 377 ...