Niger has 7 regions and one capital city- Agadez, Diffa, Dosso, Maradi, Tahoua, Tillaberi, Zinder and Niambey. Tillaberi and Maradi are target areas of our project.

Selecting vaccination sites for the initial phase of the vaccination campaign is primarily based on the epidemiological situations and logistical feasibility assessed by the Nigerian MOH. The existence of a relatively sound health care structure and overall readiness for a vaccination campaign in these regions allows for mass immunization, targeting more than 70% of the population.

The regions of Tillaberi and Maradi have demonstrated potential health care systems in terms of vaccination and surveillance. In addition, these regions experienced non-major epidemics of meningitis in 2009, and their inhabitants have been only partially vaccinated with the meningococcal A/C polysaccharide vaccine. As such, they have an excellent contextual background for observing the impact of the introduction of a new vaccine.

Tillaberi is one of the biggest administrative regions in Niger, containing the capital district of Niamey. The region is divided into six districts- Fillingue, Kollo, Ouallam, Say, Tera, and Tillaberi. Bordered by Burkina Faso on the west and by Mali on the north, it has 2.5 million people particularly clustered in Djerma and Haousa. The Niger River runs through Niger's westernmost region allowing for irrigated farming and fishing. Still, Tillaberi's population largely depends on small-scale subsistence farming, herding, and basic trade. Nearly 69% of the population live in poverty and only 59% have immediate access to safe drinking water.

Near the capital city Niambey, Maradi has 7 districts- Aguie, Dakoro, G Roumdji, Madarounfafa, Mayahi, Tessaoua and Maradi. With a population of 3 million, Maradi is the major hub for transportation, trade, and agriculture in Niger's south central Hausa region. It has long been a merchant city, lying on the major east-west paved highway which crosses from Niamey in the west to Diffa in the far east. Although the global health coverage reaches 79% of the population, health personnel runs short, with only 1 physician per 68,092 and 1 nurse per 5,322.

Further challenges relate to accessibility to the target regions. Since there is no regular flight within the country, ground transportation is the only means to access the target area. It takes about 8 hours from Niamey to Maradi with four-wheel drive, and takes even longer during the rainy season. It takes 2 to 3 hours from Niamey to Tillaberi.

Reference:
CIA, the World Fact Book, Niger
USAID, Niger Demographic and Health Survey key findings, 2006