a difference in rural and urban areas with a prevalence rate of 0.5% and 1.5% respectively. 2. Nutrition: It should be noted that malnutrition is a permanent scourge in both urban and rural areas. It is due to feeding that is unsuitable for one‟s age. The causes of malnutrition are malaria, acute respiratory infections, diarrhoea and all infections and diseases addressed by the Extended Programme on Immunization. Thus, low weight was 44% while retarded growth was 50% in 2006. Use of exclusive breast feeding climbed from 2% in 2000 to 13.5% in 2006. According to the EDSN/MICS III Survey of 2006, the prevalence of moderate retarded growth among children aged 0 to 5 is 20% and that for severe retarded growth is 30%2. Though the 2000 MICS survey confirmed that malnutrition among children below 5 was a fundamental problem, it remains true that children in Niger suffer from deficiency in micronutrients and iodine deficiency disorders. These deficiencies are an aggravating factor of infant mortality. A joint UNICEF/Health Ministry study carried out in schools revealed that out of 8,933 students aged 10 to 15, the overall prevalence of goiter was 36% in 1994 and 20% in 1999. On the other hand, the rate of visible goitre was 5.7% in 1994 and 1.5% in 19983. 3. Access to drinking water: Despite commitments made by Niger in this area, especially by ratifying international conventions and laws adopted internally, access to drinking water is not equitable throughout the national territory. The 2000 MICS survey shows that barely 43% of Niger nationals have access to drinking water. The rate in urban areas is 81% against 36% in rural areas. The persistent lack of sanitation and hygiene is an impediment not only to better health but also to the conditions of family life and a healthy environment. a2. Achievements The elaboration of programmes and their implementation with the support of development partners helped to achieve remarkable progress. Thanks to the 1994-2000 PDS, health services were decentralized and devolved. The implementation of the primary healthcare strategy led to an increase in health coverage which was 32% in 1994, 56.7% in 20024 and 65% in 2005. As part of the recovery of health costs, the rates levied on children were reduced. It should be noted that vaccinations are free of charge. NAP/SPDE 2004-2010 Multiple Indicator Population and Health Survey 4 NAP/SPDE 2004-2010 2 3 25