Terminal Illness & End-of-Life Planning in Niger: 5-Step Official Checklist

1. 1

   Coordinating palliative care and specialised medical support

   • Care in national and regional hospitals: In Niger, the clinical management of serious or chronic illnesses (such as oncology care coordinated through the National Centre for Fight against Cancer, severe organ failure, or progressive conditions) is organised around the National Hospital of Niamey, the General Referral Hospital, and regional hospital centres, in alignment with public health programmes supported by the World Health Organization [5].
   • Supportive care and continuity of care at home: The treating medical team establishes a pain-management and supportive-care protocol that can be continued on an outpatient basis or at the family home in coordination with district hospitals and integrated health centres (CSI) [5]. It is essential to request a complete medical record detailing the diagnosis, prescribed pain-relief treatments, and emergency clinical instructions [5].
   • Financial and social coverage of medical care: For salaried employees affiliated with the National Social Security Fund of Niger (CNSS) or covered by an employer health scheme, as well as for state civil servants covered under public administrative arrangements linked with the Ministry of Finance of the Republic of the Niger, the attending physician issues the medical certificates required for hospital coverage and extended treatment [1] [3].
2. 2

   Documenting advance medical wishes and designating a trusted healthcare representative

   • Written expression of care preferences: Because Niger does not operate a national electronic registry for advance medical directives, any adult with full mental capacity may record in writing, on a document dated and signed before witnesses or a notary, their preferences regarding medical treatments, limits on invasive procedures, and preferred place of care (home or hospital facility) [4] [5].
   • Designating a family spokesperson with the medical team: In Nigerien hospital practice, healthcare teams closely involve immediate family members in medical decisions whenever the patient is no longer able to communicate directly [5]. Formally designating in writing a primary family representative (such as a spouse, parent, or adult child) gives physicians a clearly identified point of contact and helps prevent family disagreements [4] [5].
   • Inclusion in the medical record: We advise providing a signed copy of these written medical wishes and the contact details of the designated representative to the supervising hospital physician, while keeping an accessible copy at the home of your family member [5].
3. 3

   Establishing bank powers of attorney, notarial mandates, and legal protection

   • Bank powers of attorney: While your family member retains full legal and cognitive capacity, it is a priority to contact their banks in Niger (or request a home or hospital visit by a bank representative) to sign a bank power of attorney enabling a trusted representative to pay medical expenses and household charges without interruption [1] [4].
   • Notarial power of attorney for administration: To carry out broader administrative acts (managing real estate, collecting rent, or completing formalities with the tax offices of the Ministry of Finance of the Republic of the Niger or social security funds), the ill person can execute a general or special power of attorney by authentic deed before a Nigerien civil-law notary [1] [4].
   • Judicial protection for incapacitated adults: If the progression of the illness later causes a lasting impairment of mental faculties that prevents the expression of will, the civil courts operating under the Ministry of Justice and Human Rights of Niger may be petitioned by the family or the public prosecutor to order adult guardianship (tutelle or curatelle) and appoint a legal administrator [4].
4. 4

   Activating disability pensions, constant-attendance supplements, and caregiver entitlements

   • Salaried workers' disability pension (CNSS): If your family member is a salaried worker affiliated with the National Social Security Fund of Niger (CNSS) and suffers a loss of at least two-thirds of their working or earning capacity due to a non-occupational illness before reaching retirement age, a disability pension claim may be filed together with a detailed medical report submitted to the fund's medical adviser [3].
   • Supplement for constant attendance by a third person: Where a disabled pensioner recognised by the National Social Security Fund of Niger (CNSS) requires constant assistance from another person to perform essential daily living activities, their disability pension includes a statutory fifty percent supplement to support daily caregiving [3].
   • Civil service medical leave and family caregiver leave: State civil servants qualify for statutory long-term medical leave with salary continuation under the administrative rules linked to the Ministry of Finance of the Republic of the Niger, while employed family caregivers may request statutory family-event leave and medical-assistance leave in accordance with the Nigerien Labour Code [1] [3].
5. 5

   Advance organisation of wills, family civil status records, and estate documents

   • Drafting a valid will: Within the legal framework supervised by the courts of the Ministry of Justice and Human Rights of Niger, any person of sound mind may execute a will (by authentic deed before a notary, in holographic form, or in accordance with their customary or religious personal status rules, subject to statutory forced-heirship shares) to organise the distribution of their assets and record any debts or claims [4].
   • Advance verification of family civil status documents: Because any future file submitted to the National Social Security Fund of Niger (CNSS) or the Ministry of Finance of the Republic of the Niger requires complete consistency across civil status records, verify now that the birth certificate, marriage certificate, and birth certificates of all dependent children are complete and accurate [1] [3].
   • Centralising property titles and cross-border coordination: Gather in a secure folder all land titles (titres fonciers), customary or administrative transfer deeds, insurance contracts, bank statements, and salary or pension slips [1] [4]. If a family member resides abroad or if assets are located outside Niger, prepare the legalisation of powers of attorney and civil status documents through the Ministry of Foreign Affairs, Cooperation and Nigeriens Abroad [2].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Administrative Procedures: Supporting Documents and Pension Formalities in Niger — Ministère des Finances de la République du Niger
2. [2]
   User Services, Consular Formalities, and Document Legalisation Procedures — Ministère des Affaires Étrangères, de la Coopération et des Nigériens à l'Extérieur
3. [3]
   The Nigerien Social Security System (CNSS - Disability, Constant Attendance, and Benefits) — Centre des Liaisons Européennes et Internationales de Sécurité Sociale (CLEISS)
4. [4]
   Official Portal of the Ministry of Justice and Courts of the Republic of the Niger — Ministère de la Justice et des Droits de l'Homme du Niger
5. [5]
   Niger: Country Health Profile and Public Health Programmes — Organisation mondiale de la Santé (OMS)