It’s in a context of climate change and health that this research aims to identify the determinants of the economic performance of farms in the rural municipality of Kourthèye (Niger) on a sample of 250 producers. By adopting a parametric approach, the levels of economic efficiency were estimated and decomposed into allocative and technical efficiency from a stochastic production frontier (Cobb-Douglas-type); and the correlation test to study the link between economic performance indicators and those of health. The farm was broken down into irrigated and dry crops. Empirical results show that there’s an efficiency differential between them. For irrigated crops, the average allocative efficiency indices are 0.35 and 0.26 for dry crops. With regard to the economic efficiency, it’s 0.17 and 0.10 respectively, reflecting the weak economic performance of farms. The examination of the economic performance determinants shows that Household size, Off-farm income, Experience in agriculture, Access to informal credit, training of farmers, and Climate information play a positive and significant role in achieving of production frontier. However, all the health indicators taken into account have a negative and significant effect at 1% on the economic performance of these farms. Thus, a policy of the state, donors and NGOs, improving health status, other significant determinants, adoption of new modern technologies could certainly improve the overall level of economic performance of farms.