CHAD. An integral health approach on and beyond Covid-19

This is the title of the project implemented by MAGIS Foundation, thanks to the financial contribution of the Italian Agency for Development Cooperation (AID 04/Ciad/12022/2021) and in close cooperation with health institutions. Through this initiative, the Foundation continues its commitment to strengthening the diagnostic and surveillance capacity of laboratories and enhancing health services in urban and rural areas to reduce communicable and non-communicable diseases in Chad.

Context

Chad, with a population of about 17 million (2020 figure, UNDP source) and a GDP per capita of USD 1,580, is ranked 187th out of 189 countries in the UNDP Human Development Report 2020. Life expectancy is 54.2 years. There are 5,000 nurses and only 700 doctors, or 3 doctors and nurses per 10,000 inhabitants. Considering the many challenges to be faced, the Chadian government has strengthened its emergency response plan to cope with the trauma suffered by the population in the most vulnerable regions. In these regions it is necessary to provide medicines and medical equipment to the health facilities that most provide public health services to the displaced and local populations.

The identified need

Chadian health care suffers from serious weaknesses, due to multiple causes.

There is poor access to basic health services for some diseases that are not sufficiently known (communicable and non-communicable diseases and new environment-related diseases). The amount of public and individual money is insufficient to meet the health needs of the most vulnerable groups. There are also widespread prejudices against hospitals, so that traditional medicine is often used, which is not always adequate.

Another health fragility is due to the insufficient number of specialised medical personnel and the lack of specialist training in hospitals. In particular, staff in rural health centres are demotivated and inadequately trained. There is also discontent among health personnel and university professors over low pay, discontent that results in continuous strikes and protests.

Health data collected at the national level is scarce (the last survey was in 2015), which does not allow for a good impact analysis within health economy.

Furthermore, the percentage of the budget dedicated to health is low (6.6% in 2016).

Finally, the global focus on Covid-19 has reduced attention on the other diseases that affect Chad (such as HIV/AIDS, malaria, hepatitis, tuberculosis, etc.) with a high incidence in terms of mortality and morbidity.

Ongoing activities

The project includes:

  • the implementation of training courses for the managers of 100 Health Centres, for 100 Community Health Officers and for the technical laboratory staff of 5 hospitals in N’Djamena (Le Bon Samaritain University Hospital Complex), Goundi, Biobè, Koutouguere and Boum Kabir;
  • the strengthening of the Minimum Package of Preventive Activities (PMA) envisaged in the National Health Plan 2016-2030 through the purchase and distribution of rapid tests (Covid-19, malaria, HIV, HBV, HCV) and new equipment for 5 laboratories;
  • structural improvements to enhance and secure the operating department, the diagnostic imaging department, and the gynaecological department;
  • the implementation of Covid-19 epidemiological serum surveillance surveys at national level, and the organisation of World Hepatitis Day.

The first results are already visible. Désiré Nasser, head of the Missidi Health Centre (Biobé district), says: “The training on hepatitis, Covid-19, AIDS was really very interesting because it brought us up to date with national and local data. The clarity of trainers’ explanations and the time devoted to discussion between us students and them was a precious moment in which we were able to express all our doubts and have our curiosities answered”.

Sabrina Atturo
Program Manager in Chad
MAGIS Foundation