Despite the efforts of the government and its health partners, recent sociopolitical crises and battles have damaged the already frail health system and contributed to increased deprivations for the most vulnerable populations, including women, children, and adolescents. The key causes that keep vulnerable communities impoverished include persistent communicable illnesses, unsuitable parenting practices, and limited access to basic social services. Chad has a significant number of nomadic and island communities who have restricted access to preventative and curative health treatments due to their movement.

The UN Inter-Agency Group for Infant Death Estimation (IGME) estimated under-five infant death in Chad to be over 100 children for 1000 births in 2018, and neonatal mortality to be thirty-three for 1000  births in its most current report. According to the most recent MICS study (2014-15), maternal mortality was over 800 deaths for 100,000 live births. The Sustainable Development Goals will not be met at the present yearly rate of decrease in death rates.

Only 34 percent of births are attended by competent personnel. Other high-impact interventions to reduce infant mortality are underused. Vaccination coverage is low: only 22% of children aged 12 to 23 months have gotten all of their immunizations. Due to low vaccination coverage and an unstable health system, Chad is prone to recurrent diseases like measles, hepatitis, meningitis, chlorea A, and the recently circulating Vaccine Derived Polio Virus (cVDPV). The most recent measles outbreak, which began in 2018 and has lasted into 2019, has affected 122 of the 126 districts in the country (97 per cent). About 30,000 suspected cases have been registered since the disease began in April 2018, with 336 deaths.

There are no precise newborn health guidelines or recommendations, and there is no national effort to improve maternity care quality. Critical goods are frequently out of stock, and data collection is insufficient. Between 2013 and 2016, household health-care spending doubled. 

Multiple deprivations continue to harm children’s health, survival, and development in Chad, which are exacerbated by recurring health emergencies and conflicts.

The Solutions

States have found that meeting with the President on a monthly basis is a successful method to repeat commitments to boost vaccination coverage, maternal neonatal, and child health.

In collaboration with the Bill & Melinda Gates Foundation, UNICEF is implementing two community-based approaches in the Lake region to support community engagement and improve demand for routine immunization services, and in Western Logone province to promote integrated health, nutrition, and WASH services at the community level, while also collaborating with the education, child protection, C4D, and social protection sectors.

UNICEF continues to support the government’s efforts to improve routine immunization programs. In response to the measles outbreaks, the Ministry of Health established a Task Force. In the fight against the epidemic, UNICEF aided the Ministry of Health by acquiring vaccines, paying operating costs, and giving technical assistance. A comparable amount of support has been given to the emerging cVDPV outbreak.

Supporting the government in developing a national strategic plan or action plan focusing on the newborn, which includes clear guidelines, standards, and protocols on the prevention and management of newborn cases at all levels of the health pyramid; an effective implementation of the free care policy and the availability of medicines; and an equitable distribution of health personnel throughout the country are some of the solutions to these challenges (availability of data collection tools, data analysis and interpretation).

In addition, as part of the Mentor Initiative, UNICEF is implementing an Integrated Community Case Management plan in three districts in Eastern Logone province, which will be expanded to Guera province.

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