Health in Chad

The Ministry of Public Health and Prevention, known locally as the Ministère de la Santé publique et de la Prévention (MSPP), works with provincial health delegations and health districts. The fourth National Health Development Plan, PNDS 4, covers 2022–2030 and aims to expand universal health coverage and primary health care. It sets 43 strategic directions, 96 expected results and 288 measures, but major gaps remain in access, health workers, infrastructure and financing. Out-of-pocket payments are high, and the available evidence does not establish nationwide free care, compulsory health insurance, a single national fee schedule, a nationwide emergency telephone number or an integrated patient record system. Primary health care means the first level of contact for common illnesses, prevention, screening and referrals. A typical pathway starts with a relais communautaire, a community health worker who may provide health education, household visits, vaccination follow-up, maternal and child follow-up, nutrition screening and referral support. Care may then continue at a poste de santé or centre de santé, followed by an hôpital de district, a secondary hospital or, when necessary, a tertiary referral facility. People can also go directly to a health centre or hospital. Mobile and outreach services extend care to nomadic communities, remote areas and refugee settlements, but distance, security conditions, flooding and the rainy season can delay transport and referrals. Preventive services include routine vaccination, campaign vaccination, malaria, tuberculosis, HIV and malnutrition screening, maternal and child care, sexual and reproductive health services, family planning, water and sanitation measures and cholera prevention. Chad introduced malaria, rotavirus and pneumococcal vaccines into routine immunization in 2024. WHO and UNICEF estimated routine immunization coverage at about 68% in 2024, while four polio campaigns in 2025 targeted approximately five million children aged 0–59 months. Community workers and health facilities support antenatal care, skilled delivery, postnatal care, newborn follow-up and child health visits. Family-planning services were supported through a project covering 45 health facilities. Care for acute illness includes maternal care, newborn and child care, malaria, tuberculosis, HIV, acute malnutrition, mental health and sexual and reproductive health services. Community-based management of acute malnutrition, known as CMAM, can be delivered through outpatient or inpatient care with referral when the condition is severe. Mental health and psychosocial support are more widely available through humanitarian programmes than through a uniformly distributed national service. Essential medicines, diagnostic tests, vaccines and oxygen are not reliably available everywhere. Four WHO-supported oxygen plants contribute to supply, but the actual stock, price, opening hours and staffing still need to be checked with the chosen facility. Refugees and host communities may receive care through humanitarian partner networks coordinated with the MSPP and the Health Cluster. In 2025, the UNHCR partner network for refugee and host populations included 20 health centres, seven health posts and two secondary hospitals. It recorded 569,834 consultations from January to June 2025, with host communities accounting for 21% of consultations, and recruited 1,247 health workers. The network also included 130 refugee health workers, including 20 doctors whose professional practice had been cleared. These services depend on the relevant province, partner programme and available funding and should not be treated as a nationwide entitlement. Follow-up may involve community workers, facility appointments, vaccination catch-up, antenatal or postnatal care, newborn and child home visits, nutrition monitoring and continued treatment for tuberculosis or HIV. Health programmes use systems such as DHIS2, a digital health reporting platform, and the TB/HIV Tracker, but record keeping remains mixed. WHO reported digital health-system maturity increasing from 25% at the end of 2022 to 50% at the end of 2024, against a 70% target for 2025; the target does not by itself confirm that every facility has a complete patient record. When acute danger occurs, go directly to the nearest centre de santé or hospital, or seek referral help from a relais communautaire. Chad has no verified nationwide emergency number or uniform triage system. Transport and ambulance capacity vary, and an outbreak or flood can lengthen delays. During the 2025 cholera outbreak, first reported on 13 July and officially declared on 24 July, community deaths highlighted the consequences of reaching care late. Infection-control, isolation and outbreak procedures depend on the facility and the local situation. Informal and traditional providers exist, but the reviewed evidence does not map them well enough to treat them as equivalent to formal health facilities.