The Ministry of Public Health is committed to improving the health status of the population in Chad through the implementation of sectorial policies including the National Health Policy 2016-2030 and several important reforms with the support of technical and financial partners.
Switzerland has oriented its cooperation policy towards a systemic approach aimed at intervening on the causes of fragility in the sector, at different levels (local, regional and national) and through various categories of actors including the State. In this context the Republic of Chad and the Swiss Confederation signed the project agreement and the Swiss Agency for Development and Cooperation (SDC) commissioned the Swiss TPH - Centre de Support en Santé Internationale (CSSI) consortium to implement the PADS (Projet d'appui aux districts sanitaires du Tchad - Yao et Danamadi) for its first phase from 2014 to 2018.
Objectives and Aims
The overall objective of the project is to "contribute to reducing mortality and morbidity in the SDC's intervention regions through better and more accessible essential services". Its specific objective is to "improve the performance of the health system as well as people's access to preventive and curative services in supported health districts, with a strong emphasis on the quality of the minimum package of activities (PMA), particularly maternal and child health."
Its expected outcomes are:
- Outcome 1: The healthcare offer is improved both in quantity and quality in the 2 supported districts
- Outcome 2: The demand for mother and child health and their effective utilization are increased in the 2 supported districts
- Outcome 3: The strengthening of health administration at district, regional and national levels progressively contributes to transparent, efficient, participative and accountable management of the health sector.
Swiss TPH and CSSI joined forces in a consortium to implement the project. The PADS mainly works in proximity and systemic support at the level of the two health districts of Yao and Danamadji, where multidisciplinary teams are integrated into the two district management teams (EDC) and work in concert with the regional level.
The project is led by a coordination team based in N'Djamena and implements its multi-level approach by bringing experiences from the peripheral to the central level, including innovations that could be replicated at national level or at least animate national dialogue.
The project carried out a baseline survey which will be replicated at the end of the current phase in order to measure the effects and results achieved. The implementation of an inclusive monitoring system in the health information system makes it possible to regularly produce indicators, notably through the DHIS2 software. In addition, the Ministry of Public Health is taking advantage of the PADS experience to extend DHIS2 to national level
Numerous inputs have been put in place by the project, particularly at the end of the second year, in order to make progress in terms of supply and demand for care and governance in health administration at all levels. These include capacity building in human resources, infrastructure, equipment, the setting up of performance based contract and actions on the health information system, the management of medicines, Community participation and social mobilization activities, mixed campaigns (children and livestock) and One health activities, as well as operational research activities.
The main beneficiaries of the project are primarily the populations of the 2 health districts and mainly the most vulnerable: women, children, indigents and nomadic populations. The district of Yao (Batha region) covers 141 217 inhabitants (2014) in 12 functional health areas, and Danamadji district (Moyen-Chari region) has a population of 123 788 inhabitants (2014) covered by 18 functional health areas.
Communities, administrative and health officials at all levels of the health pyramid and health personnel in both districts benefit from this project in terms of capacity building. Local NGOs also benefit from the project through the performance based contracts (ADRB, APDI, ATEV) and the coordinated approach at the level of the health districts must benefit other development actors including livestock agents, NGOs and the Community based health insurance Borsah in Danamadji.
The mid-term evaluation which took place in early 2017, allows the project to improve its processes and strategies while continuing to implement its multiple activities.
Centre de Support en Santé Internationale CSSI
Le Ministère de la Santé Publique de la République du Tchad
Swiss Agency for Development and Cooperation (SDC)