PREPAS - Diagnostic Study of Mixed Health - One Health
Project Abstract
Chad's healthcare system faces significant challenges due to recurring health crises, limited resources, and the impacts of climate change, particularly in its rural and pastoral regions. The Sahel's low annual rainfall of 250-500 mm limits agricultural production, positioning pastoralism as the predominant mode of production. Efficient exploitation of pastoral ecosystems depends on mobility to adapt to pests, epidemics, and environmental changes. However, pastoral areas are often isolated, making access to essential services like healthcare, education, water, and security challenging. The "One Health" approach, integrating human, animal, and environmental health, is proposed as a solution to improve healthcare delivery by fostering multidisciplinary collaboration. The Programme de Renforcement de l'Elevage Pastoral (PREPAS) is implementing mobile health approaches that integrate human and animal health services to optimize costs and improve access to care in Chad's pastoral communities. They are conducting an evaluation of these initiatives and are working with consultants to develop a national "mixed health" strategy to improve healthcare delivery for pastoral populations and their livestock.
PREPAS is funded by the Swiss Agency for Development and Cooperation (SDC) and implemented by CA17 (https://www.ca17int.eu/projet/tchad-programme-de-renforcement-de-lelevage-pastoral-dans-les-regions-du-batha-de-lennedi-et-de-wadi-fira-phase-2/)
Based on the ample experience of Swiss TPH and local partners on this topic, Dr. Monique Léchenne and Dr. Rolande Mindekem are the main consultants for this evaluation. The mission aims to evaluate the "mixed health" approach in Chad, using insights from current projects and programs to establish a foundation for implementing a mixed health system in remote pastoral areas. This includes identifying stakeholders, analyzing relevant policies and actions, and producing an action plan and a roadmap for a national mixed health strategy that integrates human and animal health for improved healthcare delivery. The activities also include a literature review and a data collection in 3 provinces (Batha, Salamat and Ennedi-Ouest) to gather information from the pastoral community and local authorities and health workers.
Overall aim: diagnose and analyze the "mixed health" approach in Chad, drawing on existing projects and institutional partners' experiences. This diagnosis will serve as a foundation for implementing a mixed health system in remote areas for pastoralists and agro-pastoralists, contributing to a broader One Health strategy.
Specific objectives:
Identify all stakeholders (at central and local levels) involved in mixed health and analyze the policies implemented in animal and human health to ensure pastoral mobility and, more broadly, the security of populations distant from health centers and veterinary posts.
Identify, describe, and analyze the various specific actions related to mixed health in Chad, comparing them with positive experiences from outside the country.
Based on this analysis, produce recommendations and an action plan for optimal implementation of mixed health in Chad (guiding strategies, approaches, and operational modalities).
From the action plan, produce a roadmap for developing a national mixed health strategy
The methodology includes a series of activities structured into three main packages:
Package 1: Historical context and current status of mixed health activities.
Package 2: Analysis of current activities.
Package 3: Proposals for future activities.
Data will be collected through interviews with ministry representatives, local human and animal health authorities and service providers and pastoral communities. On the community level focus group discussions will be held with women and men from different nomadic camps. Field missions include sites in three out of 23 provinces or Chad, namely Batha, Salamat and Ennedi-Ouest. Package one includes a literature review. Initial results presented to PREPAS shortly after data collection and literature review concludes. A detailed action plan and roadmap will be created based on the analysis, incorporating feedback from stakeholders during a multisectoral workshop.
Expected results: The project identifies human and animal health services and stakeholders, analyzes their impact on mobile populations, and develops an action plan and roadmap to implement a mixed health strategy in Chad.
