Chad

The National Health Development Plan (PNDS 4) 2022-2030 of Chad was developed following the evaluation of PNDS 3, which fell short of its objectives due to financial constraints, insufficient human resources, and structural weaknesses in the health system. The new plan aims to strengthen the healthcare sector through six key pillars: governance, financing, human resources, infrastructure, health information, medicines, and service delivery. It adopts a participatory approach involving government institutions, technical and financial partners, and civil society. The assessment of the health system highlights persistent challenges, including high maternal and child mortality rates, low healthcare accessibility, inadequate infrastructure, and gaps in healthcare personnel. Despite efforts, health financing remains below international commitments, with out-of-pocket expenses still high for households. PNDS 4 responds by setting 43 strategic directions, 96 expected outcomes, and 288 actions, focusing on Universal Health Coverage and primary healthcare reinforcement. Key targets include reducing maternal mortality from 860 to 564 per 100,000 live births and increasing health workforce density from 0.8 to 2 per 1,000 people by 2030. The plan incorporates a structured monitoring and evaluation framework, with scheduled reviews in 2025, 2028, and 2030. However, challenges remain in mobilizing the estimated 2,115 billion FCFA (3.25 billion USD) required for implementation. Effective coordination, strengthened governance, and sustainable funding mechanisms will be critical to ensuring the plan's success. Without significant financial and institutional support, achieving the ambitious health objectives may be difficult, risking continued disparities in healthcare access and outcomes.