Utilisation d'un centre de sante par des pasteurs nomades arabes - Une etude de cas au Kanem; Tchad

Attendence at a rural health centre in a nomadic setting was monitored over seve ral months to gain insight into factors determining accessibility to permanent primary health facilities by nomadic people. Multiple interactions between favorable and unfavorable fa c t o rs for health care seeking in a nomadic setting we re identified for a health care center part i c u l a rly appreciated by pastoral nomads

Quels types de service de sante pour les populations nomades? Apprentissages des activites de recherche et d'action au Tchad

To overcome barriers of access to health care of nomadic people and to alleviate inequities in health; a transd isciplinary team has initiated research and intervention activities among three nomadic groups of Chad: Foulbe; A rabes and G o u ranes. A regular and consistent commu n i c ation among all actors involved (nomadic groups; re s e a rchers; planners and administrators of health and veterinary services; etc.) through repetitive meetings and workshops showed to be a crucial element for success. Differences between ethnic nomadic groups made it necessary to develop specific communication strategies adapted to each group. As to interventions to improve the va c c i n ation cove rage; m i xed teams combining health and veteri n a ry specialists were able to vaccinate an important number of children and women and showed to have a high potential in terms of o rga n i s ational and logistic feasibility; acceptability as well as good cost-effe c t iveness. With rega rd to improving access to health care; Information - Education and Communication approaches adapted to the intervention context and linked to the provision of essential services and generic drugs showed to be crucial

Approche novatrice des vaccinations en sante publique et en medecine veterinaire chez les pasteurs nomades au Tchad: Experiences et couts

The purpose of this report is to describe a network of public health care workers; veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been va c c i n ated befo re. The objectives of the project we re to provide human vaccination in conjunction with existing ve t e ri n a ry serv ices; to evaluate the feasibility and limitations of such campaigns; to determine wh at other services could be provided concurrently; and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a s e ries of 12 vaccination campaigns in the Chari-Baguirmi and Kanem distri c t s ; more than 2100 children; 2100 women and 52000 c attle we re fully immu n i ze d. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e. ; personnel; transportation and cold chain costs ex cluding vaccine costs) was 15in Gre d aya where 3 out of 6 campaigns were carried out together with veterinarians and 4in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative; appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities; vaccination can be provided to nomadic children and women in countries with limited resources