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

RESUMO

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