The HRH situation in Chad can be characterized by insufficient quality and quantity of health workers. The situation has changed little over the past 5 years. There is currently an average of 3.7 physicians per 100,000 population and 2.1 nurses and midwives per 100,000 population (WHO AFRO, 2010), as well as geographic maldistribution of health workers, with 65% of physicians and 35% of nurses and midwives concentrated primarily in 1 region (Ndjamena) (Division de la Formation (DRH)/ Ministère de la Santé Publique (MSP), 2009). The need for initial and continuing training for health workers is challenged by an inadequate carrying capacity, lack of qualified teachers and teaching resources. Health worker attrition and demotivation result from inadequate wages and increased cost of living, lack of recognition, absence of career development, inadequate working conditions, and remoteness of certain regions coupled with a lack of transportation. A lack of national research and data on HRH is also a challenge (Plan stratégique de développement des ressources humaines pour la santé au Tchad, 2010).
Current HRH goals include:
- capacity building of staff managing health worker planning and computerization of HRH at all levels;
- increasing the number of health workers;
- equitable distribution among regional health structures according to standards specified in the strategic plan;
- strengthening capacity and production quality of national health worker training institutions;
- capacity building of mid-career health workers and staff motivation policies;
- establishing regulatory programs for HRH;
- developing a research culture in the health sector;
- establishing a framework for effective coordination; and
- adopting a clear policy of funding for training.
Chad has a significant number of partners involved in HRH development including: WHO, World Bank, EU, ADB, UNDP, UNICEF, UNFPA, AFD, AMPS, French Cooperation, Swiss Cooperation, German Cooperation for Development, Doctors Without Borders, Catholic Church, Order of Malta, and the EEMET.
COUNTRY COORDINATION AND FACILITATION (CCF) IN CHAD:
Chad has completed the following steps of the CCF process with the assistance of the Alliance:
- stakeholder identification and analysis at the country level;
- sensitization and orientation of stakeholders;
- creation of an HRH country profile;
- establishment of an HRH committee and technical working groups and their capacity building; and
- involvement of the HRH committee and technical working groups in developing an evidence-based, comprehensive, costed HRH plan.
Committee members include representatives from the following:
- development partners (WHO, AFD, EU, WB, UNICEF, ADB, UNFPA, national and international NGOs),
- the non-public sector, and
- the following ministries outside of the Ministry of Public Health:
- the Ministries of Planning, Finance, Education and Public Service and Labour, Social Action, National Solidarity and Family.
Chad is currently in the process of engaging stakeholders for resource mobilization, implementation, monitoring, and evaluation of the current HRH plan.
Health Workforce Data
- HRH Fact Sheet – Chad, WHO Africa Health Workforce Observatory Statistics (2010)
- Tchad Human Resources for Health Country Profile (2010)
HUMAN RESOURCES FOR HEALTH PLAN
Plan stratégique de développement des ressources humaines pour la santé au Tchad (Chad Strategic Human Resources for Health Development Plan), 2011-2020
HEALTH SECTOR STRATEGIES / PLANS
Country case studies & other documents
- Human Resources for Health: Requirements and Availability in the Context of Scaling-Up Priority Interventions in Low-Income Countries - Case studies from Tanzania and Chad