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To find a detailed description of the institutional contexte in Chad: -> see this section

"Initiative solidarité santé sahel" (I3S) in Chad

Two projects have emerged in order to respond to this problem:


1) The health sector support project in Chad 1 (PASST 1) (initiated in 2009, closed in 2014),

2) The Chad Health Sector Support Project 2 (PASST 2) (since 2015) financially supported by the French Development Agency through the I3S program and by the MUSKOKA fund.

There are four main components for PASST 2, the contracting authority for which is the Ministry of Public Health:

In addition to this, you need to know more about it.

  • Component 1 (= Objective 1): Strengthening the technical and operational capacities of the MSP at all three levels of the health system

  • Component 2 (= Objective 2): Strengthening of care structures (supply and quality)

  • Component 3 (= Objective 3): Training of health personnel including midwives (initial, continuing), nurses (initial, continuing), and doctors (continuing)

  • Component 4 (= Objective 4): Health financing and solidarity mechanisms for the exemption from payment for care for pregnant women and children under 5 years old

Overall, I3S aims to strengthen the healthcare offer, improve free healthcare mechanisms for pregnant women and children under 5 and support the Chadian authorities in the mobilization in favor of universal health coverage. More specifically, the aim is to strengthen the MSP's free management unit, to experiment with the expansion of the financing of the health care offer for pregnant women and children under 5 through actions pilot projects in N'Djamena and in the Moundou region, set up a health observatory in the Logone Occidental region (Moundou) and support the development of the national policy for universal health coverage.


The research questions focus on the institutional, sociological, and political aspects of the feasibility of extending health coverage. Another part of the research project will focus on the effectiveness and expected impacts of the free of charge strategy chosen by the Chadian government as part of the I3S initiative.

The main questions we want to answer are following:

  1. Effectiveness of the free health care mechanism: in what way and under what conditions can the exemption mechanism constitute a universal health coverage mechanism in Chad?

  2. Impact of the mechanism: to what extent and in what way do the exemption mechanism and the accompanying measures for the free health care policy help to increase the use of healthcare and reduce maternal and infant mortality? (epidemiological and cartographic analyzes)

  3. How resilient is the local health system in the context of the interventions?

  4. Was the governance architecture of social protection in Chad, a truly deliberative decision?

  5. What are the different health financing regimes, and what are the levels and orders of coordination between them?

Current projects

1. The effectiveness of free access mechanisms

Project members: Alexandre DUMONT (CEPED (IRD)), Wendyama Charles KABORE (IRSS), Ahmat Malick Ousman (BASE), Ramadan Kagonta (BASE), Dahab Manoufi (BASE), Valéry RIDDE (CEPED (IRD))

2. The effects of free education: spatial analyzes

Project members: Emmanuel BONNET (RESILIENCES (IRD)), Ratnan NGADOUM (University of N'Djamena), Dahab MANOUFI (BASE)

3. Study on the resilience of the health system

Project members : Idriss Ali Gali-Gali (BASE), Dahab MANOUFI (BASE), Valéry RIDDE (CEPED (IRD))

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