| Health system challenges |
Insufficient health personnel Inadequately trained health personnel Inequitable distribution of resources Medical supply issues Constraints on the Ministry of Health Lack of protocols Overwhelmed hospitals in N’Djamena Insufficient/ill-equipped BEmONC/CEmONC services Traditional birth attendants (TBA) Insufficient blood donation services Weak supervision Weak referral system Disorganized services Inequitable access to health services Infrastructure issues Quality of care issues
|
| Population-related challenges |
Nomadic population challenges Low attendance: ANC, PNC, delivery, nonmaternal care, etc. Delayed care-seeking behaviours Patient expectations Low knowledge of MCH risks Low literacy/education Cultural beliefs Poverty/low socioeconomic status
|
| Specific maternal and child health threats |
Anaemia Children’s safety Communicable diseases: malaria, HIV, human African trypanosomiasis, sexually transmitted infections, and other infections Malnutrition Low vaccination coverage Street drugs Mental health Low access to contraception Gender-based violence Low contraception uptake Poor water, sanitation, and hygiene Mental health
|
| Country challenges |
Climate: rainy season and climate change Corruption Insecurity Urban versus rural differences Nongovernmental organization-related issues Infrastructure issues
|
| Policy challenges |
Free healthcare (Gratuité de Soins) policy Lack of/weak protocols TBA Political will Weak health information systems/health data Illicit sale of medications
|
