title: [An innovative approach combining human and animal vaccination campaigns in nomadic settings of Chad: experiences and costs].
abstract: 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 vaccinated before. The objectives of the project were to provide human vaccination in conjunction with existing veterinary services, to evaluate the feasibility and limitations of such campaigns, to determine what 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 series of 12 vaccination campaigns in the Chari-Baguirmi and Kanem districts, more than 2100 children, 2100 women and 52000 cattle were fully immunized. 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 excluding vaccine costs) was 15% in Gredaya where 3 out of 6 campaigns were carried out together with veterinarians and 4% in 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.
authors.affiliation: Centre de Support en Santé Internationale de l'Institut Tropical Suisse, N'Djaména, Tchad. mahamat.bechir@its-cssi.org
authors.forename: M
authors.initials: M
authors.lastname: Bechir
authors.forename: E
authors.initials: E
authors.lastname: Schelling
authors.forename: K
authors.initials: K
authors.lastname: Wyss
authors.forename: D M
authors.initials: DM
authors.lastname: Daugla
authors.forename: S
authors.initials: S
authors.lastname: Daoud
authors.forename: M
authors.initials: M
authors.lastname: Tanner
authors.forename: J
authors.initials: J
authors.lastname: Zinsstag
mesh_terms: D000293:Adolescent; D000328:Adult; D000822:Animal Husbandry; D000818:Animals; D002596:Chad; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion / Q000191:economics / Q000458:organization & administration*; D049673:History, 20th Century; D006801:Humans; D007223:Infant; D008297:Male; D014171:Transients and Migrants; D014611:Vaccination / Q000191:economics