Chad’s routine immunization gains offer lessons for fragile settings
Chad has reached an important milestone in routine immunization: coverage for the third dose of the pentavalent vaccine (DTP-HepB-Hib3) increased from 41% in 2016 to 71% in 2025, according to the 2026 WHO/UNICEF Estimates of National Immunization Coverage (WUENIC). Over the same period, investments in service delivery and logistics helped improve the functionality of the cold chain from 27% in 2017 to 86% in 2025.
This progress reflects a sustained national effort led by the Ministry of Public Health and Prevention, with technical and financial support from WHO, UNICEF, Gavi, the Vaccine Alliance, and other partners. Key actions included stronger use of data for decision-making, implementation of the Reaching Every District approach, district microplanning, integrated supportive supervision, strengthened community engagement, and better alignment between routine immunization and supplementary immunization activities.
Particular attention was given to children in hard-to-reach areas, including nomadic, refugee and displaced populations. Advanced and mobile strategies, community dialogue and coordination with local, traditional and religious leaders helped maintain services despite insecurity, population movements, flooding risks and limited resources.
However, challenges remain. The pentavalent dropout rate between the first and third doses was still 17% in 2025, and coverage gaps persist between provinces and districts. Recent measles outbreaks highlight the need to continue identifying and reaching zero-dose and under-immunized children.
As Chad prepares for the Gavi 6.0 programming cycle for 2026-2030, the country aims to consolidate these gains by strengthening primary health care, improving cold chain capacity, expanding equitable outreach and sustaining partner alignment around one national immunization plan. The next priority is clear: move from national progress to protection for every child.
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Authors:
Dr Paluku Gilson(Team Leader VPD/WHO); Dr Mbaihol Tamadji (Immunization officer/WHO); Dr Anya Blanche (WR/WHO); Dr Abdoulaye Annour Idriss (EPI manager) ; Dr Djimornan Djikini (Head of Immunization Unit/MoH); Dr Gouaye Daiba (Head of data manager Unit/MoH); Dr Laldjimbaye Koulando (Head of Planning Unit/MoH)
Organization:
WHO Chad and Expanded Programme on Immunization, Ministry of Public Health and Prevention, Chad
Photo credits: WHO Chad