Chad
GaneshAID supported Chad in zero-dose child identification and Gavi funding application development — a country where conflict, displacement, nomadism and extreme geographic challenges combine to create one of the most complex immunisation equity environments in Africa.
Key Immunisation and Health System Challenges
Chad faces multiple, overlapping barriers to universal immunisation coverage. As one of Africa's largest countries by area, it combines vast geographic distances with a fragile health system, active conflict in several regions, large populations of refugees and internally displaced persons, and significant nomadic and semi-nomadic communities whose movement patterns make routine outreach extremely difficult.
Zero-dose children in Chad are found across all these contexts, requiring a differentiated analytical approach to understand which barriers are operating in which areas — and which interventions are most likely to be effective, acceptable and sustainable. GaneshAID supported the Ministry of Health in building this analysis and translating it into a Gavi funding application.
Chad's zero-dose challenge spans conflict displacement, nomadic mobility, rural remoteness and urban informality — each requiring different strategies, tools and partner configurations to reach children effectively.
GaneshAID Support in Chad
Zero-dose child identification and barrier analysis
Primary and secondary analysis responding to all key analytical questions from Gavi's Zero-Dose Analysis Cards ("identify" section). Additional qualitative data collection conducted where the country context required it. Analysis covered geographic coverage gaps, demand-side barriers, supply-side constraints and systemic factors — differentiated by community typology (conflict zones, rural, urban informal, mobile populations).
HCD ideation sessions for tailored solutions
Interactive ideation sessions facilitated in-person and/or remotely using Human Centred Design methodology. Sessions brought together Ministry of Health staff, EPI teams, NGOs, local CSOs and humanitarian actors to co-design new, tailored and sustainable solutions directly addressing identified barriers to reaching zero-dose children. Documentation of minutes, action items and follow-up assurance throughout.
Gavi funding application development
Development of a complete set of prioritised, sustainable programmatic interventions reflected in: (1) Theory of Change for Gavi investments; (2) the supporting country application narrative; and (3) the submitted work plan, budget and Monitoring & Learning Plan. All applications developed under Ministry of Health leadership with full EPI stakeholder engagement.
Operational Contributions and System Improvements
As part of an eight-country zero-dose programme, applications were developed successfully under the leadership of the Ministry of Health, with full engagement of EPI stakeholders including NGOs, local CSOs and humanitarian actors. The participatory approach built national analytical capacity beyond the immediate application cycle.
Ministry-led applications
All applications developed under Ministry of Health ownership — national propositions, not donor-driven products.
Differentiated barrier analysis
Zero-dose typologies and barriers identified by context: conflict zones, rural areas, urban settlements and mobile populations.
HCD-validated solutions
Tailored programmatic interventions co-designed with national stakeholders and validated through participatory ideation.
Partners and Ecosystem in Chad
Part of an eight-country zero-dose programme
This engagement is one of eight countries where GaneshAID provided participatory technical assistance for Gavi funding applications. The multi-country programme covered EAF, HSS, CCEOP and FPP funding streams, building a replicable model for equity-focused zero-dose programme design across fragile and low-resource contexts.