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Chad is a country with an approximate area of 1284 thousand sq. km. (UNO, 2001). Its population is 8.854 million, and the sex ratio (men per hundred women) is 98 (UNO, 2004). The proportion of population under the age of 15 years is 47% (UNO, 2004), and the proportion of population above the age of 60 years is 5% (WHO, 2004). The literacy rate is 54.5% for men and 37.5% for women (UNESCO/MoH, 2004).

The country is a low income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 2.6%. The per capita total expenditure on health is 17 international $, and the per capita government expenditure on health is 13 international $ (WHO, 2004). The main language(s) used in the country is (are) French and Arabic. The largest ethnic group(s) is (are) Toubou forming the majority in north, Arab in the Sahelian zone and Sara in the Soudanian zone. The largest religious group(s) is (are) Muslim (half). The life expectancy at birth is 46.1 years for males and 49.3 years for females (WHO, 2004). The healthy life expectancy at birth is 40 years for males and 42 years for females (WHO, 2004).

EPIDEMIOLOGY

There is a paucity of epidemiological data on mental illnesses in Chad in internationally accessible literature. Katz and Katz (2002) found that social strain accounted for a significant proportion of variance in depressive symptoms and somatic complaints of intellectually disabled people.

MENTAL HEALTH RESOURCES

Mental Health Policy A mental health policy is absent.

Substance Abuse Policy A substance abuse policy is present. The policy was initially formulated in 1996.

National Mental Health Programme A national mental health programme is present. The programme was formulated in 1998.

National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. Details about the year of formulation are not available.

Mental Health Legislation Details about the mental health legislation are not available.

Mental Health Financing There are budget allocations for mental health. Details about expenditure on mental health are not available. The primary sources of mental health financing in descending order are out of pocket expenditure by the patient or family, social insurance and private insurances. The country has disability benefits for persons with mental disorders. Benefits are available only for public servants who get their full salary for the initial 6 months and then half the salary.

Mental Health Facilities Mental health is not a part of primary health care system. Actual treatment of severe mental disorders is not available at the primary level. Very few psychotropics are included in the essential drug list and treatment is difficult. Regular training of primary care professionals is not carried out in the field of mental health. There are no community care facilities for patients with mental disorders. Only traditional treatment is available at the community level.

Psychiatric Beds and Professionals

  • Total psychiatric beds per 10 000 population
  • Psychiatric beds in mental hospitals per 10 000 population
  • Psychiatric beds in general hospitals per 10 000 population
  • Psychiatric beds in other settings per 10 000 population
  • Number of psychiatrists per 100 000 population
  • Number of neurosurgeons per 100 000 population
  • Number of psychiatric nurses per 100 000 population
  • Number of neurologists per 100 000 population
  • Number of psychologists per 100 000 population
  • Number of social workers per 100 000 population
  • 0.02
  • 0.01
  • 0.01
  • 0
  • 0.01
  • 0.01
  • 0.01
  • 0
  • 0.01
  • 0

Non-Governmental Organizations NGOs are involved with mental health in the country. They are mainly involved in advocacy, promotion, prevention and rehabilitation.

Information Gathering System There is mental health reporting system in the country. Mental disorders are grouped as ‘other disorders’. The country has data collection system or epidemiological study on mental health.

Programmes for Special Population There are no special programmes for any population group.

Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: carbamazepine, phenobarbital, chlorpromazine, diazepam, haloperidol, levodopa. 


Source: World Health Organization Mental Health Atlas