When nomadic pastoralists began returning to Chad from Nigeria and Cameroon about a month earlier than usual due to security threats in those countries, it presented a rare and urgent opportunity to deliver life-saving vaccines. Within just 48 hours, national and provincial health and livestock teams, working with the Lake Chad Basin Cross-Border Polio Project (LCB), mobilised to reach these mobile populations while they were within range, protecting both children and animals from diseases that could spread across borders.
Nomadic households make up 3.4% of Chad’s population, according to the 2009 census, yet their mobility means children in these communities are often missed during routine immunization campaigns and even at transit vaccination sites, as they may not pass through formal routes. This leaves immunity gaps, increases their vulnerability to preventable diseases, and heightens the risk of poliovirus transmission across districts and borders.
In 2016, the Government of Chad established the National Program for the Health of Nomadic, Island, Hard-to-Reach, Displaced, and Refugee Populations to close these gaps and expand equitable healthcare access. By 2024, the Ministry of Health had introduced integrated animal and human vaccination as part of its strategy to support universal and equitable healthcare access. To support government initiatives in this regard, the Lake Chad Basin Cross-Border Polio Project (LCB), funded by the Gates Foundation and implemented by Solina Health, works closely with the Regional Lake Chad Basin Task Force to interrupt cVDPV2 transmission in Niger, Nigeria, Chad, and Cameroon through effective multi-country collaboration. The project supports WHO AFRO’s efforts by improving immunization coverage and the quality of SIAs through coordinated cross-border planning, improved microplans and demand generation, and enhanced service delivery methods; strengthening cross-border community-based AFP and other vaccine-preventable disease surveillance through targeted screening of children under 15; and enhancing polio data reporting, documentation, and cross-border information sharing.
During data collection at Places of Interest such as IDP camps, nomadic settlements, health facilities, fishery communities, etc, and supportive supervision for the Polio Supplementary Immunisation Activity (SIA) in Mani district, the Solina Population Mobility Expert identified a unique opportunity that aligned with the LCB’s mandate. Nomadic pastoralists were returning from Nigeria and Cameroon about a month earlier than expected due to security threats, creating a brief window to reach them while they were within range. The decision was made to co-organise an integrated vaccination campaign just two days after SIA Round 2, mobilising both human and animal health teams to protect children and livestock.
The first step was to secure advocacy and planning at the national level. An advocacy meeting was held with the National Nomadic Program based on the nomadic pastoralists’ movements in the field. Together, Solina and the Nomadic Program co-developed and submitted terms of reference, including budget and vaccine requests, to the Chadian Ministry of Health Permanent Secretary to ensure vaccine availability and transport to the provincial level. Solina provided technical support and financial contributions, with 20% of operational costs covered by the LCB project and 80% by the National Nomadic Program. Financial and technical resources were mobilised, and vaccination reporting tools were developed or updated to guarantee accurate and timely data collection.
This was followed by community dialogue at the provincial level. District health authorities, the Provincial Ministry of Livestock, traditional leaders, and nomadic herders were engaged to create awareness of the integrated vaccination, agree on campaign dates, and confirm official launch activities. Vaccination sites were identified, and mixed human–animal vaccination teams, together with nomadic social mobilisers, were trained on reporting tools, antigens to be administered, integrated service delivery, and management of adverse events following immunization. All campaign actors were listed and briefed to ensure clarity of roles.
Vaccination delivery at the provincial level was adapted for maximum efficiency. Dates were adjusted based on real-time information from nomadic mobilisers and weather conditions, vaccination was provided in pirogues and across the river to reach all settlements, and daily review meetings were held with the vaccination teams and the Nomadic Program to track progress and address issues on the spot. Daily campaign reports provided accountability for both coverage and resources.
Finally, evaluation and planning for upcoming rounds were conducted. Debrief meetings with provincial teams and the National Nomadic Program assessed the implementation of Round 1, reviewed operational challenges such as the vaccination card stockout, and agreed on adjustments for future campaigns. Lessons learned were integrated into the planning for subsequent rounds to improve resource use and community engagement.
The results of this rapid, integrated intervention were significant. Within twelve days, 1,050 children were vaccinated with OPV, representing 87.5% of the 1,200 targeted. Children also received all eligible routine immunization antigens, with their details recorded to improve tracking and follow-up. On the animal health side, 6,657 livestock were vaccinated against bovine respiratory disease and ovine pasteurellosis, safeguarding pastoralist livelihoods alongside child health gains. In addition, 13 pregnant women were vaccinated against tetanus and diphtheria, and four mixed vaccination teams were deployed across four sites to ensure comprehensive coverage.
Rapid mobilisation in response to shifting circumstances is essential; the decision to launch just two days after the polio SIA was critical to reaching these communities.
- Community relays among nomadic groups are an effective mobilisation channel, provided that movement updates are shared consistently among all relays.
- Field-based technical expertise accelerates planning and stakeholder alignment.
- Enhanced data tracking has clear value, though early recruitment of qualified data clerks will be prioritised in future rounds.
- The vaccination card stockout underscored the need for proactive commodity risk mitigation.
- Above all, the strong leadership of the National Nomadic Program was central to coordinating resources and aligning partners behind the campaign.
Looking ahead, preparatory visits will take place in the Massaguet and Moito resting areas to brief stakeholders and run awareness sessions during weekly cattle markets. The second round of the integrated vaccination will be implemented alongside cholera awareness and malaria drug distribution, followed by Round 3 happening around 13–22 September. This integrated approach, anchored in national leadership, community engagement, and agile delivery, has proven effective in bridging access gaps for mobile populations. The next two rounds offer the opportunity to embed these operational lessons into future campaigns across the Lake Chad Basin, ensuring that nomadic communities continue to be protected and their livelihoods preserved.g
