AFRICAN

Notes were taken during interviews
and we gradually noticed saturation of
data, namely the information collected
was less and less new. All interviews
were conducted in French. Data were
complemented by direct observations
in the field as all four authors were part
of the project implementation, and by a
document review, focusing on documents
produced as part of the project, such
as expert reports, quarterly progress
reports, handbook of procedures for PBF
implementation in Chad etc. Qualitative
data were treated and analysed manually,
using a content analysis with an inductive
approach. We used Stata 11 and Excel 2007
to carry out descriptive statistics for the
quantitative data to monitor trends in some
key indicators. The main limitations of the
data available and the analysis processes are
presented in the discussion section.
Quantitative results
Utilization of health services
The findings show that access to health
facilities increased generally for all
indicators, even if significant differences
were sometimes observed between
facilities. Key indicators selected from
indicators purchased in PHCs are
shown below. For all results the target
population was used as the denominator.
Considering all PHCs involved in the
pilot scheme, the proportion of children
immunized by pentavalent 3 increased
from 50% to 95%, and for vaccination
against measles it rose from 48% to
91% (Figure 1). Facility-based deliveries
(including caesarean sections) increased
from 17% to 40% (Figure 2), whilst
modern contraceptive prevalence rose
from 1.2% to 6.9% (not shown here).
Conversely, some indicators remained
almost stationary, with a noticeable
seasonal effect. That was the case for
new case of curative consultations for
under five in PHCs, which remained
between 40% and 60% on average, with
peaks of 90% to 115% between July and
October, i.e. during rainy season both in
2012 and 2013 (Figure 3). Similarly the
third antenatal visit ranged on average
between 18% and 25% with peaks around
30% to 40% between January and April
both in 2012 and 2013 (Figure 4). In
all cases, results demonstrated a clear
difference between regions, with those
in the south presenting higher indicators
Figure 1. Evolution of monthly coverage rate for pentavalent and measles
immunization (average figures calculated from data from all PHCs involved in
the project)
(%) Percentage
Vaccination pentavalent
100
80
60
40
20
0
Oct 11
Nov 11
Dec 11
Jan 12
Feb 12
Vaccination anti-measles
Mar 12
Apr 12
May 12
Jun 12
Figure 2. Evolution of monthly coverage rate for assisted deliveries (average
figures calculated from data from all PHCs involved in the project)
(%) Percentage
Jul 12
Batha and Guera Mandoul and Tandjile Global
60
50
40
30
20
10
0
Oct 11
Nov 11
Dec 11
Jan 12
Feb 12
Mar 12
Apr 12
May 12
Jun 12
Figure 3. Evolution of monthly coverage rates for new curative consultations
for under 5 (average figures calculated from data from all PHCs involved in
the project)
(%) Percentage
Figure 4. Evolution of monthly coverage rate for third antenatal visit (average
figures calculated from data from all PHCs involved in the project)
(%) Percentage
Jul 12
Batha and Guera Mandoul and Tandjile Global
120
100
80
60
40
20
0
Batha and Guera Mandoul and Tandjile Global
60
50
40
30
20
10
0
Oct 11
Oct 11
Nov 11
Nov 11
Dec 11
Dec 11
Jan 12
Jan 12
Feb 12
Feb 12
Mar 12
Mar 12
Apr 12
Apr 12
May 12
May 12
Jun 12
Jun 12
Jul 12
Jul 12
Aug 12
Aug 12
Aug 12
Aug 12
Sep 12
Sep 12
Sep 12
Sep 12
Oct 12
Oct 12
Oct 12
Oct 12
Nov 12
Nov 12
Nov 12
Nov 12
Dec 12
Dec 12
Dec 12
Dec 12
Jan 13
Jan 13
Jan 13
Jan 13
Feb 13
Feb 13
Feb 13
Feb 13
Mar 13
Mar 13
Mar 13
Mar 13
ISSUE 20 • SPECIAL ISSUE ON UNIVERSAL HEALTH COVERAGE 39