Towards Integrated and Adapted Health Services for Nomadic Pastoralists and their Animals: A North–South Partnership

Abstract

Mobility of pastoralists in arid and semi-arid zones renders access to primary social services difficult. The experiences, local concepts and propositions of nomadic communities of Chad were essential to fill the information gaps on how to provide adapted health services to mobile communities. In Chad, we have taken an iterative, corkscrew-like research and action strategy: a better understanding of the determinants of health and communities’ health priorities – obtained by interdisciplinary collaborations between medicine, anthropology, epidemiology, social geography and microbiology – were integrated in the participatory identification of intervention options out of a range of possible responses by the health and veterinary services. Recommendations from national stakeholder workshops paved the way for implementing and testing new interventions. All stakeholders reviewed outcomes of interventions periodically. The programme provided opportunities for participatory processes and actions that were defined in an open way at the beginning. An appropriate North–South research partnership framework and the long-term commitment of all partners have been crucial in the process of building stakeholders’ ownership. University curricula rarely enable scientists to communicate with other disciplines, and researchers first needed to acquire skills in crossing the boundaries between human and natural sciences and between sectors. We describe here in a chronologic way the elements that led to innovative health and veterinary services for nomadic pastoralists of Chad; such as joint vaccination services of the public health and the livestock sectors and subsequent initiatives that were initiated by the nomadic communities once they began to trust the programme.