Chad

Poverty and Health Services

With desperate poverty in much of the country, over half the children in Chad are working before the age of 14. The employment-to-population ratio for women age 15 and over in Chad was 60.1, and labor force participation for women in that age group was 65.9 percent. Chad provides 14 weeks of maternity leave at 50 percent of the woman's salary, and there is also a prohibition against firing a woman while she is on maternity leave. Abortion in Chad is only permitted if necessary to save the mother's life. She must consent (unless it is impossible for her to do so), and the physician must have written approval from two other physicians, one of whom must be listed as an expert by the civil courts. It is illegal for a woman to induce her own abortion or to import drugs to induce abortions. However, illegal abortion remains common, and most cases of abortion are ignored by the legal system.

The French occupied Chad from 1897, but apart from some health services in the capital, N'djaména, mainly for the Europeans and the local [Page 177]elite, there was little effort to provide health care in rural parts of the country. After full independence in 1960, Chad's new government sought to improve the country's infrastructure, and to build clinics and establish a system of midwives in the countryside. However, as with many other parts of former French west Africa and French central Africa, the sheer remoteness of many isolated settlements make it very difficult for local mothers to access quality health and midwifery services. It has also been hampered by the lack of funds; Chad spends about $7 per head on health services, and there is still only one national hospital, 64 district hospitals, and 911 regional health centers. In 2004, there were only 345 doctors, 2,400 nurses, and 112 midwives for the entire country.

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