Perceptions of the usefulness of external support to immunization coverage in Chad: an analysis of the GAVI-Alliance cash-based support

摘要: BACKGROUND: Chad is one of the countries supported by GAVI-Alliance that remains with unsatisfactory vaccination coverage. This paper tries to understand main barriers better METHODS: These were categorised as up or downstream against health system building blocks proposed WHO and compared activities identified country in its system's strengthening grant proposal approved GAVI Alliance 2007. Data collected using a modified Delphi analysis annual report documents. RESULTS: Most anticipated under are targeting (the neglect upstream issues major importance decentralised state like Chad) aligned with, not complementary to, immunization services activities. Further, both set cash grants blind important recommendations such need address at level leadership governance financing also about initiatives promote community demand services. CONCLUSION: In slow progress aggravated several contextual barriers: size country, low population density, nomadic nature significant part peoples, recent civil war, associated unrest political instability geographical localization. this situation it would be sustain operations focus ISS grant) while taking long term view needs system. The effectively supports operations, but neglects view.