Screening of the 20-minute participatory video to members of the community in Goz kibine in Dogdore North.
Access to Healthcare

Redefining healthcare: when communities lead the way in MSF’s project in Chad

In Sila, eastern Chad, Médecins Sans Frontières (MSF) has set up a community-driven project, designing its health programme in partnership with the ministry of Health and local communities. In an area heavily affected by climate change, this initiative places the community at the heart of decision-making and implementation of activities, aiming to create a more sustainable and impactful healthcare model.

“Major floods in recent years have significantly reduced access to medical care,” says Honorine B. Uwaringenzi, MSF medical team leader in Sila. “MSF shifted its strategy to empower communities to own their healthcare, ensuring a more lasting and meaningful impact”.

Community members behind the camera

To illustrate this approach, community members were trained and actively filmed to produce a participatory video, capturing their day-to-day surroundings and their role in delivering healthcare. This powerful video offers a unique perspective, highlighting the collective efforts of the community and providing a different angle for anyone interested in community-based solutions.

Embedded in a chronic crisis

Marked by recurrent health outbreaks - such as cholera, Hep E, measles, diphtheria -, Chad faces a chronic health crisis. Weak official health structures, insufficient qualified personnel and shortage of supplies of medicines are exacerbating the situation. In addition, the lack of roads and means of transport, compounded by environmental changes like recurrent flooding, continues to further isolate villages and communities.

Throughout the years of intervention in Chad, MSF learned the limitations of setting up humanitarian aid models in Chad based on strengthening the public health system in formal health structures. This approach may question the sustainability of intervention models after MSF’s departure: how does MSF ensure the durability of its actions in a protracted crisis like Chad?

The project of MSF in Sila seeks to address this question by actively involving the community through a decentralized approach.

Co-creating care with communities for a sustainable change

"Community members face many barriers to access health structures, so early disease detection and treatment poses a significant challenge” explains Uwaringenzi, “Preventive measures with access to early screenings and treatments are essential and increase chances of a positive outcome in case of illness”.

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Article 24 July 2025