Constraints to scaling-up health related interventions: the case of Chad, Central Africa

This analysis of constraints to scaling-up health-related interventions in Chad shows that emphasis has to be put on systemic approaches which address absorptive capacity, on removal of structural constraints, and on efficient and equitable production of health services. In the production of services the development of infrastructure must not exceed the development of human resources. If the millennium development goals are to be achieved, major investments in basic and in-service training and in management skills are crucially needed. In addition, the study shows the importance of promoting health services which actively seek to fulfil community demands and those of disadvantaged groups.