With extensive experience managing nutrition and development programs, Ibrahima Ndao is leading efforts to combat child mortality in Chad through vitamin A supplementation (VAS). As the project director for Nutrition International, he is at the forefront of a lifesaving initiative to provide children aged six to 59 months with high-dose vitamin A every six months, protecting them from preventable diseases and safeguarding their survival.

Operating in a context marked by high vulnerability, displacement and conflict, Ibrahima and his team work closely with the Ministry of Health in Chad, particularly the Directorate of Food and Applied Nutrition, to leverage their expertise to overcome logistical and systemic barriers, delivering measurable outcomes. In this Q&A, Ibrahima shares his journey, the unique challenges of working in Chad, and the innovative approaches that are driving the program’s success.

Read on to learn how Nutrition International is making a difference and why this work matters to those involved.

Can you please introduce yourself?

I am a trained food technology engineer and hold a master’s degree in nutrition and health. Between 2010 and 2011, I participated in a professional development program at Tulane University’s Department of International Health and Development in the United States.

I began my career with UNICEF in Senegal, then worked with the Rural Micro-Enterprise Promotion Project, funded by the International Fund for Agricultural Development (IFAD), where I served as a regional office manager in rural Senegal.

In 2007, I joined Nutrition International, where I have worked for nearly 15 years, holding various positions to support universal salt iodization, food fortification, and VAS programs. In 2022, I was invited to take on the role of project director in Chad.

What does your current role for VAS in Chad look like?

Nutrition International operates in Chad to ensure that children aged six to 59 months receive two annual doses of vitamin A supplements through biannual campaigns. We also support post-event coverage surveys (PECS) after each campaign.

As the project director, I am the main focal point for Nutrition International’s programming in Chad. My role involves ensuring the project is implemented in line with the organization’s vision, mission and values. I am responsible for achieving quality results within agreed timelines, supervising the team, and managing relationships with the government and other partners.

Why is VAS needed in Chad?

Vitamin A supplementation is a vital public health intervention to protect children from vitamin A deficiency. This deficiency makes them vulnerable to preventable diseases and death. Vitamin A strengthens their resistance to illnesses such as measles and diarrhoea, reduces the risks of stunting, and protects against vision loss.

It is considered one of the most cost-effective interventions for reducing child mortality. In Chad, where child mortality rates are among the highest in Africa, VAS is essential.

Nutrition International supports VAS in many different country contexts. What makes the Chad context unique?

Chad is one of the world’s poorest countries and faces a number of challenges. This year, severe flooding has caused significant damage, including loss of life, destruction of homes and ruined crops.

Moreover, Chad is surrounded by conflict-affected countries: Libya, Sudan, and the Central African Republic. It also suffers from attacks by Boko Haram; dozens of people recently lost their lives in a military base attack near Lake Chad. These crises have led to massive population displacements and an influx of refugees.

Finally, some areas in Chad are difficult to access, complicating the organization of supplementation campaigns. These factors make Chad’s context particularly challenging.

What is Nutrition International’s role in supporting the Ministry of Health to administer VAS and in procuring vitamin A capsules for the country?

Before 2021, VAS campaigns were irregular in Chad. For these campaigns to significantly impact child health and survival, they must occur twice a year, with an interval of four to six months.

Since the second half of 2021, Nutrition International has provided technical and financial support to the Ministry of Health to organize regular, biannual national campaigns. We also provide the full national supply of vitamin A capsules to Chad, funded by Canada, and in partnership with UNICEF.

We work closely with the DANA (Direction de l’Alimentation et de la Nutrition Appliquée) to plan these campaigns. This involves preparing training materials, data collection tools, micro-plans, budgets, and commodities distribution plans. Additionally, we provide logistical and financial support for field teams and supervision.

How would you describe Nutrition International’s approach to this work?

Our approach focuses on two main strategies:

1. Resource optimization: Wherever possible and appropriate, we integrate VAS campaigns with other campaigns, such as polio vaccination, to maximize available resources.
2. Strengthening coordination: We initiate advocacy meetings to improve collaboration between nutrition and vaccination teams. This has enhanced the integration of campaigns, making their implementation more harmonious and efficient.

We also prioritize building strong partnerships with the government and other stakeholders.

In what ways is gender equality considered when it comes to access to VAS?

There is no discrimination in access to VAS. We strive to reach all children, whether in homes, schools, churches, mosques, refugee camps or markets.

PECS results show that 95% of those responsible for children are women. Targeted awareness raising activities for these caregivers needs to be considered to be an effective strategy to strengthen children’s access to vitamin A.

Overall, can you share a key learning that has come out of VAS programming in Chad and how that learning is being utilized?

Here are three main lessons:

1. Seize opportunities for joint campaigns: Collaborating with vaccination teams, such as for polio campaigns, allows for resource pooling.
2. Prioritize door-to-door strategies: This approach is well-suited to Chad’s context
3. Conduct PECS after each campaign: These surveys help improve future campaign preparation and implementation by introducing corrective measures.

These lessons can be applied in other countries organizing VAS campaigns.

What motivates you in the work that you do?

What motivates me is the opportunity to contribute to saving children and lives. As long as I have this chance, I will continue to dedicate myself to this work.

Learn more about our work in vitamin A supplementation.

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