Illiteracy in Chad 1

Fighting Illiteracy in Chad: A Health Communication Intervention

Seth Boledovic
School of Public Health, University of Maryland
HLTH234: Global Health Messages: Understanding Exposure & Impact
Angshuman Kashyap
January 21, 2024
Illiteracy in Chad 2

Fighting Illiteracy in Chad: A Health Communication Intervention

Chad, located in North Central Africa is the fifth largest country in the African continent
by landmass. Most of the population lives by agriculture, which offers a key insight into the
literacy problem within the country (Chad | History, Flag, Language, Population, Map, & Facts
| Britannica, 2024). Chad has the lowest literacy rate of any country worldwide, with only 27%
of the population being literate, meaning that 73% of the population is unable to read and write
(Literacy Rate by Country 2024, n.d.). This problem stems from the low access to high-level
education within the country, according to UNICEF, “Three out of four students are supervised
by teachers whose highest level of education is not above secondary schooling.” With limited
access to education, parents being illiterate themselves, and many jobs within the country not
needing literacy techniques, it creates a chain reaction where nobody in any generation can teach
children how to read and write. It should be noted that due to social norms of women often
taking care of the house, the illiteracy rate among girls is higher than that of boys, as 77% of
girls aged 15-24 are illiterate (Education | UNICEF Chad, n.d.). Throughout the rest of this
paper, I will put forth an idea, and discuss the details for an intervention on how we can deal with
the health problem of illiteracy, especially among children and young adults in Chad.

Health Behavior
My intervention will focus on teaching and promoting the learning of reading and writing
for children and young adults. This will be done through a variety of efforts that will be touched
on in later sections.

Health Outcome
As a result of the intervention, I hope to see a few main outcomes. First, there should be
an increase in literacy rates and therefore an increase in cognitive capabilities for children who
are literate when compared to those who are still struggling with literacy progress. Furthermore,
there should be some other changes that correspond directly to an increase in literacy. Higher
levels of literacy should cause a change in mortality rates due to an increase in understanding of
healthcare and healthcare resources. Patients will have an easier time reading medication
prescriptions and important health announcements that could be life-saving or add valuable years
to the end of one's life. Literacy also helps to pull people out of poverty, being literate a new
range of jobs opens up that are not just in the main agriculture sector. According to the World
Health Organization, 42% of Chad lives in poverty which contributes to a high level of hunger
amongst the youth. By pulling people out of poverty with new jobs, we hope the quality of life of
many families across the country increases (Human Rights Watch, 2023). Lastly, increases in
literacy have been seen to create improvements in self-esteem and mental health. This is
especially important when empowering women within the country, and teaching them to read
and write at a young age can make them feel better about themselves as they move forward into
adulthood.

Existing Interventions
There have been attempts to increase literacy and improve education in Chad in the past,
as well as some ongoing efforts. The Project to Strengthen Education and Literacy in Chad
(PREAT), is part of three national developmental plans set forth by the Chad government starting
in 2017 that will be carried out through 2030. This plan is supposed to cause action and the “aim
is to strengthen basic education in Chad, in a context of fragility requiring the preservation of
Illiteracy in Chad 3

educational provision and support for improving the quality of teaching and system management
(Project to Strengthen Education and Literacy in Chad (PREAT) | International Bureau of
Education, n.d.).” Although there is very little evidence so far of the intervention's success since
the intervention is very recent, the initial outlook seems positive as it is being backed by the
International Bureau of Education. Another intervention aiming to tackle illiteracy within the
country is the “Chad Improving Learning Outcomes Project”. This intervention plans to increase
access to primary education while also focusing on teaching, especially the quality of that
teaching, in areas of reading, writing, and math. The project aims to help strengthen the
recruitment and financing of school teachers, specifically community teachers. This is important
as a large portion of the population cannot attend public school, or they choose not to attend so
they rely on community members for schooling. However, this still does not tackle the students
who live in very rural areas, so my intervention will include a piece specifically targeted at rural
accessibility (Chad to Improve Learning Outcomes in Basic Education, n.d.). Once again, sadly,
this intervention is ongoing and the grant was not approved until midway through 2022. In 2018
the government of Chad decided to implement an Interim Education Plan (PIET) which covers
all educational sub-sectors. The plan defines priorities within the development of pre-school
provision, properly equipping classrooms, and properly training teachers. This plan was a
success, from 2016 to 2021 there was almost a 4% increase in literacy, and this interim plan was
extended after 2020 (Project to Strengthen Education and Literacy in Chad (PREAT) |
International Bureau of Education, n.d.).

Known Barriers
When looking at the accessibility of interventions within Chads’ population, we must
look at the rurality of the country itself. Although there are a decent number of urban areas, they
are not the ones that cause issues. Rather it is the rural agricultural areas that will have the most
issues being reached, and they are also the population with the highest illiteracy rates. The
people who live in these areas may also need more convincing when presenting our message.
Most of them work in the agricultural sector which does not need literacy to properly function.
They might also have set times in which their work needs to be done, so in-person availability
could be difficult. Reaching the masses when everyone is spread out is a daunting task for any
form of intervention. When looking at the current education breakdown of Chad it is not strong,
and this makes intervention very difficult to implement as well. You need educators to teach
people to read and write, especially children, the basics of reading and writing. However, with
the vast majority of educators never going past secondary schooling, many of them cannot teach
the children what they need. This creates an issue for this intervention, we need to focus
resources on recruiting people to educate who are capable while also thinking about funding the
addition of external educators from different countries who are fluent in the common languages
of French and Arabic.
Another barrier regarding the implementation of any literacy intervention is how one
spreads the word that any intervention is even going on. One must remember their target
audience is unable to read or write, so anything involving written language is practically useless.
If you are on a budget mass media campaigns lack affordability unless large stake grants are
approved. Many of these people also live in poverty and do not have access to TV, especially in
rural areas, therefore one must think in much detail about the best way to tackle the problem at
hand. Finally, Chad has suffered from multiple humanitarian crises and also has suffered from
the effects of other countries' crises, especially within the past 10 years. Currently, there are over
Illiteracy in Chad 4

600,000 refugee children within the country, many fleeing from Sudan. All of these children are
also adding to the illiteracy rates within the country and accommodations should also be made to
some extent to reach the children within the refugee camps (although this will not be the main
focus of the intervention).

Key Influencers
Multiple key influencers will play a large role in the institution and implementation of
this intervention. The first key influencers are the educators who are at the organizational level,
these will be the people who interact with the children and young adults the most and are the
ones mainly instilling knowledge into the younger generation. Within the interpersonal level, we
have parents and grandparents, these are the main influences on children within the home. To
promote the development of literacy for children it is integral that we have support of the adults
within their households and communities. Another set of influencers at the organizational level
are healthcare workers. Healthcare workers should be able to promote the benefits of literacy and
help promote our intervention within their spaces. By having them explain to children and their
parents the benefits of literacy, and specifically health literacy for their case we can reach more
people and hopefully save lives. The last key influencers which are at the highest level of the
socio-ecological model are the public policy leaders and government officials. To have any
intervention work you need the backing of the people at the highest level. By influencing policy
and getting the support of the government you can reach the most amount of people and
therefore make the greatest impact possible.

Target Audience
Through this intervention, we plan to increase the literacy of young children and young
adults so therefore we must target the populations that can provide the necessary resources to
these members of society. The most important target audience is the parents of these children.
We want to reach as many people as possible so therefore mothers and fathers in rural and urban
areas will be targeted, even though each comes with their own sets of challenges. By targeting
the parents we hope they will put their children in a position where they can be educated and
learn to read and write, without the parent's support this becomes very difficult as they may not
send their children to school and rather have them work around the house or on the farms (if they
live in a rural area). The second audience we must target is the educators themselves. This is the
audience that we need to teach the children and provide them with the knowledge. Without
educators realizing the importance of their job it is difficult to make a change, and the illiteracy
epidemic that is currently ravaging the country will continue. Once again though, the educator's
job is not important unless the parents send them to school in the first place, or allow the
educators into their homes. The last audience our intervention will target is the healthcare
workers. We want to use the healthcare workers as an extra catalyst for the parents to understand
the benefits of literacy. We hope that the healthcare workers already know these benefits, but are
willing to be convinced to push these benefits onto other members of the community. Targeting
all of these members of society, while having a heavier focus on mothers and fathers, we hope to
improve the literacy of the younger children and adults within both the urban and rural
communities of Chad.
Illiteracy in Chad 5

Channel
Multiple channels will be used throughout the intervention, ranging from individual to
mass communication. On the individual level, anyone who goes into a healthcare setting will be
given resources by a healthcare professional on the benefits of literacy and this will allow for a
personal one-on-one conversation between parents and health professionals. Individual
conversations will also happen in education settings between parents and educators about
supporting reading and writing within the home. Hopefully, conversations will occur in the
workplace regarding the economic benefits of literacy, however, this will not be a main focus
throughout the intervention period. Using interpersonal communication a hotline will be made in
which parents (and anyone else interested) can call and learn about different resources over the
phone due to the difficulty of understanding any form of written information for most of the
population. Using group communication will also be an important aspect of pushing our health
behavior. Using community seminars and radio programs we would create a sense of
togetherness in fighting the issue. This will also bring members of more rural communities
together to discuss the issues and allow intervention workers and educators to reach as many
people as possible. Lastly, mass communication will be useful for reaching as many people
across the country as possible. Posters in high-traffic areas depicting images of the intervention
message along with TV ads with important messages and images will be used.

Message
The message for the intervention will be aligned with the health behavior goal talked
about in the opening sections of promoting the learning of reading and writing for children and
young adults. Using different communication channels images of educators and parents
supporting children's reading and writing will be displayed, showing that literacy is a group
effort. Healthcare professionals, educators, and other intervention members in their conversations
with parents and other professionals will help to instill the spoken message of “Supporting your
child learning to read and write will allow them to take care of themselves and you(parents) as
they grow older, along with allowing them to earn more money for their eventual families.” We
want the parents to be able to see some of the benefits of having their child be educated so we
can create a shockwave effect through future generations.

Intervention
My intervention will have a lot of working components to reach as many people within
our target area as possible. The first part of the intervention involves the media campaigns that
will be run in both the rural and urban areas. To start we will be running these campaigns in
N'Djamen which is the largest city and the capital of Chad along with communities in the
southern region of Hadjer-Lamis which is north of the capital. This area is much more rural and
the people in this region will have limited contact with those that live in the city allowing us to
analyze the data from both regions separately to make future changes. These media campaigns
will include posters with pictures displaying our message and other images promoting parents
supporting the literacy of their children. These are put in huge traffic areas such as outside stores,
on transportation, within the workplace, and in healthcare settings. T.V. ads will also be run
across the areas, however, for people in rural areas who do not have access to T.V. they will be
shared over the radio. This will not be as effective since no images can be shown but it is one of
the challenges that we face during implementation.
Illiteracy in Chad 6

Across both regions, we will instill a hotline that parents, educators, or anyone else
interested can call and learn about the intervention and gain literacy resources to help their child
succeed. This hotline number will be given to all students at school as a part of a packet to take
home to their parents. Children who do not go to school will not have access to this packet,
however, the number will still be displayed on all of the posters posted in the community and be
displayed within workplaces and healthcare facilities. People manning the hotlines will be able to
answer questions ranging from the importance and benefits of literacy, to how one can support
their child, where to send their child for help, and much more.
Furthermore, group discussion sessions will be run by trained educators to answer
community questions in person. This will be extremely helpful for tight-knit rural communities,
as it promotes a sense of togetherness in this task. Invitations will be sent out to community
members who have children under the age of 21, however, anyone is welcome to attend. These
group sessions will be run once every two weeks in a set location, within the cities there will be
more than one location due to the vast amount of people. A single location would not suffice in
accommodating the number of parents that we hope would show up, this also reduces travel costs
for individuals who are coming from farther out.
When parents go into a healthcare setting they will be invited to discuss the benefits of
literacy with healthcare professionals, the same way it would be done in group discussions
except this is a one-on-one conversation. This would ensure that they can get personal questions
answered that they may not want to discuss with their peers in a group setting. The same types of
conversations will be held in education settings, having talks with children and parents alike will
be beneficial to pushing our health behavior.
The last, and arguably the most important portion of this intervention will be the teaching
of students and children. Educators who are fluent in both Arabic and French can volunteer to
run specialty classes within the areas and teach these languages to the students. Parents can either
enroll these students in classes themselves, or the public schools can offer the classes (if the
government wishes to support this intervention a portion of each school day could be taken to
promote reading and writing in public school). These educators can be either citizens of Chad
who are fluent in the language or volunteers from other countries who wish to help out. Due to
unlimited funding, these volunteers will be paid for their duties and housing will be given. For
rural areas these volunteers can be requested to give lessons at the citizen's house, this would
give special access to people who live in these areas and are not able to attend school as often if
at all.

Evaluation Plan
Process Evaluation:
Each part of the intervention will have its process evaluation technique to get raw data on
how many people are being reached. Although it is impossible to track the number of people
seeing posters, T.V. ads can be tracked and the number of people tuning in at the times the ads
are run will be noted down and processed. Group sessions will have headcounts for every session
and the number of attendees will be tracked. I will collect call logs from the hotline and then be
able to confirm these calls using the caller's phone number. Volunteers will perform qualitative
phone calls after a few weeks to determine how much the conversation helped and what they
remembered about their earlier conversation. Although healthcare workers are unable to share
specific information regarding what they talk about with patients, a rough count can be done. We
will not know anything about the demographics in this case, however, we will know the number
Illiteracy in Chad 7

of people who had a one-on-one conversation which is good information. Lastly, the public
school system already tacks attendance, and therefore getting a count of who was coming to
school during those lessons should be relatively easy and we should also be able to track which
of these students' parents are attending other parts of the intervention such as the group sessions.

Outcome Evaluation:
The intervention will last for a total of a year with qualitative focus group discussions
happening at the beginning, halfway point, and end of the intervention process. These focus
groups will be with parents, educators, and any other members of the community who want to
share their opinions. These members will be randomized community members who either teach
children or members of the community with children under the age of 21. Each focus group will
have approximately 20 members and gather feedback on the implementation and workings of the
intervention. Gathering data from some of our key target audiences and influencers is important
for future work. One focus group will be done in the rural community and one in the urban
community to get opinions from all intervention groups. Alongside these focus groups, a
randomized pre- and post-design will be implemented to test the literacy of children and young
adults. Every child under the age of 21 will be mailed a survey(to get the most responses
possible) and this will be a basic literacy exam. Test scores from the initial and final survey will
be evaluated to see if there is a change in literacy amongst the children. Surveys will also be
mailed to the parents of these children and they will have questions about whether or not the
parents support having their child learn to read and write and whether they understand the
benefits that coincide with it. Together these methods should give a good indication of how well
the intervention worked in promoting healthy behavior and improving literacy.

Intervention Effects:
I hope to see that my intervention had a positive impact on the literacy rates of children
and young adults within the regions of Chad where the intervention took place. I also hope that
parents are more supportive of their child learning to read and write and are aware of the benefits
that come alongside literacy. Hopefully, this intervention will create a long-lasting domino effect
in which each new generation has a higher literacy rate than the last. This domino effect will
hopefully bring along other benefits such as lower mortality rates and better mental health for
these populations.
Illiteracy in Chad 8

References
Chad | History, Flag, Language, Population, Map, & Facts | Britannica. (2024, January 19).

https://www.britannica.com/place/Chad

Chad to Improve Learning Outcomes in Basic Education. (n.d.). [Text/HTML]. World Bank.

Retrieved January 20, 2024, from

https://www.worldbank.org/en/news/press-release/2022/04/15/afw-chad-to-improve-lea

rning-outcomes-in-basic-education

Education | UNICEF Chad. (n.d.). Retrieved January 20, 2024, from

https://www.unicef.org/chad/education

Human Rights Watch. (2023). Chad: Events of 2023. In World Report 2024.

https://www.hrw.org/world-report/2024/country-chapters/chad

Literacy Rate by Country 2024. (n.d.). Retrieved January 20, 2024, from

https://worldpopulationreview.com/country-rankings/literacy-rate-by-country

Project to Strengthen Education and Literacy in Chad (PREAT) | International Bureau of

Education. (n.d.). Retrieved January 20, 2024, from

https://www.ibe.unesco.org/en/project-strengthen-education-and-literacy-chad-preat