Vaccination is a fundamental pillar of public health, effectively preventing many infectious diseases. However, in remote rural areas, equitable access to vaccination services remains a major challenge. The Kyab health district in Chad is a case in point, with a high proportion of under-immunized children. The aim of this study is to assess the effectiveness of the advanced vaccination strategies implemented in this district, identify the constraints encountered and formulate recommendations for improving vaccination coverage.This is a descriptive and analytical study conducted between November 2024 and March 2025. Of the district's 22 health centers, 15 managers were included. Data were collected using questionnaires administered to health center managers, and by mining secondary data from the district's vaccination database. Analyses were carried out using KoboCollect, SPSS and Excel software, and the results show that 90% of the villages covered are located in very remote areas, home to over 75% of the targeted children.
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