Despite the start of oil production in 2003, around 40% of Chad’s population lived below the poverty line as of 2018. The population will continue to grow rapidly because of the country’s very high fertility rate and large youth cohort – more than 65% of the populace is under the age of 25 as of 2022 – although the mortality rate is high and life expectancy is low. Chad has the world’s second highest maternal mortality rate as of 2017. Among the primary risk factors are poverty, anemia, rural habitation, high fertility, poor education, and a lack of access to family planning and obstetric care. Impoverished, uneducated adolescents living in rural areas are most affected. To improve women’s reproductive health and reduce fertility, Chad will need to increase women’s educational attainment, job participation, and knowledge of and access to family planning. Less than a quarter of women are literate, less than 10% use contraceptives, and more than 40% undergo genital cutting.

As of December 2022, more than 403,000 refugees from Sudan and more than 120,000 from the Central African Republic strain Chad’s limited resources and create tensions in host communities. Thousands of new refugees fled to Chad in 2013 to escape worsening violence in the Darfur region of Sudan. The large refugee populations are hesitant to return to their home countries because of continued instability. Chad was relatively stable in 2012 in comparison to other states in the region, but past fighting between government forces and opposition groups and inter-communal violence have left more than 380,000 of its citizens displaced in the eastern part of the country as of 2022.