Assessment of Ear, Nose, and Throat (ENT) Services in Tertiary Hospitals of N’Djamena: Human Resources, Technical Equipment, Clinical Practices, and Quality Indicators

Background: Otorhinolaryngological conditions represent a major public health burden in sub-Saharan Africa, where the shortage of specialists remains critical. In Chad, N’Djamena concentrates virtually all national ENT resources; yet no comprehensive assessment of its tertiary-level services has been conducted to date. Objective: To provide an exhaustive description of ENT services in N’Djamena’s tertiary hospitals with respect to human resources, technical equipment, task-delegation practices, continuing medical education, infection control, and quality indicators. Methods: A multicentre descriptive cross-sectional survey was conducted from 13 to 20 April 2026 in all six tertiary hospitals of N’Djamena with an identifiable ENT service (participation rate: 100%). A structured 80-item questionnaire was administered to department heads, and a composite quality improvement score (0 - 12 points) was calculated for each service. Results: The six departments collectively employed 10 ENT physicians (including two expatriates), with no certified audiologists or speech-language pathologists. Task delegation to allied health staff was universal but rarely governed by written protocols. Basic consultation equipment was broadly available; however, audiological functional investigation was virtually absent (speech audiometry, tympanometry, otoacoustic emissions, auditory evoked potentials: 0/6). Specialised surgery (tympanoplasty, functional endoscopic sinus surgery, mastoidectomy) remained highly limited. Thirty-four medical evacuations abroad were recorded over twelve months. No department had a formalised continuing education programme or accreditation. Quality scores ranged from 4 to 11 out of 12. Conclusion: ENT services in N’Djamena’s tertiary hospitals exhibit heterogeneous and constrained capacities, hampered by specialist shortages, a critical deficit in functional audiological investigation, and insufficient quality governance. Simultaneous strengthening of human competencies, technical infrastructure, and quality mechanisms is essential.