Ending preventable deaths in Togo

New

The world has never possessed such an arsenal of interventions and policies for curing disease and prolonging life. Sadly, the power of these interventions is not matched by the power of health systems to deliver them comprehensively and on an adequate scale to those in greatest need. Togo’s healthcare system is one of the most chronically underfunded and understaffed in West Africa, and is consequently insufficient in procurement, distribution and the quality of basic care provided. Integrate Health has created a community-led low-cost model to make high-quality primary healthcare available to the Togolese population. We’re supporting them to scale it up with the aim of reaching 240,000 people by 2021.

Duration
2019-2021
Focus area
Access to Basic Services
country
Togo
partner
Integrate Health

Context

In Togo, one in 25 women die from pregnancy-related issues and nearly one in ten children don’t live to celebrate their fifth birthday. That’s 15 times the rate for developed countries. The majority of these deaths are from diseases that are entirely treatable at very low cost, like malaria, diarrhoea and pneumonia.

Unfortunately, essential healthcare - including personnel, supplies and training - is largely insufficient and underfunded throughout Togo. As a result, 70% of the country’s population, nearly six million people, live without access to adequate healthcare.

Action

Integrate Health has created an effective low-cost model to integrate high-quality primary healthcare in potentially every clinic and community in Togo.

The model includes the following components:

  • Trained, equipped, supervised and paid community health workers, primarily women, actively seek out patients in their local communities and provide them with home-based care, free of charge.
  • Nurses and midwives working in public government clinics are coached and supervised by a Clinical Mentor to ensure competent and effective care is provided.
  • The pharmacy managers that work in every clinic are also trained by a Clinical Mentor to ensure a reliable and integrated supply chain is in place so that the right medication is always available in the right place at the right time.
  • Pregnant women and children under five access lifesaving healthcare services at the clinics free of charge.

Integrate Health’s package of services creates a seamless and easily replicable system of healthcare delivery that has already demonstrated its effectiveness.

Preliminary data revealed a 48% reduction in under-five mortality in the pilot communities where Integrate Health works over three years. In addition, facility-based deliveries increased by 95%, prenatal consultations by over 200%, and consultations of sick children under-five by over 400%.

Expected results

We’re supporting Integrate Health to grow from 4 to 24 clinics, serving a total of 240,000 people by 2021.

Long-term strategy

Togo’s healthcare system is one of the most chronically underfunded and understaffed in West Africa.  Given the impact demonstrated to date, Integrate Health sees its primary healthcare model as a cost-effective, feasible strategy for Togo to strengthen its national health system and achieve its ambitious goal of a 33% reduction in child mortality by 2022. The organisation is working to encourage the Ministry of Health to adopt this model as national policy.