Physical Health Togo Project #22946

End Preventable Deaths of Women and Kids in Togo

by Integrate Health

Project Report | Apr 12, 2023
Integrate Health Q2 FY23 Report

By Jennifer Schechter | CEO and Co-Founder

Q2FY23 Metrics

PROGRAM HIGHLIGHTS

Successes

Integrated Primary Care Program Handover in Kozah: Despite delays, Integrate Health has reached a significant milestone in the process of handing program ownership over to Kozah district health officials in the Integrated Primary Care pilot sites. In November, Integrate Health signed a protocol agreement with the Kozah district health director and Kara regional health director, formalizing next steps for the handover process. This agreement defines and formalizes the budget and payment structure, monitoring and evaluation plan, and supply chain management process. Integrate Health and government partners are now recruiting a comptroller who will sit on the district health team and oversee the handover process including finalizing the workplan and budget for the first quarter under the new handover structure. A communication plan to inform all stakeholders including community members is being developed, and an official launch ceremony of the handover is planned for early 2023.

Integrate Health’s Verbal Autopsy Project: In December 2022, an abstract submitted by Integrate Health’s Research Manager, Dr. Désiré Dabla, was accepted to be presented at the 2023 International Maternal Newborn Health Conference in Cape Town, South Africa. The abstract details the results of Integrate Health’s verbal autopsy project, a research project launched in January 2022, to test the use of a digitized version of the WHO's verbal autopsy tool.

In Togo, there is no national death registry, making it challenging to identify biological causes of death. The verbal autopsy project aims to test the feasibility of using the WHO tool to identify causes of maternal and neonatal death in the communities Integrate Health serves, and to use that information to develop targeted interventions, thereby reducing mortality. For example, depending on the causes of death identified, solutions could include earlier interventions for high-risk patients.

Integrate Health tested three algorithms designed to work with the WHO tool and determined that the Tarrif 2.0 algorithm was the most accurate when comparing the algorithm-assigned cause of death to clinician-assigned causes of death.

In the second half of FY 2023, Integrate Health plans to extend the use of the verbal autopsy tool in five districts of the Kara region. To do this, CHW Supervisors have been trained to use the tool and conduct verbal autopsies in their communities. Expanded use of the tool will provide Integrate Health and Ministry of Health (MOH) partners with more accurate information on causes of death and can better direct resources and interventions as needed.

mHealth Initiative in Kéran: In the Kéran district of Togo, where no mHealth tools were previously used, Integrate Health is pleased to report that all 49 CHWs are now using a new tool called Tonoudayo, which means “How is your health” in the Kabyé language. Integrate Health’s mHealth team, informed by over five years of experience piloting various mHealth tools, used the Medic’s open-source Community Health Toolkit to build a customized tool to fit the Togolese context. This solution is cost effective and allows for a level of app customization, data control, and ownership that is very valuable. In October 2022, 11 CHWs in the Nadoba community in Kéran were trained on the new tool. They piloted the tool for six weeks and found that the app performed well, and data quality was high. Based on this successful pilot, the remaining 38 CHWs in Kéran were trained on how to use Tonoudayo. We are also switching over 31 CHWs in the Kozah district from an older Medic Mobile pilot tool to Tonoudayo.

Challenges

Health Center Solar Panels: As part of Integrate Health’s infrastructure improvement strategy, we install solar panels at health centers that were previously without electricity. Maintenance of the solar equipment is a persistent challenge as it requires technical expertise from solar companies as well as close collaboration with health center staff and district health leadership. Currently, at the Koundoum health center in the Bassar district, necessary solar panel repairs have been delayed as our program team is coordinating with health officials to search for available solar panel technicians. Our team is working as quickly as possible to solve this immediate need and is developing a long-term maintenance plan for solar panels across the region.

EXPANSION HIGHLIGHTS

Successes

Strengthening Community Ownership: For the past year, Integrate Health has supported the Togolese MOH to reinforce the capacity of community health center management committees (COGES) across Togo. COGES provide a key community accountability mechanism as they are composed of elected members of the community who play a management role in the functioning of primary healthcare centers. In November 2021, Integrate Health and the MOH piloted a training program for COGES members in the Kozah and Haho districts of Togo. The training, which covered how to effectively identify and prioritize health center needs, build budgets, and identify resources, was deemed successful by COGES participants and government officials. Recently, the MOH asked Integrate Health to accompany them in the scale-up of this pilot program across the country. In November 2022, Integrate Health and the MOH hosted a training-of-trainers workshop for eight health administrators from each region of Togo, who will in turn train COGES nationwide on resource mobilization. We are pleased to be supporting the government in this effort to strengthen local ownership of the health system.

Guinea Expansion: The Guinean MOH has formally requested Integrate Health implement its pilot program in the Kouroussa District of the Kankan region of Guinea. In response, Integrate Health has begun an initial analysis of the health system in Kouroussa, including extensive meetings with partners and the District Health Director. This work will continue and inform pilot program design and development.

Integrate Health has also made progress with regards to staff recruitment in Guinea. Dr. Aboubacar Diakite, formerly Guinea Interim Country Representative, has been officially hired as Guinea Country Director. Aboubacar joined the Integrate Health team in August 2021 as a consultant to perform a landscape analysis of the Guinean health system. As a Guinean physician with extensive experience in Guinea including during the Ebola epidemic, he has been the driving force behind Integrate Health’s country expansion strategy ever since.

Two additional staff have been added to the team in Guinea: Moriba Traore, Human Resources Manager, joined Integrate Health in January, and Adama Mansaré, Director of Finance and Administration, will join the team at the end of February.

ORGANIZATIONAL HIGHLIGHTS

Successes

Ouagadougou Partnership Annual Meeting: In December, Integrate Health’s Deputy Country Director, Anita Kouvahey-Eklu, and Director of Innovation, Dadou Tcheou, attended the 11th Ouagadougou Partnership Annual Meeting in Niger. This was the first time that Integrate Health leaders participated in this important convening. The Ouagadougou Partnership is a coalition of governments and technical and financial partners dedicated to reproductive health equity in the francophone West African region. The Integrate Health team was accompanied at the conference by representatives from the Togolese Ministries of Health and Finance, along with a group of youth leaders and lawyers dedicated to gender equity. Participants shared challenges and lessons learned in promoting family planning. Togo was represented heavily in the meeting, and this is encouraging as Integrate Health continues to build out key partnerships with stakeholder in the West African region.

Integrate Health Board Activities: Integrate Health is pleased to welcome three new experts to our board of directors. Lola Adedokun is the Executive Director of the Aspen Global Innovators Group and brings a wealth of experience in both philanthropy and global health. Jumoke Adekeye and Marieme Niang Camara are two talented board apprentices recruited with the support of The Boardroom Africa. Jumoke is the Country Head of the Clinton Health Access Initiative in Benin. Marieme is the Managing Director and Head of Africa at Axendo, a diversified global trading, commodities, and procurement group. To read more about the Board Apprentice Program, please check out a recent blog post on Integrate Health’s website here.

Infectious Disease Center, Ateda: In November, a provisional reception was held to celebrate the construction of an Infectious Disease Center in Ateda, Kara. Integrate Health has been supporting the MOH to finance construction of the center since 2020, support which started as part of Integrate Health’s COVID-19 response. The project was a collaboration between Integrate Health, the MOH and the German Development Bank (KFW). As the only center with infectious disease treatment capacity in all of northern Togo, this facility will meet a significant need and ensure that Togo is better prepared for the next pandemic.

Challenges

Strategic planning process: In Summer 2022, Integrate Health launched a five-year strategic planning process. While now underway, the process was significantly delayed due to the challenge of finding experienced, available consultants with the French language skills Integrate Health requires. To address these challenges and oversee the entire process, Integrate Health formed a strategic planning committee of 14 members, representing every Integrate Health team, including a CHW. The mandate of the committee is to ensure that the strategic planning process is not only inclusive, but participatory, and ultimately effective. The committee serves as a link between the consulting team eventually hired to lead the process and the organization. The strategic planning committee meets weekly and reports monthly to a larger advisory committee, a group of over 30 staff, who provide additional feedback as necessary.

The consultants are now in the data collection phase and will conduct interviews with over 40 key stakeholders. A leadership workshop will be held on March 13th and 14th in Lome. The entire process will conclude by the end of April. This is the first time Integrate Health is employing such an inclusive process for the strategic plan, and we look forward to launching and sharing our new strategy in the coming months.

Community Health Worker Spotlight

Toba Skon, a father of three, lives in the Agbanda community in the Kozah district. Toba has worked as a CHW in Agbanda for the last seven years. When he first moved there 12 years ago, there were limited health services in the community. The closest health center at Sarakawa, eight kilometers away, was served only by a head nurse and a birth attendant. People from Agbanda preferred to travel over 15km away instead to the health center in Tchitchao, where there were more health personnel and where they received a better level of care. Those who were unable to travel the distance often used the service of traditional healers instead.

Toba was among the first cohort of CHWs trained to serve communities around the Sarakawa health center in Kozah. Initially, Integrate Health was interested in recruiting women to work as CHWs. However, there were few women with the minimum required educational qualifications, so the position was opened up to men, and Toba applied. Toba recalled the long journey his wife had to make to Tchitchao for the birth of their first child, and, apart from the opportunity to make a living, he appreciated the objectives of the program, which ensures women in his community are trained to give care and receive free quality care closer to home.

The work was not always easy, and Toba recounted a particular incident, early on in his career, when he encountered a child with a severe fever who was having convulsions. He immediately took the child on his motorcycle to the Sarakawa health center. Fortunately, the head nurse knew exactly what to do and was able to save the child. The nurse also gave Toba some tips on how to reduce a fever the next time he was in such a situation.

Toba has gained the respect of the community in Agbanda because of the amazing work he does. He also feels supported by Integrate Health, not just through the trainings he receives but also through recognition of his hard work. Toba is grateful that he is able to make a living from this work: a living that helps him take care of his family, send his children to school, repair his motorcycle, and buy gifts for his wife.

Quote:

“I would like to express my gratitude to Integrate Health for thinking of Sarakawa and my community. The implementation of this program is very beneficial for the surrounding populations. Thank you also for this opportunity and chance that you are giving to women to be essential links in their respective communities in providing quality health care to other women and children. This work and remuneration allow them in turn to be able to support their families by helping their husbands with daily expenses, which is a great plus and a great asset for them. If my wife had the educational level required, I would have encouraged her to apply as well. Two salaries at home are still better than only one.”

FINANCIAL HIGHLIGHTS

This quarter, Integrate Health received generous renewal funding from seven partners. We remain grateful for your continued support and are excited to be able to continue providing lifesaving primary care to communities in need in Togo and Guinea.
In December, with support from our Board Chair, Integrate Health began implementing a strategy to hedge the USD to CFA exchange rate. The hedging strategy allows us to lock in gains from a strong dollar and increase certainty in our budgeting and cashflow management.

Thank you to everyone who contributed to our end-of-year fundraising campaign! We raised over $120,000 from 48 donors. The support from our grassroot network of funders, many of you included, is greatly appreciated, and we look forward to continuing to work together in 2023!

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Dec 19, 2022
Integrate Health Q1 FY23 Report

By Jennifer Schechter | CEO

Q1FY23

Integrate Health Gathers for All Staff Retreat

In August, Integrate Health staff joyfully reunited in Kara, Togo for an All Staff Retreat and celebration. This was the first time since 2019 that Integrate Health’s distributed team, based across the country of Togo and across the world, came together in person. The retreat was an opportunity to celebrate our achievements and reorient around Integrate Health’s values, mission, and strategy for the future. The week-long retreat included strategy sessions, cross-team meetings to foster collaboration on current projects, and site visits to observe Integrate Health-supported health centers and shadow Community Health Workers. The retreat made space for fun too—Integrate Health rented the town’s soccer stadium and hosted a staff soccer game. The players, sideline-cheerers, and spectators were equally lively.

The retreat culminated in an all-staff celebration of almost 400 people, including 200 Community Health Workers, staff from Integrate Health’s partner organization Association Espoir Pour Demain-Lidaw, and health sector and community leaders. The celebration included dancing and music, congratulatory words from the district health director and mayor’s office representative, and staff awards based on Integrate Health values. Integrate Health’s CEO, Country Director, and Human Resources Director hosted a townhall-style Q&A session where colleagues had the chance to ask organization leaders anything. The discussion ranged from salary and benefits to the future of government collaboration and country expansion.

The retreat took significant time and resources to plan, yet it was effort well spent to pause and celebrate the work accomplished in order to mobilize more energy and determination to reach our goals ahead.

PROGRAM HIGHLIGHTS

Successes

Transfer of IPCP in Kozah: This quarter, Integrate Health reached an exciting milestone in transferring ownership of the Integrated Primary Care Program to the government in Togo. The Kozah District Health management team and Integrate Health signed an agreement to officially integrate Clinical Mentors into the district health management team. For now, these key personnel will continue to be paid by Integrate Health; however, they will be directly supervised by the District Health Director, allowing them to be fully integrated into the district team. Clinical Mentors deliver one of the four key pillars of Integrate Health’s approach, and therefore this represents a significant transfer of program implementation ownership to the district-level government.
Research publication: In August, a new paper written by Integrate Health’s research team and faculty collaborators was published in Global Implementation Research and Applications. The paper, “A Pragmatic Approach to Qualitative Formative Evaluation of an Integrated Primary Care Program in Togo, West Africa,” describes Integrate Health’s process of collecting data through key informant interviews to inform program improvement and implementation. This is an important report that highlights the advantages of including both program implementers and stakeholders in any qualitative evaluation process. Click here to access the full paper.
Vaccine coverage improvement: In September, a community vaccination campaign was organized at the Kpétab health center in the Dankpen district. This was as a result of a quality improvement initiative led by Integrate Health’s Monitoring, Evaluation, and Quality Improvement (MEQI) team. After a routine review of key performance indicators in Dankpen, the MEQI team discovered Kpétab had especially low vaccination rates in comparison to other health centers in the district. The Clinical Mentor at that site conducted a refresher training with health center staff focused on vaccination coverage, and the health center team carried out a community vaccination campaign, which led to an
increase in vaccine coverage rates for children in the area from 43% in FY22 Q2 to 178% in FY22 Q4. (Note that the
over 100% indicates children outside of the catchment area being reached with essential vaccines.)This is an example of how Integrate Health’s MEQI and program teams work together, establishing a feedback loop where data is reviewed and program weaknesses are addressed in a timely manner.

Challenges

Construction delays: Planned renovations at the Natiponi health center in the Kéran district have been delayed because of severe damage to the road due to heavy rains. The road is under repair, and the Integrate Health team is hopeful that construction equipment and supplies will again be able to access Natiponi in the coming weeks.
Community feedback: In July, Integrate Health participated in five community townhall meetings across the Binah district, organized by health center staff. These meetings brought together Integrate Health team members, health center staff, community leaders, women's groups, and community members. Community members thanked their nurses, midwives, and Community Health Workers for high-quality care delivery. However, they also raised some challenges they face when seeking care at the health centers, including essential medicine stockouts and poor reception and bedside manner. Community restitution meetings serve a pivotal role in ensuring that the health system is accountable to its community. The Binah district health management team and Integrate Health take this feedback from patients extremely seriously and are co-designing specific quality improvement plans to address the two issues raised.

EXPANSION HIGHLIGHTS

Successes

MOU in Guinea: Integrate Health has officially signed a partnership agreement with the Ministry of Health (MOH) in Guinea to solve critical challenges in the implementation of the national community health strategy. Further, Integrate Health kicked off the district selection process for direct service delivery. Integrate Health and the MOH have co-developed terms of reference for the selection process, which is anticipated to be completed by January 2023.
Wezou implementation update: Over a year ago, in August 2021, the Togolese government launched a new initiative to provide free healthcare for pregnant women across Togo. The initiative, called "Wezou," increased access to healthcare for women by removing the cost of care for many services—a key barrier to accessing lifesaving care. Integrate Health is excited to report that during the first nine months of the program, over 206,000 pregnant women have been enrolled. In addition, the Wezou program has supported close to 100,000 deliveries and subsidized more than 206,000 prenatal consultations. At the launch of the program, the government announced an envelope of $5M for program implementation and has spent close to $2M to date. This is a great step that demonstrates the Togolese government’s commitment to universal health coverage.

Challenges

Delays in Togo expansion prep: Integrate Health is currently awaiting official authorization to begin the co-design process for government-led implementation of the Integrated Primary Care Program in a new district in the plateau region of Togo. Once official authorization is obtained, a co-design committee will be formed with a first task of district selection. Integrate Health will remain very flexible in managing timelines for this critical expansion, given the constraints of working through government. With this new district implementation, we are piloting a new approach to have implementation co-led with the Ministry of Health from the beginning. We knew that this strategy would have greater risks, given that many decisions are outside of our control. However, we believe that this approach is essential to drive our ultimate national scale goals to ensure quality primary care reaches all eight million Togolese people.

ORGANIZATIONAL HIGHLIGHTS

Successes

Annual Report 2022 published: Integrate Health is pleased to share its 2022 Annual Report. Please explore our digital snapshot, and download the full report here.
IH Global Support Team Renaming: This quarter, Integrate Health reflected on changing the name of our "US team" to more accurately illustrate that our teams outside of West Africa exist to support, assist, and serve with the teams based in Togo and Guinea. Integrate Health conducted an internal survey, giving all staff an opportunity to participate in the process. By an overwhelming vote, Integrate Health staff decided that the term “Global Support Team” better communicates an identity that clearly demonstrates our framework for cross-country partnership and centering the leadership of our country teams in providing strategic direction for the organization.
Integrate Health and Togo UNGA Participation: Integrate Health was excited to join the events surrounding the UN General Assembly in New York. We are grateful to our funders and partners who made the time to meet with our team during the busy week. Togo was also well represented in New York. Integrate Health’s CEO and Chief Partnership Officer met with the Minister of Health and discussed furthering our partnership. In addition, Togo’s Foreign Minister, Robert Dussey, spoke at the UN General Assembly and stressed the importance of climate justice and equity. As part of his speech, the foreign minister said: “Africa expects more equality, respect, equity, and justice in its relations and partnerships with other powers, regardless of who they may be.” To read more about Minister Dussey’s statement, please click here. Integrate Health is committed to addressing the intersection of health and climate justice and looks forward to partnering with the government of Togo on this important initiative.
Lightful Academy Bridger Program: For the past six months, Integrate Health’s communications team participated in the Lightful Academy's BRIDGE program, an online training with one-on-one support aimed at building skills to improve an organization’s online presence. The Lightful courses and our dedicated coach provided key insights that will inform a revamp of our organizational communications strategy, currently in development.

FINANCIAL HIGHLIGHTS

This quarter, Integrate Health received generous funding from two new partners and three renewed partners. We remain grateful for your continued support and are excited to be able to continue providing lifesaving primary care to communities in need in Togo and Guinea.
In August, IH launched an international tender to support the purchase of vehicles for both Togo and Guinea. The tender process utilized procurement best practices, and eight bidders responded to the request. As a result, we were able to save approximately $40,000 (25% of the total purchase cost).
Integrate Health continues to benefit from a strong dollar, which has appreciated by nearly 20% versus the CFA over the last year. Our finance team is exploring avenues to lock in the current exchange rate and improve management of foreign currencies in our accounting and budgeting systems.
After many months of negotiations and waiting, Integrate Health received a letter from the Togolese Office of Taxation and Revenue confirming our Value-Added Tax exemption for projects with clear benefits to local communities. This will facilitate the importation process of needed equipment and supplies and will reduce costs for Integrate Health.

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Aug 26, 2022
Integrate Health Q4 FY22 Report

By Jennifer Schechter | CEO and Co-Founder

Q4 FY22 Metrics

INTEGRATE HEALTH
EXPANDS THE INTEGRATED PRIMARY CARE PROGRAM

This quarter, Integrate Health has driven forward multiple plans to expand the Integrated Primary Care Program (IPCP), with one critical change. To ensure sustainability and scalability, the replication of the IPCP will be led, first and foremost, by the governments of target countries. During this quarter, Integrate Health began discussions with Togo’s Ministry of Health to expand the IPCP to a second region of Togo. Integrate Health also entered into partnership discussions with the Ministry of Health in Guinea to expand Integrate Health’s support to a second country in West Africa.
While Integrate Health began reflections on expansion into a new country nearly two years ago, the past quarter has deepened these efforts. First, Integrate Health believes that West Africa, specifically francophone West Africa, requires additional support and attention to achieve national health goals. That said, Integrate Health does not wish to infinitely expand as an international NGO. As Integrate Health grows intentionally, we aim to contribute to strengthening a “winning coalition” for primary healthcare in each country where we work by reinforcing the existing ecosystem of government and civil society organizations.
The selection of Guinea, as a second country for Integrate Health to support emerged following extensive country scoping activities and was based on compelling need, strong political will, an explicit invitation from the Guinean Ministry of Health, and the existence of an evidence-based national community health strategy aligned to Integrate Health’s approach.
Integrate Health aims to leverage the lessons learned in Togo to support government and civil society organizations in Guinea to replicate, study, and scale key innovations in primary healthcare. Integrate Health believes that we can learn more and faster by partnering with governments and communities in two comparable but different country contexts, both dramatically underserved francophone West African nations. We look forward to providing further updates as this expansion work continues.

PROGRAM HIGHLIGHTS
Successes
Ultrasound Training Program Updates: In April, the ultrasound program launched in the Kara region. Nineteen machines are in use in 25 health centers. Prenatal consultations are done according to a schedule, and health centers communicate their schedule to the district authorities, who deploy the machines accordingly. Trained midwives conduct ultrasound screenings free of charge, and women in the communities are notified in advance of the ultrasound screening schedules. A focal point in the regional health office is responsible for compiling data and reporting on the ultrasound program, as well as overseeing financial management. This is an exciting example of the Ministry of Health regional health team taking ownership of key components of the Integrate Health approach. To date, 1,202 women have already benefited from free ultrasound screenings.
Community-Based HIV Testing Initiative: On April 28, Integrate Health’s partner organization, Association Espoir Pour Demain, launched a community-based HIV testing initiative in the Bassar district as part of the Togolese government’s new initiative for proactive case detection and care delivery. A total of 125 Community Health Workers, associated with 22 health centers, have been trained to conduct HIV testing in their communities. This is a pilot initiative supported by Integrate Health that will be expanded to other districts and regions based on implementation results.
Clinical eHealth Trainings: The Integrate Health e-Health team and Monitoring, Evaluation, and Quality Improvement (MEQI) team have been working together to digitize paper-based reporting forms used by clinical mentors and Community Health Worker (CHW) supervisors. The forms were digitized using the District Health Information Software (DHIS2) and were designed to sync directly to Integrate Health’s instance of DHIS2. In May and June, the e-Health and MEQI teams trained all coordinators, clinical mentors, and CHW supervisors on how to use the new digital tools as well as how to use spreadsheet programs such as Microsoft Excel. The team has worked tirelessly to move from a paper-based reporting system to a digital system where all information will be in one place and easily accessible to other teams. This training is an important step towards achieving that goal. The new reporting system will be piloted and tested, with full rollout scheduled for July 2022.

Challenges
Contraceptive Coverage Measurement: This quarter, Integrate Health has continued to address measurement challenges with the indicator for modern contraceptive coverage. The MEQI team has implemented a data quality initiative and continues to work with regional and district health officials to identify the root cause for the discrepancy between paper register and DHIS2 entries. In addition, efforts to improve digital data collection have been intensified. Integrate Health expects this challenge to be resolved in the coming months.
EXPANSION HIGHLIGHTS
Successes
Expansion into Plateaux and Savanes regions of Togo: Integrate Health is in the early planning stages of supporting the rollout of the IPCP in a new region in Togo, directly implemented by the government. In June, program team members conducted site visits in two regions of Togo, Plateaux and Savanes, to meet with health workers and see firsthand how the primary health system currently functions. Integrate Health is in conversation with the Ministry of Health at the national level to co-create the implementation plan for this expansion.
Challenges
Slow rate of transfer of the IPCP within Togo: While expansion plans are underway in Togo, the transfer of the IPCP ownership in Kozah district has been stalled due to other government priorities. During the last quarter, Integrate Health held five work sessions with the Kozah district health management team to discuss the transfer process and highlight next steps to endure smooth transfer. Discussions are still ongoing, and Integrate Health is on track to begin transfer activities in July 2022. In the meantime, the Integrate Health program team will focus on building leadership capacity to implement these planned activities over the coming year.

ORGANIZATIONAL HIGHLIGHTS
SUCCESSES
Green community center: Integrate Health is excited to begin work on the construction of a new training center—a model of environmentally sustainable design that will also serve as Integrate Health’s headquarters in the city of Kara, in northern Togo. The “Green Center,” as the building is called, is designed as an energy-efficient, regenerative, and community-centered building with the goal of providing a hub for primary healthcare experts. The building will also serve the Adabawéré community, who donated the land on which the center will be constructed. To design and construct the building, Integrate Health is partnering with MASS Design Group, an architecture firm based in Rwanda, and Construction for Change, which has a project manager embedded with the Integrate Health team in Kara. The concept for the building was inspired by the traditional Togolese Tata Somba homes with origins as far back as the eighteenth century, which, in addition to being symbols of Togo’s landscape, were built to be socially and environmentally efficient. The Green Center will highlight what is possible in sustainable design and underscore Integrate Health’s commitment to work at the intersection of health and climate justice.

Challenges
Phishing attempts: Integrate Health is seeing a major increase in phishing attempts and was the victim of an attempted fraud incident in April where hackers obtained access to an Integrate Health email account. Fortunately, the issue was detected early, and there were no losses. All Integrate Health employees participate in ongoing cybersecurity training, including test phishing attempts. Integrate Health aims to build on current practices by performing a risk assessment and developing a cybersecurity strategy to protect our organization and staff.

FINANCIAL HIGHLIGHTS
Successes
This quarter, Integrate Health received generous renewal funding from two partners. We remain grateful for their continued support. In addition, the Board voted for and approved Integrate Health’s FY 23 budget. We are excited to be able to continue providing lifesaving primary care to communities in need in Togo and Guinea.

Spotlight on Kpatchama Lattah, Midwife
Kpatchama Lattah directs the maternity ward at the Adabawéré health center in the district of Kozah. She received a diploma of midwifery in 2012 from the Midwifery School of Kara and has been working in Adabawéré since 2014. Kpatchama always wanted to become a midwife as far back as she can remember. The mother of one of her childhood friends was a midwife, and Kpatchama admired how her friend’s mother helped women in their community to improve their wellbeing.
At the Adabawéré health center, Kpatchama attends to about 30 women per day, sometimes more. When she first started working there, she realized that the health center was already well-established in the community, and many patients came there for their medical care. Kpatchama realized soon, however, that for pregnant women, there was a lack of access to ultrasound services. She observed that there were two main reasons for this. The first was a reluctance among women due to religions reasons. Some women were reluctant to have ultrasound screenings because they felt trying to determine information such as the sex of their baby would be against God’s will. The other, more common reason was due to the cost of the screenings.
Before Integrate Health started providing ultrasound screenings in April, women were referred to another hospital farther away to receive this service, and the cost of both the transportation to the hospital and the ultrasound screening was a major barrier to access. Since the ultrasound program was launched in April, more women have been able to access ultrasound screenings. Kpatchama is happy to have participated in the training program and is pleased that the maternity ward of the Adabawéré health center is now able to provide this much-needed service to patients free of charge.

Links:

Integrate Health website

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