End Preventable Deaths of Women and Kids in Togo

Program Highlights

Successes

-            This quarter 33 Community Health Workers from the Dankpen district were newly trained in family planning. With the aim of transitioning program implementation to local ownership, for the first time this training was led by the District Health Office of the Ministry of Health with the Integrate Health program team providing support. Following the training, the Community Health Workers completed a month-long internship under the supervision of healthcare providers at each health center. Integrate Health was pleased with the success of the training and plans to incorporate these changes into all trainings moving forward. 

-            Renovations of four clinics in the Bassar district began, in partnership with Construction for Change and the 30/30 Project. The Construction for Change team alongside engineers from the Ministry of Health, visited each site to solidify construction plans. After hiring a contractor, the construction officially launched across all sites in December.

Challenges

-            Integrate Health has noticed a high rate of home-based deliveries since launching in the Dankpen district in July 2019. Upon investigation, the program team discovered that to visit the clinics, pregnant women needed to cross a river, that by traditional customs  is thought to cause harm to pregnant women. To address this concern, Integrate Health trained Community Health Workers, in partnership with health center staff and community leaders, to share key messages with pregnant women and their partners to help explain the risk of home-based deliveries. We are exploring additional options to make the journey easier.

Expansion Highlights
Successes

-            The Togolese Ministry of Health (MOH) validated a new National Health Quality Assurance Policy in November. A few weeks later Dr. Baba, Director of Health Facilities within the MOH, conducted a site visit to Kara to learn about Integrate Health’s clinical mentorship approach and explore adaptation of this approach and the tools used for quality assurance. Integrate Health continues to support the Ministry of Health on development of the implementation plan for the new national policy.

-            Integrate Health is pleased to announce that the Kéran district was randomly selected to be the next district for implementation of the expansion of the Integrated Primary Care Program! The Integrate Health program team will now begin preparations for a July 2020 program launch in the Kéran district, which will bring the total population served to 200,000 across 18 clinics with 142 Community Health Workers.

Challenges

The Togolese Ministry of Health is currently supporting multiple mHealth pilots with various funders and partners that use competing technologies.  Integrate Health is working to understand the vision of the Ministry of Health and its partners.  We hope to help facilitate a process where the mHealth strategy and tool selection is clearly articulated.  We will align our efforts in the mHealth space with that of the Ministry of Health and key partners. 

Organizational Highlights

Successes

-            The 2018 990 and Independent Financial Audit of Integrate Health have been finalized. The auditors found no weaknesses or deficiencies, and only noted a few observations for improvement. Integrate Health’s CEO, COO, and Finance Manager will address any observations immediately.

-            Integrate Health published a protocol manuscript for its Phase Two study in the journal Implementation Science. Entitled “Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: a pragmatic effectiveness-implementation study protocol,” this study will generate knowledge to improve delivery of high-quality healthcare services to our current  population of over 140,000 in northern Togo and ultimately help inform national-scale strategies.

-            This quarter, Integrate Health is happy to welcome two new team members: a new Communications Associate (US) and MEQI Associate (Togo). Integrate Health is still recruiting for a Deputy Country Director and Logistics Assistant, both to be based in Togo.

Challenges

-            Although 70% of Integrate Health staff are women, it has been difficult to improve recruitment of women for in-country positions, especially senior positions. Integrate Health is working on a strategy to address this challenge and hopes to be able to both recruit and promote more women into leadership positions.

Financial Highlights

Successes

-            Integrate Health received renewal funding from 13 existing partners, new funding from two partners, and has pending applications for three new funding partners this quarter.

Challenges

-            An application to Conservation, Food, and Health Foundation was not accepted.  

Patient Profile:

Bidipoumè, a Dankpen Community Health Worker, was conducting home visits when she met Bilere, a 20-year-old pregnant woman. Bilere, was nearly full term, and could not stand due to pains she felt in her ribs and chest. Bidipoumè expressed the importance of visiting the health center, and Bilere agreed. On the following day, Bidipoumè visited Bilere, and realized she did not go to the health center. Concerned for her health, Bidipoumè decided to bring her to the clinic herself. After they arrived together at the health center, Bilere was diagnosed with anemia, which was successfully treated. Bilere decided to deliver her baby at the health center, and on December 27^th, she gave birth to a healthy baby. After her delivery, she called her Community Health Worker, Bidipoumè, and was thankful for the knowledge and care provided.  Proactive case visits and regular follow up by Community Health Workers, integrated with improved care at health centers, help ensure women like Bilere receive the care they need and deserve.

Links:

• Integrate Health website