End Preventable Deaths of Women and Kids in Togo

INTEGRATE HEALTH SUPPORTS GOVERNMENT TO MAKE HEALTHCARE FREE

In October, the government of Togo released the Togo Roadmap 2025, an ambitious plan to prioritize health as a key pillar of national development over the coming years. To achieve this, the government of Togo is committing to universal health coverage as the central health priority. With this historic plan, reforms are promised to guarantee access to healthcare for pregnant woman, children under the age of 18, seniors, and vulnerable populations, by reinforcing Togo’s primary healthcare infrastructure, equipment, and personnel, including the creation of a cadre of professionalized Community Health Workers.

Togo Roadmap 2025 is not just aspirational. Within the first two months of publishing the plan, the Ministry of Health asked Integrate Health to assist with the mechanics of providing free care to pregnant women nationally. To date:

- Integrate Health hosted the Deputy Minister for Universal Health Access to observe program implementation including free care.
- In partnership with Financing Alliance and UNFPA, Integrate Health supported the Ministry of Health by costing different program scenarios. The work culminated in a presentation of an essential maternal health package to the senior leaders of the Ministry of Health.

- Integrate Health began a two-week pilot at six sites with the Ministry of Health to test the expansion of an electronic administration platform that could be used to register pregnant women and facilitate payments from government providers.
- The Ministry of Health has suggested free maternal care may roll out nationally in the coming month.

The government of Togo’s commitment to the outlined Togo Roadmap 2025 is a huge step forward. The commitment mirrors Integrate Health’s approach and is a reflection of years of discussion and demonstration. As the government has shown strong political will, Integrate Health is poised to support its efforts as policies are codified, implementation plans are developed, and financing is mobilized.

The following report describes progress made over the past three months, including successes and challenges as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions or suggestions.

PROGRAM HIGHLIGHTS

Successes

• On October 14, 2020, the Integrated Primary Care program officially launched in the Kéran district of northern Togo! All 44 new Community Health Workers received intensive supervision this quarter, and the Kéran district community members have been pleased with their new access to healthcare.
• Anita Kouvahey-Eklu, Deputy Country Director, trained ten Integrate Health Clinical Mentors and Community Health Worker Supervisors in adult learning theory in December. The five-day training covered topics including creating a positive learning environment, evaluating skill levels, and using audiovisual support. This training was a key effort in ensuring that mentors and supervisors have the tools and skills they need to support frontline health workers in delivering high-quality care.
• This quarter, the District Health Department conducted end-of-the-year personnel evaluations as part of the Integrated Primary Care Program. Having the evaluations be conducted by local government staff was critical to not only strengthen the collaboration between the district government and Integrate Health, but also to serve as a step in the continuation of handing over program components to the Ministry of Health.

Challenges

• Integrate Health launched a pilot of the mHealth application, ThinkMD, in October to 68 Community Health Workers in the Bassar and Dankpen districts. After the pilot launched, Integrate Health experienced difficulties with real-time data collection in rural communities. Integrate Health and ThinkMD are troubleshooting various challenges and hope to resolve all issues over the coming months.

EXPANSION HIGHLIGHTS

Successes

• In December, Integrate Health hosted a press conference in Lomé, focused on the COVID-19 Action Fund for Africa personal protective equipment distribution and Integrate Health’s COVID-19 assistance to the Ministry of Health. The press conference was successful with national news coverage and support from the Ministry of Health and WHO.
• Integrate Health began a collaboration with UNICEF and the Ministry of Health in the Bassar district. As a result of the collaboration, professional Community Health Workers will support UNICEF’s Child Friendly Communities initiative and assist volunteer Community Health Workers in creating a population registry and coordinating care for pregnant women and children under- five. This will be a great learning opportunity for Integrate Health and partners.

Challenges

• The Quality Assurance Manager, a dual-hire role serving as part of both the Integrate Health and Ministry of Health teams, began a six-month leave in November to pursue continued education. A newly hired, Community Coordinator, will help to backfill this position during the Quality Assurance Manager’s leave.

ORGANIZATIONAL HIGHLIGHTS

Successes

• After months of recruitment, Integrate Health has officially launched a Research Advisory Board Committee, which includes two Togolese researchers. The committee will guide the Integrate Health research team and will assist in answering key research questions.
• This quarter, Integrate Health filled two critical positions: Digital Health Manager and Resource Mobilization Officer. Dawkin’s Kamara joins the Integrate Health team as the new Digital Health Manager, and Lucien Lia as the Resource Mobilization Officer. Both positions are based in Lomé and will support Integrate Health and the Ministry of Health’s joint efforts.

Challenges

• Recruitment has taken longer than anticipated over the last year. The amount of work to accomplish on both daily implementation and strategic levels has grown to be too large for one Human Resource Manager. To increase capacity and efficiency, last quarter Integrate Health hired a Human Resource Assistant. This quarter, Integrate Health has opened recruitment for a senior-level Human Resource Director.

FINANCIAL HIGHLIGHTS

Successes

• This quarter, Integrate Health received renewal funding from nine partners, and new funding from one new partner.

Challenges

• One reach application was not accepted.

CHW Profile: Meet Mariette

Over the last few years, Mariette was a seamstress and a farmer, struggling to provide for herself and her family. Although she could not pay school fees, Mariette worked hard to ensure her children were taken care of. When Integrate Health posted the Community Health Worker job in her community in the Kéran district, Mariette was the first person to write her name down. After excelling in the interviews and trainings, Mariette officially passed the Community Health Worker test and began providing care in October in her community. For the first time, Mariette receives a monthly salary. With her first two months of salary, Mariette’s children have started school again, outfitted with new school supplies and dresses. When asked how she feels that her children are back in school, Mariette said, “in the past, I could not have imagined that myself, but I did it, and it is such a pride for me.” By employing mostly women as Community Health Workers, Integrate Health has watched communities transform with high quality healthcare and Community Health Workers reinvesting in their communities.

Links:

• Integrate Health website