End Preventable Deaths of Women and Kids in Togo

Review of National Health Development Plan in Togo shows improvements in community health indicators

This past September, Integrate Health (IH) participated for the first time in the joint annual performance review of the health sector. Organized by the Ministry of Health (MOH), a series of events held in Lomé under the theme "Strengthening primary healthcare to accelerate universal health coverage" brought together key stakeholders including public institutions, technical and financial partners, civil society, andcommunity organizations to assess progress with implementation of the 2023–2027 National Health Development Plan (PNDS). The review focused on programmatic, financial, and health outcomes in 2024.

Fifty-seven PNDS indicators under five health axes were reviewed to measure progress and guide future actions. Progress was noted on 63% of indicators, while 16% remained consistent and 21% declined in performance.

In the Health System and Community Health axis, where IH is most involved, improvements were noted on indicators related to increased healthcare worker density, improved drug availability, better care utilization, and increase of trained Community Health Workers. In the axes focused on Essential Health Services and disease control, improved indicators were related to lower maternal mortality, increased number of births attended by skilled personnel, higher vaccination rates, and lower incidence of malaria and tuberculosis.

During the review, IH shared experiences and lessons learned from our community-based approach, as well as information on how the Integrated Primary Care Program contributes to improving access to and quality of maternal, reproductive, and child healthcare in rural communities. The PNDS Permanent Secretariat, Dr. Dogbé Kokou Sika, expressed his satisfaction at the positive trend for the health sector.

IH is proud of our work with the MOH and will continue to support health system strengthening initiatives in Togo. 

Togo Highlights

Success

Community Health Worker (CHW) geospatial mapping: In 2022, IH created the first national registry of CHWs in Togo as part of the national reformed CHW policy; however, the data was not mapped. Geospatial mapping helps governments and partners understand Community Health Workers’ reach and coverage as well as communities’ needs. This quarter, IH supported the geospatial mapping of CHWs and health centers in the Anié district and all seven districts of the Kara region. This mapping aims to ensure that each community has a CHW and to show their location in relation to health centers to improve efficiency and strengthen referral networks. The data is also used to improve planning and monitoring of health services in remote areas. Geospatial data were used to compare against the national CHW registry, which highlighted that some villages have assigned CHWs despite being less than five kilometers from a health center, which is noncompliant with Togo’s community health policy. In addition, new health facilities have been built, causing discrepancies in CHW assignments. Following the mapping, IH will cross-check geospatial data with information from community stakeholders to better identify CHWs and update the CHW database. After reviewing the data in the Anié district, the MOH will recruit additional CHWs if needed, and IH will work with the MOH to identify other technical and financial partners to map CHWs nationally.

Challenge

Expansion of reimbursement model for the Integrated Primary Care Program (IPCP) services in Kara health centers:This quarter, IH and government partners validated the IPCP handover plan for the Kara region. The first year of the three-year plan focuses on transferring user fee removal and supply chain strengthening by transitioning the financing mechanism from an operating grant to a reimbursement model in 21 IH-supported health centers in four districts (Bassar, Dankpen, Keran, and Binah). Activities this quarter included the training of healthcare providers, standardizing the IPCP package of services eligible for reimbursement across all health centers, and updating procedural manuals. While there was strong community mobilization and buy-in from healthcare providers for the new reimbursement model, there is a learning curve for those implementing it for the first time. For example, at some health centers, IH found that certain procurement procedures were not fully followed, resulting in incomplete adherence to the IPCP package of services. To address this issue, IH continues to work with the MOH to further orient health center staff and establish a mechanism for regular and targeted supervision of providers.

Guinea Highlights

Success

Data quality improvement in Kouroussa district: In September, IH organized a bi-monthly joint data assessment and validation mission with the Kouroussa district Health Management Team in the seven IH-supported sites in Kouroussa (Babila, Banfélé, Baro, Douako, Kanséréyah, Kiniero, and Koumana). The goal was to assess the quality and accuracy of health data collected between March and April 2025, using the Lot Quality Assurance Sampling (LQAS) method to measure quality by sampling a subset of items from a larger set. The assessment focused on 12 key indicators related to maternal, child, and community health services. In order to identify discrepancies and determine the data accuracy rate for each center, data was verified using primary tools from health centers, then compared with monthly reports from clinical mentors. The results of the analysis showed a notable improvement in data quality at IH-supported sites. For example, the Babila health center’s data accuracy rate increased by 40% from January (35%) to March 2025 (75%). The next joint data assessment will be conducted in the second quarter of FY26, and IH will continue to support the Guinean government to improve the reliability and quality of the health information system data to inform decision making.

Challenge

Stockouts of antimalaria drugs in Kouroussa district: Guinea’s supply of antimalarial drugs was previously funded by two sources: the President’s Malaria Initiative (PMI) via USAID, covering Labé, Kindia, Boké, and Conakry regions; and the Global Fund, covering Mamou, Faranah, Kankan, and N'Zérékoré regions. The suspension of USAID funding led to significant shortages in the PMI-supported regions and, since July 2025, the National Malaria Control Program (PNLP) has experienced stockouts of antimalarial drugs. In response, the PNLP redistributed stocks originally allocated to the Global Fund-supported regions in order to cover the entire country. This has resulted in temporary shortages in several districts, including Kouroussa, where IH works. Antimalarial drugs are distributed free of charge and are essential for community-based case management conducted by CRs. Malaria remains the leading cause of under-five consultations in health facilities and is a key component of the Integrated Management of Childhood Illnesses (IMCI), alongside respiratory illnesses, diarrhea, and malnutrition. The MOH and the PNLP are working to resolve the issue at the national level, and IH is supporting health centers to plan and manage their limited stock as best as possible.

Organizational Highlights

Chief Executive Officer (CEO) transition: After 20 years of service, IH Co-Founder Jenny Schechter has decided to step down from the role of CEO and transition onto the Board. Under Jenny’s leadership, IH scaled high-impact programs across Togo, expanded into Guinea, and built a strong foundation for lasting change. Jenny will remain deeply engaged with the organization through her new role serving on the Board and will continue to support IH’s strategic growth.

Following a planned leadership transition led by the IH Board of Directors over the past year, IH is proud to announce that Emily Bensen will assume the role of CEO in January 2026.

Emily Bensen brings meaningful experience, including a decade working with IH in a variety of roles, most recently as Chief Partnership Officer. From spearheading the launch of the IPCP in Togo in 2015 to establishing new multi-million-dollar partnerships and leading IH’s expansion to Guinea, Emily has played a significant role in the organization’s growth and health impact achieved to date. We congratulate Emily on her new role and are excited for this new phase. Please read the full press release on IH’s website here.

Recruitment: IH welcomes Dieynaba Thiam-Ka, our new Managing Director based in Conakry, Guinea. Dieynaba joins IH with extensive background and experience in International Development, most recently having managed a large USAID private sector program in Senegal. She is an experienced manager and leader who combines warmth and compassion with efficiency and effectiveness. We are confident that Dieynaba's leadership will enrich our organization and foster stronger collaboration across our teams, amplifying IH’s ability to make a meaningful difference in the communities we serve. Please join us in welcoming Dieynaba to IH!

United Nations General Assembly: In September, IH participated on the sidelines of the 80th session of the United Nations General Assembly (UNGA80) in New York. Melanie Joiner, IH’s Senior Director of Partnership, co-facilitated a Sidebar dialogue focused on innovations and how to scale and finance resilient community health systems in partnership with governments. Jenny Schecter, IH’s outgoing CEO, spoke on a high-level panel at a breakfast organized by the Community Health Impact Coalition (CHIC), and was interviewed for DevEx’s Impact House. In her interview, Jenny explained how IH’s "learning lab" approach helped the Togolese government implement free maternal healthcare reaching over 600,000 women and how this same approach is now helping to unlock sustainable funding for community health workers' salaries in Guinea. See the full interview with Devex Impact House here.

In addition, incoming CEO Emily Bensen and Melanie Joiner were interviewed by Fix the News where they highlighted how IH is working alongside the MOHs in Togo and Guinea to build stronger, more sustainable primary healthcare systems. Read the full article here and listen to the full interview here.

Publication of Phase 2 impact study results: IH is excited to share that the phase 2 impact study on the IPCP scale-up districts has now been published in Pediatrics. The five-year study, led by researchers at Albert Einstein College of Medicine, evaluated the expansion of IH’s community-based IPCP in four scale-up districts. Results of the study indicate that when children receive care from the IPCP, they have a 29% lower risk of death, representing 45.5 deaths per 1,000 live births, compared to 64.5 deaths per 1,000 live births among those who did not receive care from the program. The new findings mirror the 30% reduction in under-five mortality seen in the pilot study (2015-2020) and further demonstrate that the IPCP can maintain effectiveness and impact at scale. The IPCP's consistent impact, coupled with its modest cost, suggests that it can be a blueprint for other Lower- and Middle-Income Countries (LMICs) seeking to improve child health outcomes at scale. Read the full published study here.

Community Health Worker spotlight: Kandjoura 

In Kanséréya, Guinea, Kandjoura  is more than a CHW; he is a leader, a mentor, and the bridge between remote villages and the health system. Originally from Boké, a major city, he left his family to serve in one of the country’s hardest-to-reach areas.

“Even if I was far from my family, I could still provide for them. Everything held together,” he recalls of the period when his stipend was supported by external funds.

But when that funding abruptly stopped, so did the payments. The shock was devastating, leaving him and his colleagues uncertain about their future.

At that critical moment, IH acted quickly, stepping in with salary adjustments that restored hope. “It was the best decision. We felt heard and supported,” Kandjoura says.

Regular CHW salaries are not just financial support; they are recognition, dignity, and motivation to continue life-saving work. Without them,CHWs risk losing the stability they need to keep serving their communities. With them, leaders like Kandjoura can continue to save lives, inspire peers, and sustain the backbone of healthcare in Guinea’s most remote villages.

Financial Highlights

• This quarter, IH received generous renewal funding from five partners. We remain grateful for your continued support.
• This quarter, IH finance teams in the US, Togo, and Guinea conducted internal audits in preparation for the external audit of FY25 financials. The FY25 external audit is expected to be completed by November 2025, and the final report will be uploaded to IH's website.