Togo is a West African country with over 8 million residents. Currently, there is a health care crisis affecting these 8 million. Health care in Togo has a history of unreliable and poor-quality emergency care conditions. Often, medical care is inadequate, and medications are unreliable. According to Africa Development and Cooperation, in 2017, Togo was said to have the worst health care in West Africa due to their high mortality rates and persistent high morbidity. The current infant mortality rate in Togo for 2023 is 43.162 deaths per 1,000 live births. Many factors contribute to the sub-par health care systems such as lack of quality staff, outdated medical practices and ineffective financial resources. 

While Togo has been struggling with their health care, they are beginning to improve their health care system. The methods that are in place to improve health care in Togo are training for health care professionals, spreading qualified health care workers to public clinics and the integration of a universal health care system. 

World Health Organization

The World Health Organization, in collaboration with the World Bank, is supporting the country by implementing solutions to its health care crisis. The World Health Organization is supplying 14 training schools for paramedical personnel with teaching, computers with videoconferencing materials, and 600 midwives and nurses who have recently trained in infection prevention. The World Health Organization has used its Pandemic Emergency Financing Facility (PEF) funds to ensure the supply of equipment to training centers. This equipment will provide continuous training and face-to-face and teleconferences available to health care workers in the country. They will also contribute to updating the curriculum for health workers and increase the capacity of training centers. The World Health Organization is putting effort towards training personnel and updating training facilities to begin improving health care in Togo.

Integrate Health 

Integrate Health uses a primary health care approach to improve the national health care system in Togo. One of the first ways Integrate Health is improving health care in Togo is by integrating professional health workers. As Togo only has 347 practicing doctors in the country, they rely on other sources to get more health care workers. Community Health Workers are many people’s first point of contact with the health system. These workers go door to door with personal protective equipment and supplies to provide lifesaving care. These workers train to administer treatment for children with respiratory infections, malaria and malnutrition. They also screen newborns and pregnant mothers. Workers also refer patients to health centers for advanced care when necessary. There are currently 200 community health workers in Togo.

Integrate Health is also pursuing improvements in the supply chain and infrastructure within Togo. Medications are commonly not in stock and are hard to get because health centers are outdated. To combat this, Integrate Health is overseeing improvements like building water towers, bolstering infrastructure, training pharmacy managers in equipment, ordering medication and managing medical supplies. With improvements in these areas, health care professionals will be better equipped to help patients, which will build trust. Currently, the renovations have fixed 17 health centers, and 28 supply chain managers have received training.

Another step Integrate Health is taking to begin improving health care in Togo is eliminating user fees. The pay-for-service culture that Togo’s system has cultivated has low user rates, which provides little funds to renovate the systems. Removing these fees will increase user rates in health care systems. To do this, Integrate Health provides monthly operating grants to the health centers to cover the cost of the services incurred. They also have people donating funds to invest in the costs covered by the pay-for-service fees.

Universal Health Care Systems

Recent legislation has established the creation of a universal health system (l’assurance maladie universelle – AMU). The government plans to have this plan completely rolled out by 2025, which would cover all residents. The system would have two tiers: the public and private sector employees (RAMO) and the individuals on public assistance (RAM). Under RAMO, employees would enroll at the beginning of their employment with coverage that extends to children and spouses. Coverage for RAM would be provided directly by government revenue. While this has yet to be rolled out, this will be a step towards fleshing out Togo’s health care system and giving people access to the care they need.

Conclusion

Although Togo has encountered significant difficulties in its health care sector, the nation is committed to creating positive change within its health care system. A multifaceted approach is achieving these goals.

One pivotal aspect of this transformation is the extensive training and development programs for health care professionals. By investing in the education and skill enhancement of its health care workforce, the country aims to ensure that its medical practitioners are equipped with the latest knowledge and expertise, thereby improving health care in Togo. 

Furthermore, Togo recognizes the importance of extending the reach of qualified health care workers to public clinics. By decentralizing health care services and ensuring that well-trained professionals are available in various regions, the country aims to enhance accessibility to health care services, particularly in rural and underserved areas. This initiative is improving health care in Togo.

– Sara Agosto
Photo: Flickr