Togo

Togo, a small West African nation situated between Ghana and Benin, is home to 6.1 million people. Despite recent economic progress and an increase in primary school enrollment among girls, health trends are static or worsening:

• Maternal, infant, and childhood mortality remain unacceptably high;
• Life expectancy has declined from 57.3 years in 1990 to 55 in 2005;
• The country’s HIV prevalence rate, at 4.1 percent among adults, is the third highest in West Africa;
• Among 15- to 24- year olds, the HIV prevalence rate is 2 percent for men and nearly 6 percent for women.

To counter these trends, EngenderHealth work with partners in Togo to:

• Improve the quality of health care
• Promote maternal, infant and child health
• Address HIV and AIDS through integrated health care
• Expand contraceptive choice

 
Improving the Quality of Health Care
Togo is one of 21 West African countries included in EngenderHealth’s Action for West Africa Region—Reproductive Health (AWARE-RH) Project. Since its launch in 2003, in Togo this USAID-funded project has:

• Encouraged passage of the Reproductive Health Law, which increases access to family planning and reproductive health care;
• Advocated for increased funding to improve the country’s health programs;
• Used a model called “REDUCE” to highlight the economic benefits of improved maternal health care.

 
Promoting Maternal, Infant, and Child Health
In Togo, pregnancy-related complications cause 570 maternal deaths per 100,000 live births. Moreover, for each maternal death that occurs, 20 to 30 women suffer from pregnancy-related disabilities. While most maternal deaths are preventable, mother and newborn health programs remain severely under-funded in Togo and other West African nations. EngenderHealth works with its partners to improve maternal, infant, and child health by:

• Mobilizing community participation in health care and encouraging families to better prepare for routine births;
• Improving provider skills in basic and emergency obstetric care;
• Training community health workers to prevent infant deaths from acute respiratory infections, malaria, and diarrhea;
• Upgrading equipment at health facilities and clinics in the remote Central and Plateau regions;
• Developing a new treatment protocol (sulfadoxine pyrimethamine) to prevent malaria in pregnant women;
• Providing comprehensive postabortion care services, including counseling, referral, and infection prevention.

 
Addressing HIV and AIDS Epidemic through Integrated Health Care
Throughout West Africa, EngenderHealth trains peer educators to integrate family planning messages and materials into HIV prevention programs. In Togo, HIV prevention activities include targeting truckers and residents along the main transport corridors between Togo and Niger with information on HIV prevention, family planning services, and voluntary HIV counseling and testing services.

 
Expanding Contraceptive Options
A shortage of skilled providers, inadequate supplies, and lack of accurate information about methods have hindered men’s and women’s access to modern contraception in Togo. Through the ACQUIRE Project, funded by USAID, EngenderHealth collaborates with the country's Ministry of Health, Pathfinder International, and other agencies on the following initiatives:

• Training health care providers in family planning and counseling skills;
• Promoting the use of Norplant and the intrauterine device (IUD), two low-cost, long-acting contraceptive methods;
• Educating providers about the latest medical standards regarding infection prevention and IUD insertion, removal, and counseling;
• Developing a national plan to ensure the availability of family planning and reproductive health supplies;
• Encouraging the government to include funding for contraceptive commodities in the national budget.