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 worked 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

 
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. From its launch in 2003 to its close in 2008, in Togo this USAID-funded project:

• 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 worked 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 has trained peer educators to integrate family planning messages and materials into HIV prevention programs. In Togo, HIV prevention activities included 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.