Community Health Care Improvements for Women & Children in Togo, West Africa | 2017

World Centric + Integrate Health

$52,602.00 from profits from fiscal year 2017

Nearly 1 in 10 children born in Togo, West Africa, will die before their 5th birthday from diseases that are entirely treatable, such as malaria, diarrhea and pneumonia. 368 women die per 100,000 live births. Most health care in Togo is costly, poor quality, and not easily accessible. Integrate health works to transform the poorest performing clinics in to centers of excellence by creating infrastructure improvements, providing clinical mentoring, equipping proactive Community Health Workers, and eliminating user fees.

This is the expansion of a project we funded with 2016 profits.

The Impact

World Centric funding will support care at 4 current sites while replicating the model at 5 new sites:

• Serve a population of 72,634 people
• Perform 35,000 sick child consultations
• Perform 6,700 pre- and post-natal consultations
• Perform 990 facility-based deliveries.

Indirect impact:

• Health improvements from access to quality health care
• Wages for 60 Community Health Workers
• Wages for 4 nurses
• 70% reduction in child mortality at the sites

The Approach

Integrate Health has developed a replicable primary healthcare delivery system that includes four components. This comprehensive system has been designed and tested for effectiveness. Each component operates to remove a barrier to lifesaving care.

• Clinical Capacity-Building. Ensuring high-quality care by providing ongoing training and continuing medical education to nurses and midwives.
• Community Health Workers. Community Health Workers (CHWs) are frontline healthcare providers, predominantly women, recruited from the community they serve. They are trained, equipped, supervised, salaried, and fiercely passionate, combining a lifetime of local knowledge with an ongoing medical education.
• Supply Chain and Infrastructure. Integrate Health’s approach to improving supply chain management and basic infrastructure ensures that providers have high-quality facilities to work in and the tools they need to adequately care for their patients. Clinical mentors coach pharmacy managers to ensure proper supply, equipment, reporting, and ordering so that the right medication is in the right place at the right time.
• User Fee Removal. Research shows that even very small fees sharply limit access to healthcare. The pay-for-service nature of Togo’s healthcare system creates a vicious cycle where low utilization rates leave the health center with little investments while the community receives little care. By removing financial barriers, specifically costs at the point of care, use of lifesaving healthcare services increases dramatically. Clinics see more patients, and patients get the care they need.

This integrated model provides a seamless healthcare system that transforms poor clinics and communities into lifesaving centers of care. This model can be replicated at a cost of only $10 per capita with a 10:1 return on investment based on the benefit per life saved

AboutIntegrate Health (Santé Intégrée)

A World Centric partner since 2017.

Integrate Health (Santé Intégrée) provides HIV care and treatment services in northern Togo, West Africa, where these services were previously not available. The organization is one of the most effective healthcare delivery services operating in the country. They focus on involving community members in the dynamics of the organization, ensuring that the programs are responding directly to patient priorities.

Integrate Health was founded in 2004 in an effort to support individuals living with HIV who were fighting for their right to healthcare. This work contributed to the creation of the most effective HIV care programs in Togo. This effort led to their current work to integrate health into every community and clinic.

Updates

April 2019
At the 12-month mark, Integrate Health exceeded their targets in all areas:

• Serve a population of 72,634 people: Actual = 93,479.
• 35,000 sick child consultations: CHWs performed 50,677 consultations.
• 6,700 pre- and post-natal consultations: 8,440 performed.
• 990 facility-based deliveries: 1,476 deliveries performed.

The impact of hiring rural women as CHWs has ripple effects well beyond improved health in the community, and stimulation of rural economies. Many female CHWs report being treated better by their husbands, including being asked for their input on family matters, now that they are able to contribute financially to the household. In addition, CHWs who are mothers report sending their daughters to school, and therefore taking an important first step to ending a cycle of gender inequity.

September 2018
At the 6 months mark, Integrate Health is exceeding their targets in all areas:

• Serve a population of 72,634 people: Actual = 92,375.
• 35,000 sick child consultations: To date, CHWs have performed 22,478 consultations. 64% of 12 month target.
• 6,700 pre- and post-natal consultations: 4,116 performed. 61% of 12 month target.
• 990 facility-based deliveries: 559 delivers performed. 56% of 12 month target.

Based on preliminary data, the mortality rate of children under the age of 5 has been reduced by 50% in the communities being served. IH expects 70% reduction by the end of 12 months.