Integrated Health Systems Strengthening Support to Strengthen Leadership, Improve Governance, Promote Learning, and Achieve Universal Health Coverage in Togo

The Challenge

Togo is on a journey to achieve universal health coverage (UHC). This goal is reflected in many policies and strategies. The National Health Development Plan outlines the government’s plan to increase access to quality care at all health system levels and develop mechanisms for increased financial access to health care. However, key challenges remain, including free access to essential services, sustainable financing, and civil society engagement. These challenges are reflected in Togo’s high out-of-pocket health spending, including catastrophic health expenditures, sub-optimal quality of care, and inequitable access to health care. While collaboration between stakeholders has improved with a notable achievement of a shared vision for UHC, meaningful citizen and civil society engagement in UHC decision-making remains limited and inadequate, constraining efforts to ensure that UHC reforms are equitable and responsive. Togo also lacks a systematic learning mechanism to promote iterative adaptions and improvements for advancing UHC.

The Opportunity

In addition to the National Health Development Plan, Togo also developed an ambitious health roadmap in 2020, which specified targets for attaining UHC, including improving multi-sectoral stakeholder collaboration and target setting and designated a Delegated Minister for Access to Universal Health Care. To deliver on the full potential of Togo’s UHC plans, the Accelerator can support the ministry of Health and its Delegated Minister for Access to Universal Health care in prioritizing essential services to be delivered free of charge, including family planning and ensuring that vertical diseases programs such as HIV/AIDS that are heavily reliant on donor funds are integrated into Togo’s health system and sustainably financed by domestic resources.

Our Work

In collaboration with it’s the Government of Togo and the Accelerator’s regional sub-award partner, the Centre de Recherche en Reproduction Humaine et en Demographie (CERRHUD), and various UHC stakeholders in Togo, the Accelerator has supported the development and implementation of Togo’s integrated UHC plan to help improve access to health for all in Togo.

The Accelerator is also strengthening specific components of UHC, including family planning (FP) and maternal and neonatal health services, by supporting the launch of Togo’s Wezou program in 2021, which provides a free package of essential maternal, newborn, and postpartum services for women and newborns. The Accelerator conducted a costing to estimate the costs of providing free FP services up to 2 years postpartum and to provide free FP for adolescents and youth ages 10 to 24 years old over a five-year period.

The Accelerator continues to build civil society capacity and engagement in UHC-decision making by providing on-site and remote coaching through trainings; financial, technical, and planning support for UHC-related advocacy activities; and sharing UHC resources with civil society platforms to build members’ skills in social accountability, monitoring and evaluation, advocacy techniques and knowledge of UHC.

The Accelerator is also promoting sustainable domestic financing for HIV by assessing the current status of HIV financing in Togo and advising the Government of Togo on the sustainable transitioning of HIV financing from international to domestic resources.

Finally, the Accelerator supports regional and cross-country peer learning and knowledge translation as it finalized the development of a national UHC learning agenda that promotes the application of UHC knowledge, synthesizes lessons learned on the design and implementation of UHC and highlights best practices.