Integrated Clinic and Community-Based Delivery of Reproductive Health Services in Togo

Hope Through Health (HTH) has developed a service delivery innovation that is transforming public healthcare systems in underserved nations like Togo. HTH’s approach implements a bold new service delivery model in partnership with the Togolese Ministry of Health (MOH) to strengthen primary health care (PHC) across RMNCH including family planning (FP). On the community-level, this model will build demand, by training and equipping local women as community health workers to effectively educate and enroll women into potentially life changing FP programs. On the clinic level, this program will improve supply, by entirely eliminating clinical user fees to reduce inequities in access, training clinical staff on patient-centered care through an ongoing mentorship program, and improving supply chain management through ongoing training. HTH is piloting this approach, which uses demand and supply-side components to increase uptake of FP, directly in pubic clinics in four underserved communities in northern Togo where contraceptive prevalence is as low as 4%. Low utilization of FP contributes to Togo’s unacceptably high maternal mortality rate of 450 per 100,000 and child mortality rate of 78 per 1,000. This approach, which supports Togo’s FP 2020 Program and Service Delivery Commitment made in October 2014, is being implemented by HTH in partnership with the MOH to demonstrate effectiveness and inform future work by the Government of Togo to replicate this model at national scale.