One of my first significant engagements as I joined Integrate Health as Global Managing Director at the beginning of May was meeting with Togo’s Minister for Universal Health Access, the Honorable Jean-Marie Koffi Ewonoule Tessi. Accompanied by our CEO, Jennifer Schechter, and Togo Country Director, Christophe Gbeleou, we discussed the future of Universal Health Coverage (UHC) in Togo, its financial implications, and the future of an already strong partnership. The Minister’s enthusiasm and commitment were palpable, reflecting a significant shift in governmental priorities towards health equity and universal health access. For me, it was exciting and energizing.
I left feeling inspired by the profound implications of this new ministry for Togo’s journey towards UHC. The creation of the Ministry for Universal Health Access is a monumental step forward for Togo. This dedicated ministry signifies a focused commitment to health equity. The separation from the Ministry of Health and Public Hygiene underscores a strategic decision to prioritize accessibility, availability, and equity in healthcare. This commitment aligns perfectly with Integrate Health’s mission and values, and very well reflects the strides Integrate Health and the government have made together in advancing community health. This meeting was not just an introduction but a revelation of how deeply our missions align, opening a window of opportunities for the future.
A Ministry for Universal Health Access: The means to an end
The establishment of the Ministry for Universal Health Access is a testament to Togo’s President Faure Gnassingbé’s renewed dedication to achieving UHC. This dedication by Togo’s Head of State has been demonstrated by concrete actions such as the Wezou program which rendered maternal healthcare free and accessible to all pregnant women throughout the country. The new ministry underscores the country’s commitment by providing the necessary administrative focus and resources to ensure health services are accessible to all. With a substantial increase of the total health sector budget, the ministry is equipped to make significant strides in healthcare service delivery. This funding boost is aimed at accelerating the implementation of Universal Health Insurance (AMU), which became operational in January 2024 and is critical in limiting out-of-pocket spending.
This initiative is relatively unique in the African context, as very few countries have established an independent Ministry solely dedicated to UHC. Most countries integrate UHC efforts within their existing Ministry of Health structures, making Togo’s approach a pioneering model for the continent. By creating a dedicated ministry, Togo can ensure a more focused and coherent strategy towards achieving UHC, potentially serving as a blueprint for other nations on the continent.
This initiative aligns closely with Integrate Health’s mission. For over 20 years, Integrate Health has demonstrated the effectiveness of a community-based approach in Togo. Integrate Health’s Integrated Primary Care Program (IPCP) has significantly reduced mortality in resource-limited settings, with a Pediatrics study indicating a 30% decline in under-five mortality over five years. Such accomplishments highlight the importance of community health in achieving UHC and provide a solid foundation for the Ministry for Universal Health Access to build upon. This alignment allows both the ministry and Integrate Health to synergize their efforts to ensure that every Togolese citizen benefits from equitable and accessible healthcare services.
What this means for Integrate Health and the future
The establishment of the Ministry for Universal Health Access marks a significant advancement in expanding and sustaining our community health initiatives. For 20 years, Integrate Health has partnered with the Togolese Ministry of Health to build a robust community health system, delivering high-quality care to those who need it most.
Our collaboration with the Ministry has been transformative. By involving local health officials from the beginning, we embedded our programs within government systems, demonstrating the effectiveness of our IPCP and significantly reducing under-five mortality. Strong relationships at various government levels ensured the continuity and expansion of our programs. Key to our success has been transferring ownership to government partners. By embedding our staff within government teams and gradually shifting responsibilities, we ensured our programs became integral parts of the national health system, securing their long-term sustainability.
Looking ahead, the new ministry represents a bold vision for achieving UHC in Togo. As we transition from an NGO-led program to a government-owned system, such a critical decision from the government marks an advancement of our collaborative efforts and a new beginning. It symbolizes the government’s commitment to health equity and strengthens our resolve to continue enhancing community health services. Together, we can build a healthier, more equitable future for all Togolese citizens.
Conclusion
Togo’s establishment of the Ministry for Universal Health Access is a critical step towards achieving UHC. By prioritizing community health and ensuring equitable access to healthcare, Togo sets a model for other nations to follow. This alignment of governmental priorities with Integrate Health’s mission reinforces the efficacy of community-based health services. Our 20-year partnership with Togo’s health sector, marked by significant reductions in mortality and improved health outcomes, stands as a robust foundation for this renewed commitment to universal health coverage.
The creation of the Ministry for Universal Health Access not only symbolizes the government’s dedication to health equity but also provides a blueprint for integrating health workers into the broader health system. This progressive move ensures sustainability and scalability, paving the way for a healthier future. As we move forward, our focus will remain on leveraging community health as a cornerstone of UHC, fostering resilience, and improving health outcomes for all.