Koudjoukalo heads to a compound in the rural outskirts of Sarakawa in northern Togo, West Africa. A Community Health Worker, trained to care for her neighbors, she has come to stop a killer — one operating in plain sight. Despite the afternoon heat, she feels a shiver down her spine as she enters the dark interior of a family home. Her purpose here is to help prevent this child’s death. The sound of five-year-old Esi stifling a cough makes her worry she is too late.
In Togo, nearly one in ten children will not live to see his or her fifth birthday. Malaria, diarrhea, pneumonia, HIV, and malnutrition are all easily treatable conditions. They can be managed at a very low cost, yet needlessly claim lives. In fact, they do so at a rate fifteen times higher than that of developed countries.
Esi is sick with pneumonia. It is an illness serious enough in the States to raise alarm. When it strikes my children, it is cause for concern. Midnight runs for antibiotics and cough syrup. Sitting up at their bedside through the night. Listening close to the quality of the cough, with the same intensity of Koudjoukalo, as it shifts in evening hours.
For Esi and her family it is different. Antibiotics at 24-hour pharmacies are not on every corner. Access to hospitals, clinics, and basic medical care is often compromised by geographic distance and financial barriers. Togo lacks the functioning healthcare system required to deliver effective treatments to women and children in need. Essential components, including personnel, supplies, and training, are currently absent or insufficient throughout much of the country. As a result, UNICEF named Togo the 15th Most Dangerous Place to be born in the world in 2018.
As one of the only international NGOs with a sustained presence in northern Togo, and with a proven track record for success, Integrate Health is uniquely positioned to turn this tide, eliminate barriers to care, and end needless deaths. Integrate Health is working to change the culture of health in Togo and beyond by developing a replicable primary healthcare delivery system that includes four components. The components — using community health workers, building clinical capacity through mentorship, strengthening supply chain infrastructure, and waving user fees — work together to form a comprehensive system that has been designed and tested for effectiveness. Each component operates to remove a barrier to lifesaving care.
This integrated model provides a seamless healthcare system that transforms poor public clinics into lifesaving centers of care and 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.
In Esi’s case, these components work together to ensure she receives the care she needs. Koudjoukalo provides antibiotics and aspirin to manage the infection and get the fever under control. If Esi needs more intensive treatment — IV fluids or oxygen therapy — Integrate Health ensures that hospital fees are covered so that finances do not act as a barrier to care.
In Sarakawa, near Esi’s home, a struggling health center was given new life. Essential infrastructure repairs, like running water, a working latrine, and electricity, were made along with the addition of a Clinical Mentor, who provides supportive supervision to ensure competent providers and high-quality care through a peer-to-peer mentorship approach.
In this way, Integrate Health is helping to change the culture of health in Togo. We are helping children like Esi to recover from treatable illness, so they can avoid preventable deaths and live to celebrate a 6th birthday.