For many people around the world, healthcare as been challenging, hard to access, and not the quality you would hope to receive—even before COVID-19. Take one nurse in Togo who describes the biggest change in her career, “Before, when I didn’t have the knowledge and training in health care, I would send women away to other centers. Now I can welcome them and treat them here.”
If that’s been your experience of health care, it’s not a surprise that you might be reluctant to get involved with the system. Building trust and confidence are critical—especially with health workers.
It’s possible to change that. In fact, 95,715 more people got health care in Togo—including 4,000 kids with vaccines, because of work building trust between health workers and communities.
Want more people to get vaccines? Access family planning? Wear masks? Make the health system work for them.
Sometimes, the most basic ideas can make the biggest difference. As one patient says, “Welcome services got better. Now the staff come tell us if they are busy and that they will be with us soon. That’s already an improvement.”
One religious leader describes an experience bringing a woman to a health center, “It was a delicate [complicated] birth. The midwife assured us not to be afraid and that she would do her best and everything would go well. I was waiting for the woman to be sent somewhere else for the birth. Thank God, they had the skills to treat her here.”
Promoting Maternal and Child Health in Togo reached 19,426 people directly and 45,074 indirectly between 2018-2020. The project had $550,190 from GlaxoSmithKline.
What changed?
- More people got healthcare: 95,716 people got access to additional or improved health care—more than twice what the project initially estimated.
- Kids got vaccines: 4,069 kids got measles vaccines—the last of their childhood vaccines that means they are now fully vaccinated.
- Women are accessing family planning: Women are 2.5 times more likely to use a modern contraceptive, and 2,701 women accessed family planning services.
- Women feel better about their experiences. 94% of women say their health workers are listening to them. 91% say that now health workers are patient with them.
- Women are more satisfied with services: 96% of women are satisfied with integrating family planning services into vaccination campaigns. 93% of women are satisfied with overall health services, and 95% with vaccines.
- Health services improved: 70% of women say health services improved—especially when they are giving birth.
- Health workers are proud of their work. Recounting how things are better at her health center, one nurse says, “Before, getting people to come for childhood vaccinations was like pulling teeth, and we didn’t talk about family planning at all. People were really reluctant to get vaccines or family planning. Now we integrate both services.” Another nurse says, “Before, when I didn’t have the knowledge and training in health care, I would send women away to other centers. Now I can welcome them and treat them here.”
How did it happen?
- Help health workers get the skills they need. The project trained 22 formal health workers and 710 community trainers on skills like post-birth care, family planning, counselling, and maternal and child health care.
- Provide options—and information in lots of different formats. One key was providing a range of choices for how to get information. Of women who now are interested in family planning, 58% said a counselling session convinced them, 43% said it was a visit from a community health worker, and 44% found a community information session helpful.
- Invest in health workers to help change behavior. Of women who changed their mind to adopt health services, 42% said it was because of information they got from a formal health worker at a health center. 24% said it was because of a community health worker, and 26% said it was from a community information session.
- Get communities talking. 10,580 women and 6,168 men participated in community dialogue sessions about health services, vaccines, and family planning.
Want to learn more?
Check out the evaluation (in French)