Integrate Health (formerly Hope Through Health) – Togo

Integrate Health (IH) has developed an affordable and replicable healthcare delivery system focused on reducing maternal and child mortality rates in rural and remote areas of Togo.

At the time of the Risk Pool Fund grant in 2018, IH provided high quality healthcare to 40,000 people through 9 health centers across northern Togo and was 6 months into a 3-year fully funded grant with Vitol Foundation to replicate the Integrated Primary Care Program.

IH worked locally with an accredited Togolese partner organisation in order to procure supplies from the national pharmacy distributor, CAMEG. However, during this project, IH separated from the local partner and found itself unable to stock its partner clinics with medications.

To address the problem, IH negotiated a contract with CAMEG that would allow each clinic to procure medicine directly (with IH providing oversight and support) but needed to provide a $42,000 deposit which was outside the scope of the original project funds.

As IH had no reserve funds that could be accessed, Risk Pool Fund provided a grant to cover the additional cost of the security deposit and the new procurement system started as scheduled in July 2018. The Risk Pool grant not only allowed the original project to carry on as planned, but also reduced the administrative burden on IH staff and increased the autonomy of the public clinic pharmacy managers, by transferring the CAMEG ordering task from IH to the pharmacy managers.

The project did continue to have ongoing challenges, as CAMEG struggled to keep up with demand. However, IH found itself in a position to support procurement on a national level due to its existing relationship with CAMEG facilitated by the RPF grant.

Today, IH has adopted a two-pronged approach to strengthening the essential medication supply chain in Togo. Firstly, increasing the management capacity of supply chain agents at the health centre level through ongoing training and support and secondly targeting the regional and national management levels by maintaining the annual contract (the one negotiated during the RPF grant) with CAMEG, and co-signing the contract with the Regional Health Management Team. In this way, IH has successfully implemented an integrated ‘top-down, bottom-up’ approach that strengthened the existing supply chain systems and, in the context of the 2020 pandemic, ensured that medicine availability rates were not affected by COVID-19.