ProSanté: strengthening the health system

Project description

Title: Health System Strengthening – Sexual and Reproductive Health and Rights
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Togo
Lead executing agency: Ministry of Development Planning and Cooperation (MDPC)
Overall term: 2017 to 2020


Togo’s health system is underfunded. The infrastructure is often inadequate or outdated, and there is also a shortage of suitable staff. This is leading to poor-quality treatment for the population, which in turn results in falling demand for health care services. About a third of people suffering from illnesses do not even visit health care services. The situation is no better when it comes to reproductive and sexual health: only about one in six married women uses modern family planning methods, and only 57 per cent of pregnant women attend four prenatal appointments.

Climate change and altered temperature and rainfall patterns are causing diseases to spread further, especially in countries such as Togo. Heavy rainfall is making malaria more prevalent, for instance. Food supply is reduced by droughts and rising temperatures, making the population more vulnerable to illness.


Access for the population to high-quality health care, especially sexual and reproductive health services, is improved, and demand has increased.


The project is introducing a quality management system in 30 health centres in the Kara region. This involves working closely with the regional office and the district authorities of the Ministry of Health.

The staff in these centres receive systematic in-service training, for example on modern family planning methods and emergency prenatal and newborn care. Working in tandem with its Togolese partners, the project is acting to ensure that the population makes more use of health services. To this effect, a comprehensive communication strategy is being implemented. One of the priorities is to inform people about their sexual and reproductive rights.

In addition, the project is supporting the Ministry of Health in planning staffing requirements in health care up to 2030. Advisory services, organisational analyses and the development of new countrywide documents and strategies enable the ministry to better manage activities in the health sector. One focus here is on ensuring high quality.

The project supports the development of a climate strategy for the health sector so that Togo’s health system can prepare better for the consequences of climate change. Data have already been collected for this purpose. In parallel with this, the project provides support in applying for finance from climate funds.
The GFA Consulting Group is helping to implement the project in the Kara region.


  • Initial drafts for a quality policy and strategy in the health sector in Togo are now available.
  • A regional quality strategy has been developed for the Kara region, and this is being implemented in the 30 health centres supported by the project. As part of this, training has been provided to 70 employees of the regional office of the Ministry of Health and of the health centres. The centres have carried out a self-evaluation in this context and prepared individual work plans, and they have been equipped with the necessary materials. In addition, 210 members of the administrative committees of these centres have been trained. Ongoing support is being provided to the committees.
  • The project has trained 19 instructors and over 100 employees of health centres in the Kara region on the topic of family planning. As a result, the participants can provide advice on suitable methods to 242,000 women of child-bearing age.
  • Almost 450 women have already opted for a family planning method thanks to information campaigns.
  • The project has trained over 1,000 young mothers in the Kara region as multipliers. They will in turn initiate conversations about issues such as unwanted pregnancies. Almost 300 female market traders have also been trained in raising awareness of the importance of reproductive health services such as prenatal checkups.
GIZ2019 TOGO_03

Additional information