Health in Togo

Togo's formal health system is overseen by the Ministère de la Santé, de l’Hygiène Publique, de la Couverture Sanitaire Universelle et des Assurances. It operates through central, intermediate and peripheral levels. Six regional health directorates and 39 district health offices coordinate services, while public and private facilities provide care. In 2023, Togo recorded 2,152 health facilities, including 1,362 private facilities, 227 pharmacies and 13 pharmaceutical depots across 117 health communes. For a non-urgent problem, a community health worker, called an agent de santé communautaire or ASC, may provide first contact and direct the patient to a peripheral care unit, known locally as a USP. A district hospital, or HD, provides the first referral level. Regional hospitals, called CHR, handle more complex cases, while three teaching hospitals, called CHU, and specialist clinics provide tertiary care. Referral and counter-referral are intended to connect these levels, but the available pathway depends on the facility's staffing, equipment, opening hours and available medicines. Traditional medicine practitioners, known as PMT, are also widely present, but this pathway is mainly informal and does not replace the formal referral system. In an acute emergency, go immediately to the nearest facility able to provide the needed care, such as a district hospital, regional hospital or teaching hospital. A nationwide personal ambulance service or single individual emergency number has not been reliably confirmed. The COUSP coordinates public health emergencies rather than routine ambulance dispatch. Geographical access was estimated at 90.6% in 2024, but actual access can be lower or slower because of distance, road conditions, transport costs, regional staffing, diagnostic capacity, beds and medicine shortages. No reliable nationwide fee schedule or waiting-time list applies to every facility. The amount and timing of payment depend on the provider, service, medicine, region, transport and any applicable insurance or assistance arrangement. Routine immunization reached more than 90% nationally for each reported antigen in 2024. Togo introduced the R21/Matrix-M malaria vaccine nationwide on 1 September 2025, mainly for children under five. Other malaria measures include insecticide-treated nets, preventive treatment during pregnancy, seasonal preventive treatment for children under five in 23 districts and preventive treatment for children under two in 16 districts. HIV and sexually transmitted infection, tuberculosis, maternal and newborn, nutrition, eye-health, school-health, substance-use and non-communicable disease programmes operate alongside these measures. Malaria was the leading reason for consultations in 2021, accounting for 60.6% of consultations overall and 65.3% among children under five. Acute respiratory infections accounted for 11.5% overall and 15.8% among children under five. Among adults aged 18 and over, hypertension was estimated at 27.4% and diabetes at 4.9% in 2021. HIV prevalence among the sexually active population was estimated at 1.72% in 2022. Maternal and child services include prenatal consultations, assisted delivery, emergency obstetric and newborn care, postnatal care, family planning, prevention of mother-to-child transmission, newborn care and community services. In the first quarter of 2024, 74.9% of recorded births were attended by skilled staff; 1,495 births occurred at home or during transport, representing 2.86%. Regional differences remain substantial. In 2024, 84.6% of emergency obstetric and newborn care facilities had the essential functions, while 64.7% were functioning facilities under the relevant assessment. Mental-health services are being expanded through the 2024–2027 national programme. Its scope includes mental disorders, addiction, neurodevelopment, sleep, eating and sexual disorders, suicide prevention and post-traumatic stress. Community-based and integrated services remain an area of development, so available support differs by location. Medicines are supplied through health facilities, pharmacies and programmes linked to the national essential-medicines system, DPML, CAMEG-TOGO and regional and district structures. Product availability varies by region and medicine, and stock-outs can delay treatment or follow-up. Prescription and dispensing rules depend on the facility and programme. After treatment, keep referral papers, test results, prescriptions, appointment dates and medication instructions. These records support counter-referral, chronic disease reviews, HIV or tuberculosis follow-up, antiretroviral treatment, rehabilitation and mental-health care. Article 34 of Togo's Constitution recognizes a right to health, while the state declares equal access and quality of care as goals. A single nationwide patient charter, consent procedure and complaints process could not be reliably identified in the available sources. In practice, provide accurate medical information, follow prescriptions and appointments, and comply with the rules of the facility providing care.