Despite significant gains on basic health indicators, Togo’s health system remains fragile (Africa Renewal, 2010). Periodic disruptions became particularly trying for the public during a 2018 strike when even essential services were unavailable (Tounou-Akué, 2018; L-frii, 2018; alome.com, 2018; VOA, 2018; Kamako, 2018). Striking health-care workers have sought better working conditions and technical platforms as well as better salaries (Republicoftogo.com, 2018; lomeinfos.com, 2018).
Critics have also challenged the system’s governance, but solutions proposed by the government have not convinced its social partners (Togotribune.com, 2018). Union leaders acknowledge that management outsourcing may bring improvements at Togo’s largest health facility, the Centre Hospitalier Universitaire Sylvanus Olympio, but they also insist that investments beyond good governance are needed to bring the system up to par (Lomeinfos.com, 2018).
In the most recent Afrobarometer survey in Togo, citizens clearly express their dissatisfaction with health services in their country. They cite health as one of their top priorities for government action and give the government poor marks for its performance in the sector. Meanwhile, fully three-fourths of Togolese report having had the experience of going without needed health services during the past year.