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Key findings
  • Health ranks near the top among problems that Togolese say their government needs to address, second only to unemployment.
  • Three-fourths (76%) of Togolese say they went without needed medicine or medical care during the 12 months preceding the survey, including 36% who say this happened “many times” or “always.” Poor and less-educated citizens are particularly likely to lack health services.
  • Almost half (48%) of respondents who sought care at a public health facility during the year preceding the survey say it was difficult to obtain the care they needed. This is a modest improvement from 2014
  • A plurality of Togolese think that things are getting worse when it comes to health services: Compared to “a few years ago,” 44% say their ability to get care has deteriorated, while 33% say it has improved.
  • Six in 10 Togolese (62%) say the government is doing a poor job of improving basic health services, an 11-percentage-point increase in negative evaluations since 2014.

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.

Thomas Isbell

Post-doctoral research fellow and research assistant at Afrobarometer

Hervé Akinocho

Hervé Akinocho is the director of the Center for Research and Opinion Polls – CROP, based in Lome in Togo.