Oct 2, 2020

Integrate Health Q4 report Apr-Jun 2020

Quarterly Indicators
Quarterly Indicators

As COVID-19 brought the global economy to a halt, the team at Integrate Health ratcheted up their efforts. In early March, as the first case was detected in Togo, the team rapidly and seamlessly pivoted to emergency response mode, proactively procuring personal protective equipment and other essential supplies, conducting facility readiness assessments, and communicating directly and regularly with the community, through multiple channels and in local languages, to disseminate timely and accurate health information.

As cases have continued to climb in Togo slowly but steadily, the team has pivoted again, accepting that the COVID-19 pandemic will be present in Togo for the foreseeable future. As a result, the team has redesigned both pandemic response and routine service delivery activities to permit all activities to continue under new social distancing and infection control guidelines. Trainings continue, redesigned and delivered in new ways. Procurement of personal protective equipment and supplies is now routine and ongoing. Most importantly, all health service delivery, both in health centers and by Community Health Workers, continues. Integrate Health is committed to doing everything we can to minimize disruptions to routine primary healthcare as the pandemic endures. As a result, we are proceeding with expansion plans and are on track to expand to serve an additional 39,531 people through five health centers and their communities in the Kéran district beginning in October 2020. Strong primary healthcare is now more important then ever.

The following report describes progress made over the past three months in Integrate Health’s pandemic response and routine primary care activities, including successes and challenges as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions or suggestions. We welcome your feedback and thank you for your support.

 

Program Highlights

Successes

-        This quarter, Integrate Health was able to procure an initial order of personal protective equipment (PPE) to equip Community Health Workers and health center staff, as well as critical equipment such as isolation tents, hand washing stations, and ventilators. While Integrate Health Community Health Workers have always used gloves and hand sanitizer, Integrate Health procured surgical masks and face shields, including some made in Togo, per COVID-19 protocols.

  • To further support Community Health Workers who are on the frontline of the pandemic, Integrate Health offered all Community Health Workers the option to opt out with full paid leave for any reason. All 95 Community Health Workers elected to continue working. Additionally, the team collaborated with the Ministry of Health to organize stress management training for Community Health Workers. This training, led by mental health professionals, covered topics including how to identify signs of stress, understand stress, and manage stress. Furthermore, Community Health Workers were trained on the use of infrared thermometers to permit temperatures to be taken with no-touch protocols.

 

Challenges

-        Integrate Health is learning how to adapt to new conditions created by COVID-19. Because of social gathering restrictions, Integrate Health had to postpone biannual community meetings indefinitely. We are exploring alternate ways to secure community feedback. To continue Community Health Worker and health center provider training, Integrate Health has redesigned trainings for smaller groups, supplemented by clinical practicum. Although this adaptation enables training to continue, it will now take longer to complete due to the restrictions on number of participants.

 

Expansion Highlights

Successes

-        During this quarter, Integrate Health, with the support of our partners from the Ministry of Health, Construction for Change, and the 30/30 Project, completed renovation of four health centers in the Bassar district. Newly equipped with essentials like running water and electricity, these buildings now reflect the dignity of the patients and care afforded inside their walls.

-        Integrate Health Country Director, Christophe Sesso Gbeleou, and Integrate Health Board Member, Dr. Meskerem Grunitzky Bekele, were invited to meet with the Minister of Health in Lomé. The Minister expressed his appreciation for Integrate Health’s support of the Ministry’s COVID-19 response and reiterated his commitment to ongoing work to optimize Togo's Community Health Program and strengthen the delivery of primary healthcare nationwide. 

-         The Ministry of Health's Director of Maternal and Child Health conducted a very productive visit to Integrate Health-supported sites in June to learn about Integrate Health’s approach. This visit, which included detailed presentations on Integrate Health's Costing and national Investment Case projections, will support the Director's ongoing work to inform national policy. 

 

Challenges

-        Integrate Health made the difficult choice to delay the planned expansion into the Kéran district from July to a tentative date of October 2020. In May, as national restrictions were eased, Integrate Health proceeded with preparation activities under new guidelines to respect social distancing and limit the size of in-person gatherings. In June, all CHW candidates underwent screening exams, and the top 50 CHW candidates were presented to village chiefs (via photos on a tablet) in partnership with Kéran district health officials.

 

Organizational Highlights

Successes

  • Integrate Health is pleased to announce that Anita Kouvahey-Eklu has joined Integrate Health as Deputy Country Director, based in Lomé. Anita brings extensive experience from a long career with the Ministry of Health and other NGOs across Togo, including most recently overseeing the national Community-Based Family Planning Program of ATBEF (local affiliate of International Planned Parenthood Federation).

-        This quarter, Integrate Health made exciting progress on a large-scale effort to strengthen data management systems. The first step has included revising and updating all key performance indicators to ensure alignment with Ministry of Health definitions and calculation methodology. Integrate Health completed a review of all existing Integrate Health and national Ministry of Health indicators and finalized an updated and aligned indicator list to be implemented in July 2020.

 

Challenges

-        In May, Integrate Health was the victim of a phishing scam. After being alerted to the scam, Integrate Health worked with a technology consultant to strengthen internal email, technology, and communication systems. All employees have completed a professional training to enhance cybersecurity moving forward. 

 

Financial Highlights

Successes

-        This quarter, Integrate Health received COVID-19 funding from ten existing partners, renewal funding from five existing partners, and new funding from one partner.

 

Challenges

-        An application to USAID Development Innovation Ventures was not accepted this quarter.

 

Funding Snapshot:

Three-year funding Need

$24M

 

FY20 Projected Expenses

$6M

 

Current Funding Runway

9 Months (6 months operating + 3 months reserve)

 

Spotlight

Nika bikes to work every morning as one of the two Community Health Worker Supervisors in the Bassar district. As a Supervisor, Nika oversees and supports 19 Community Health Workers. In his role, he helps to reinforce the link between the health center staff and Community Health Workers. This role has become even more vital with the introduction of COVID-19 in Togo; Nika now supports Community Health Workers as they refocus to ensure the community learns about and understands COVID-19 prevention. Although his priorities have shifted with the COVID-19 pandemic, Nika is learning how to cope. Nika reflected on the recent Integrate Health stress management training, organized in collaboration with the Ministry of Health Regional Health Director. He said, “I was inspired by Community Health Workers, Supervisors, Clinical Mentors, Head Nurses, and Maternity Officers coming together to learn about stress management. It was a very important training and has helped us cope with every situation we come across and how to manage our stress.” Nika is motivated to continue his important role in bringing together Community Health Workers and health center staff, especially now during this critical time.

Links:

Jun 8, 2020

Integrate Health Q3 Impact Report Jan-March 2020

Output Metrics
Output Metrics

On January 21, 2020, The World Health Organization indicated that the novel coronavirus was being spread by human-to-human transmission. On March 6, 2020, the first case reached Togo. In response, Integrate Health has taken aggressive and proactive action in an effort to minimize the spread of the virus, while ensuring continuity of primary healthcare and in turn, lessening the impact of the virus in our communities. 

As a leading healthcare organization in Togo, it is essential that Integrate Health protect its employees while also working to continue to provide high-quality healthcare to our patients. COVID-19 presents opportunities to demonstrate how Community Health Workers are an essential part of the health system, especially when it is stressed. Integrate Health is deepening our relationship with the government by operating as a responsible partner in support of Ministry of Health efforts, coordinating closely with other technical partners, demonstrating how Community Health Workers can contribute to fighting a pandemic, and modeling how we can strengthen the resiliency of clinics to take on COVID-19 while continuing to fight the major killers in Togo. An effective implementation of our pandemic response is a strategic imperative as well as an opportunity to accelerate and amplifying our goal to strengthen the national primary health system across Togo.

The following report describes additional progress made over the past three months, including successes and challenges, as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions. Thank you for your support.

Successes

  • After the arrival of COVID-19 in Togo, Integrate Health quickly equipped Community Health Workers with key messaging from The World Health Organization, to disseminate in their communities as a part of communication efforts to dispel rumors and misinformation, and to educate households on the prevention of COVID-19.
  • In March, Integrate Health placed an immediate, initial order of PPE and infrared thermometers for all Community Health Workers and clinic staff, as well as purchased essential health center equipment. All Community Health Workers already used gloves and hand sanitizer per existing protocols but were quickly equipped with masks for additional protection.

Challenges

  • With 301 confirmed cases of COVID-19 as of May 18, 2020 and this number consistently growing, IH has postponed the Integrated Primary Care program launch in the Kéran district, originally scheduled for July 2020. IH has developed a revised implementation plan incorporating necessary changes to comply with social distancing mandates in Togo. This revised plan aims for an early October launch date. IH will continue to reassess and revise this plan as necessary, as the situation is still rapidly evolving in Togo.

 

Expansion Highlights
Successes

  • In February, a partnership agreement was signed to formalize a research collaboration between Integrate Health, the Ministry of Health, and the Togolese National Research Institute, INSEED. This agreement will formally engage the three parties in Integrate Health research activities including sharing best practices and learning opportunities, as well as provide an external review of research activities in line with national practices for research in Togo.
  • Since March, Integrate Health has participated in the Ministry of Health’s COVID-19 rapid response task force, which meets twice weekly with key Ministry officials and other partners (UNICEF, GIZ, WHO). In response to our own estimation of needs and detailed requests received from the national and regional Ministry of Health, Integrate Health has procured and is actively working to continue to procure critical equipment and supplies including personal protective equipment.

Challenges

  • Two important activities planned by the Ministry of Health with support from Integrate Health have been postponed to respect social distancing guidelines. The Mid-Term Review of the National Health Development Plan and the workshop series to utilize the Community Health Worker AIM tool will resume when possible. Planning continues for both activities, which are an important source of collaboration between the Ministry of Health and Integrate Health.

 

Organizational Highlights

Successes

  • In January, Integrate Health continued making critical updates to data systems, including developing a new indicator framework, automating data preparation, and improving tools used by Community Health Workers. This comprehensive plan will further align data systems with the Ministry of Health while driving quality improvement. Read more about this exciting work in our latest Medium data series!  
  • Integrate Health is pleased to announce two new team members; Amanda Wheeler Singer, Integrate Health’s new Director of Research and Sahaletou Yelebo Marie, the Development and Operations Assistant.
  • Integrate Health continues to manage close collaboration with global partners and co-authored a position paper with the Community Health Impact Coalition, “Priorities for the Global COVID-19 Response”.

 

Challenges

  • Unfortunately, due to the uncertainty of the COVID-19 pandemic, Integrate Health evacuated most expat staff in the beginning of March, prior to Togo suspending all air travel. All staff across the US and Togo are working remotely until further notice.

Financial Highlights

Successes

  • This quarter, Integrate Health received one new grant opportunity and one renewal opportunity from an existing partner.

CHW Profile:

Essodam Patawalo, an Integrate Health Community Health Worker in the Bassar district, was recently asked about how her work has changed since COVID-19. She said, “Since community meetings are not allowed, we no longer have the opportunity to bring people together to hold educational talks to tell them about this pandemic, so we are doing door-to-door outreach to talk to people in the community about prevention measures to avoid the spread of the virus. This is a big job in addition to our usual work. But we're trying as much as we can to get it done. We make sure that mothers and children always have access to care and to the information and practices necessary for their well-being. We therefore take every opportunity to better explain to them the hygiene precautions and measures necessary to prevent the spread of this virus.” When asked what advice she would give to her fellow Community Health Workers, Patawalo responded: “The work we do in the field is great and noble. And it is time for us to take on a great challenge in front of our people, our country, and the world that is watching us.”

Funding Snapshot Q3 2020
Funding Snapshot Q3 2020

Links:

Feb 10, 2020

Integrate Health Q2 Impact Report (Oct-Dec 2019)

Funing Snapshot FY20 Q2
Funing Snapshot FY20 Q2

Program Highlights

Successes

-            This quarter 33 Community Health Workers from the Dankpen district were newly trained in family planning. With the aim of transitioning program implementation to local ownership, for the first time this training was led by the District Health Office of the Ministry of Health with the Integrate Health program team providing support. Following the training, the Community Health Workers completed a month-long internship under the supervision of healthcare providers at each health center. Integrate Health was pleased with the success of the training and plans to incorporate these changes into all trainings moving forward. 

-            Renovations of four clinics in the Bassar district began, in partnership with Construction for Change and the 30/30 Project. The Construction for Change team alongside engineers from the Ministry of Health, visited each site to solidify construction plans. After hiring a contractor, the construction officially launched across all sites in December.

 


Challenges

-            Integrate Health has noticed a high rate of home-based deliveries since launching in the Dankpen district in July 2019. Upon investigation, the program team discovered that to visit the clinics, pregnant women needed to cross a river, that by traditional customs  is thought to cause harm to pregnant women. To address this concern, Integrate Health trained Community Health Workers, in partnership with health center staff and community leaders, to share key messages with pregnant women and their partners to help explain the risk of home-based deliveries. We are exploring additional options to make the journey easier.

 

Expansion Highlights
Successes

-            The Togolese Ministry of Health (MOH) validated a new National Health Quality Assurance Policy in November. A few weeks later Dr. Baba, Director of Health Facilities within the MOH, conducted a site visit to Kara to learn about Integrate Health’s clinical mentorship approach and explore adaptation of this approach and the tools used for quality assurance. Integrate Health continues to support the Ministry of Health on development of the implementation plan for the new national policy.

-            Integrate Health is pleased to announce that the Kéran district was randomly selected to be the next district for implementation of the expansion of the Integrated Primary Care Program! The Integrate Health program team will now begin preparations for a July 2020 program launch in the Kéran district, which will bring the total population served to 200,000 across 18 clinics with 142 Community Health Workers.

 

Challenges

The Togolese Ministry of Health is currently supporting multiple mHealth pilots with various funders and partners that use competing technologies.  Integrate Health is working to understand the vision of the Ministry of Health and its partners.  We hope to help facilitate a process where the mHealth strategy and tool selection is clearly articulated.  We will align our efforts in the mHealth space with that of the Ministry of Health and key partners. 

Organizational Highlights

Successes

-            The 2018 990 and Independent Financial Audit of Integrate Health have been finalized. The auditors found no weaknesses or deficiencies, and only noted a few observations for improvement. Integrate Health’s CEO, COO, and Finance Manager will address any observations immediately.

-            Integrate Health published a protocol manuscript for its Phase Two study in the journal Implementation Science. Entitled “Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: a pragmatic effectiveness-implementation study protocol,” this study will generate knowledge to improve delivery of high-quality healthcare services to our current  population of over 140,000 in northern Togo and ultimately help inform national-scale strategies.

-            This quarter, Integrate Health is happy to welcome two new team members: a new Communications Associate (US) and MEQI Associate (Togo). Integrate Health is still recruiting for a Deputy Country Director and Logistics Assistant, both to be based in Togo.

 

Challenges

-            Although 70% of Integrate Health staff are women, it has been difficult to improve recruitment of women for in-country positions, especially senior positions. Integrate Health is working on a strategy to address this challenge and hopes to be able to both recruit and promote more women into leadership positions.


Financial Highlights

Successes

-            Integrate Health received renewal funding from 13 existing partners, new funding from two partners, and has pending applications for three new funding partners this quarter.

Challenges

-            An application to Conservation, Food, and Health Foundation was not accepted.  

 

Patient Profile:

Bidipoumè, a Dankpen Community Health Worker, was conducting home visits when she met Bilere, a 20-year-old pregnant woman. Bilere, was nearly full term, and could not stand due to pains she felt in her ribs and chest. Bidipoumè expressed the importance of visiting the health center, and Bilere agreed. On the following day, Bidipoumè visited Bilere, and realized she did not go to the health center. Concerned for her health, Bidipoumè decided to bring her to the clinic herself. After they arrived together at the health center, Bilere was diagnosed with anemia, which was successfully treated. Bilere decided to deliver her baby at the health center, and on December 27th, she gave birth to a healthy baby. After her delivery, she called her Community Health Worker, Bidipoumè, and was thankful for the knowledge and care provided.  Proactive case visits and regular follow up by Community Health Workers, integrated with improved care at health centers, help ensure women like Bilere receive the care they need and deserve.

Links:

 
WARNING: Javascript is currently disabled or is not available in your browser. GlobalGiving makes extensive use of Javascript and will not function properly with Javascript disabled. Please enable Javascript and refresh this page.