Assessing efforts to lower maternal and child mortality in Togo

Over the past decade, rates of maternal and child morbidity and mortality in Togo have remained high despite global progress. Child mortality among children under five years old in the West African nation is attributed to diseases that are easy and cheap to prevent and treat, including malaria, acute lower respiratory infections, and diarrheal diseases.

While Togo has a national strategy for addressing this issue, critical gaps to quality health access remain. The Integrated Community-Based Health Systems Strengthening (ICBHSS) initiative seeks to address these gaps while strengthening the public sector health system in northern Togo.

To evaluate the effect and implementation strategy of the ICBHSS initiative over 48 months in the catchment areas of 21 public sector health facilities, CUNY SPH Associate Professor Heidi Jones, in collaboration with the non-governmental organization Integrate Health, published a study protocol in the journal Implementation Science.

The study will gauge the effectiveness of the initiative by looking at changes in mortality rates among children under five years old. The research team will also assess the program's implementation strategy, measuring its reach, adoption, implementation, and maintenance. They will conduct a mixed-methods assessment using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework.

This protocol provides a model for embedded implementation research in public sector service delivery to facilitate demand-driven research and evidence-based policy change. Close collaboration amongst practitioners, policymakers, and researchers is crucial to addressing research questions for policy change benefitting local communities.

"Our research is expected to contribute to continuous quality improvement initiatives, optimize implementation factors, provide knowledge regarding health service delivery, and accelerate health systems improvements in Togo and beyond," Jones said.