1. Dr Kokou AGOUDAVI, MD, PHPM Chief Officer NCD Ministry of Health TOGO
NDCs Situation in TOGO
International Seminar on the Public Health Aspects of NCDs / Lausanne Jan 2010
Dr Kokou AGOUDAVI, MD, PHPM Chief Officer NCD Ministry of Health TOGO

2. Outline
-Location - Demographic and Socio-economical situation - Health System - Reality of NCDs in TOGO - Opportunities Action Plan - Challenges

3. TOGO: LOCATION
Capital: Lome
Surface area:56,600 km2

4. Demographic and socio-economical Situation
Population : 5,337,000 (2009)
< 15 = 47,7%
15-64= 48,0%
>65 = 4,3%
Crude birth rate : 3,700/100,000 live births
Crude mortality rate : 1,300/100,000 live births
Prevalence HIV : 3,2%

5. Demographic and socio-economical Situation (2)
Life expectancy : 55,1 years
In TOGO, 80% of public investments is financed by external aid.
The Income per capita: 350 U.S. $ / year (WB)

6. Health System’s Organization
Central level
Regional Level
District level
Ministry of Health and General Direction of Health
(Teachings Hospitals, and others national school of health)
Definition , monitoring and evaluation of the overall health system
Sanitary regions: 6
(Regional Direction of health, Regional hospital, Health services in regional)
Implementing the National Health Policy and Monitoring program in district level
District of Health : 35
(DPS, District hospital , Primary health care units, private health center)
Implementation of the National Health Policy

7. What is the reality of NCDs in Togo?
NCDs are not yet integrated in the Surveillance of Diseases in our Health System
STEPS Survey on RF = No
Absence of national database of NCDs’ morbidity and mortality
However:
Some hospitals and local survey data are available
And Some Programs have been implemented

8. What is the reality of NCDs in Togo? (2)
Programs’ implementation
Programs
Creation
Data
Policy
Injuries and Disabilities
1974
Available
Yes
Oral Health / Noma
1988
Mentale Health
1995
CVD
1996 No
Diabetes
Cancer
2009
Hospital (Available)
National (Not Available)

9. What is the reality of NCDs in Togo? (3)
NDCs = Public Health issue in TOGO
Epilepsy: 7.14% (Thesis 1995);
Hypertension: 25% (3rd Symposium hypertensiology March 06);
Diabetes: Survey in Lome Commune : 1,79% en 1998 and 2,6% en 2006
Stroke (Hospital): 32.92% (Thesis 2005);
Mental and behavioral Troubles: 27.93% (PhD 1995);
Oral Health /Dental disease: periodontal disease, 80%, dental caries, 34% (Survey 1998)
GYTS (2007): Tobacco use among Youth 14%

10. What is the reality of NCDs in Togo? (4)
Data to Policy
Data are not used in the Central Level to develop Policies/ Programs
Causes:
Lack of Coordination of NDCs programs
Gaps between Scientifics (Universities) and the Ministry of Health (Policy Makers)
Lacks of Resources (Humans, Financials, materials)

11. Opportunities, 2010 Action Plan, Challenges

12. Opportunities
NDCs is taken in consideration in the New PNDS 2009 – 2013 validated in 2009.
Based on this:
New Chief Officer of NCDs was appointed in August 2009
New FP for Cancer Programs

13. Opportunities (2) Interests in NCDs Reinforced
-Advocacy Meeting lead by IDF’s President with Ministry of Health and Parliament’s President to allocate adequate resources in NDCs Programs (August 2009)
-Capacity building: Training of 40 Health Professionals in Diabetes 'care and prevention
Advocacy Meeting with Health District and Regional Directors to integrate NCDs in the National Disease Surveillance (December 2009).

14. Opportunities (3) Interests in NCDs Reinforced (2)
Advocacy Meeting with Health District and Regional Directors to integrate NCDs in the National Disease Surveillance (December 2009).
Draft of STEPS survey on NDCs RF’s protocol developed (December 2009)

15. Short term Plan 2010
Integration of 5 NCDs in the Diseases Surveillance (January 2010):
- Hypertension
- Diabetes
- Asthma
- Sickle Cell Disease
- Epilepsy
National Cancer Registry (January 2010)

16. Short term Plan 2010 (2)
Introducing of Tobacco Prevention in Secondary School Curriculum
NCDs’ Programs need assessment January 2010
STEPS survey on NCDs RF in second quarter 2010
Development of NCDs Action Plan
Cervical Cancer Screening Program with IARC/ UICC

17. Challenges Resources (Manpower, Financing, Materials)
- Human: for implementation of policies and activities from central to community.
- Financial: allocation of sufficient budget within the MOH for NCDs Prevention.
- Material: Tools, supports, guidelines for the Implementation and the M&E of NCDs’ Programs

18. Challenges (2) 
Partnership: skewed towards the fight against communicable diseases. Lack of partnership in NCDs Prevention, apart from the few programs (Oral Health for example/ NOMA “Communicable”)
Networking (National, International): Transfer of Knowledge and Competences
Researches : Support/ Funding/ Public Health Institute

19. K_agoudavi@yahoo.fr / Mobile (00228) 913 34 43
Merci !
/ Mobile (00228)