Effect of COVID-19 on demand for healthcare in Togo.

BACKGROUND: Demand-side barriers to health care are as important as supply-side factors in deterring patients from obtaining effective treatment during COVID-19. Developing countries, including Togo, have focused on reducing the risk of health care utilization during this period by ensuring basic health care services as an important policy to improve health outcomes and meet international obligations to make health services accessible. METHODS: The data used to cover all 44 districts in the six (6) health regions of Togo, are from a national home survey. They are collected from July 8th to 17th, 2020. In each district chief town, a minimum of thirty (30) households were included by a systematic two-stage random draw (neighborhood and then home). Based on these data, the multinomial regression model was used to identify risk factors for the request for health care services during COVID-19. RESULTS: A total of 1946 (with a response rate of 98.3%) participants were addressed in the study. The finding on households with age above 60 years indicated that the relative risk ratio (RRR = 23.97; 95% CI = 0.93; 615.38) allowed them to practice self-medication in lieu of modern healthcare facilities. The multinomial model revealed that the relative risk ratio of pre-COVID-19 activities (RRR = 4.87; 95% CI = 1.018; 23.38) permits households to rely on their self-medication choice and (RRR = 3.14; 95% CI = 0.91; 0.83) prefer public health facilities. Given that the head of the households (RRR = 0.19; 95% CI = 0.017, 2.11) is educated, he prefers the choice of private health centers during COVID-19 pandemic to public health facilities. CONCLUSION: This study has demonstrated that the majority (30.49%) of patients sought health care. The analysis shows that the loss of employment, activities before COVID-19 in households and areas not infected by the pandemics allow them to ask for health care (self-medication and public hospitals) despite the COVID-19 impacts. However, higher education and age determine a different choice of health care delivery by households. Thus, policy makers need to cast special emphasis on social policies to address home health shocks.

COVID-19 and the impact of cash transfers on health care use in Togo.

BACKGROUND: Cash transfer program during pandemics provide a social protection mechanism to improve the health of the most vulnerable households. This article analysis the impact of cash transfers on household demand for health care during Covid-19. METHODS: Using data from the survey conducted from 8th to 17th July 2020 covering all 44 districts in the 6 health regions of Togo under the direction of the United Nations Office for Project Services (UNOPS), we used propensity score matching and the ESR model. These models allow us to analysis the impact of cash transfers on health care use during Covid-19. RESULTS: Analysis of the results shows a positive impact of cash transfers on the use of health care services in Togo for beneficiary households. In addition, the health insurance promotes the use of health care among households' socio-economic factors. CONCLUSION: This cash transfer program is an effective approach to improving access to health care services for the most vulnerable households, particularly in the most disadvantaged settings. Thus, policy makers need to extend these cash transfers to a large part of the population during this Covid-19 health crisis as it has a positive impact on the demand for health care.

Prenatal consultation and survival of children under five in Togo.

INTRODUCTION: Child survival is low in Togo, often linked to socio-economic and other exogenous factors such as lack of antenatal consultation and Bacille Calmette-Guérin (BCG) vaccination. These different variables impacting the chances of survival of children underneath five have not been completely examined. The objective of this study is to analyse the socio-economic variables that influence the survival risk of children beneath five in Togo. METHODS: These different variables influencing the chances of survival of the data used is from the 2017 MICS6 Overview. It speaks to an arrangement of broadly agent tests of families, children matured 0-5 years, women matured 15-49 years and men matured 15-59 years. Information on pre-birth meetings and the inoculation status of children at (BCG) were collected from this overview. The Cox corresponding risks backslide illustrate is used to evaluate the connection between pre-birth visits and child survival. RESULTS: The risk of survival in children beneath 5 years is high as the age of the mother increases. This risk is 0.48 for the age between 19 and 24 years (AHR = 2.485, 95% CI 1.49-4.13). A child born to a woman with no education is at high risk of child survival (AHR = 2.96, 95% CI 092-9.36). Furthermore, the results show that women with twins have a high risk of 0.44 of the death of these children (AHR = 1.44, 95% CI 1.25-1.67). In addition, (BCG) vaccination has been related with an expanded recurrence in children, where it was found that 70.37% of vaccinated children were born to women who had experienced pre-birth meetings. CONCLUSION: Basic risk variables for child survival can offer assistance in defining policy suggestions for children's wellbeing. The results recommend they have to empower policies to improve women's proficiency, the presence of a wellbeing insurance framework is suggested to decrease the burden of care, implement a procedure for access to antenatal meetings.

Effets de la COVID-19 sur la variation du revenu et la sécurité alimentaire des ménages au Togo.

L'objectif de ce papier est d'analyser les effets de la COVID-19 sur la variation des revenus, la modification de la consommation alimentaire et les stratégies d'adaptations des ménages au Togo. Pour se faire, les modèles probit et logit multinomiale ont été utilisés en se basant sur des données collectées auprès de 1405 ménages dans 44 districts des 6 régions sanitaires. Les résultats révèlent que les ménages dans lesquels le chef a perdu son emploi sont plus exposés à une baisse de revenu et donc à une réduction de leur consommation alimentaire pendant la pandémie. Toutefois, les transferts monétaires octroyés aux personnes vulnérables ont un effet positif, mais non significatif sur le changement de leur revenu. Par ailleurs, les ménages bénéficiaires de prestations sociales au sein desquels le chef a un niveau d'éducation supérieur, sont plus susceptibles de supporter les effets de la pandémie. Ainsi, pour les ménages ayant ressenti un effet modéré ou sévère de la crise, la probabilité est élevée qu'ils diminuent leur consommation alimentaire. A cet effet, il serait intéressant d'étendre les prestations sociales aux acteurs du secteur informel et d'accélérer la mise en place du registre social unique pour un meilleur ciblage des ménages vulnérables.