Geographical coverage and dominant socio-demographic profiles of community health workers in Togo

Abstract Background In Togo, community health workers (CHWs) provide primary healthcare to people living more than 5 km from a health centre or who are geographically difficult to reach. This study presents the geographical coverage of CHWs, as well as their socio-demographic characteristics and, more specifically, the dominant profiles that make them up, in order to inform decision-makers and help them define priorities for managing this workforce. Methods Data were provided by the Community Health and Elderly Division of the Togolese Ministry of Health. The coverage of government CHWs in Togo was described by region and district using the number of CHWs, the area of regions and districts, and the number of CHWs per 10,000 inhabitants. The variables “sex”, “main occupation” and “secondary income-generating activity” were used to determine the dominant socio-demographic profiles of CHWs. The results were presented overall and by health region. Results The results show major disparities in CHW coverage between regions, but also between districts. Regional coverage varies from 1.0 to 15.5 CHWs per 10,000 inhabitants. CHWs are mainly men (81%) with a median age of 41. The most common profile of CHWs in Togo and in all regions is that of men working in farming, except in the Grand Lomé region where the dominant profile is that of female retailers. Furthermore, 3.3% of CHWs are housewives with no secondary income-generating activity. Conclusions This study contributes to a better understanding of the geographical coverage and socio-demographic characteristics of government CHWs in Togo. Optimising the size and coverage of CHWs to ensure people’s access to primary healthcare would merit further investigation, as would the issues of gender equity, remuneration and the working hours of CHWs.