Togo/In Akoumapé, Togo tests an integrated model for the first 2,000 days of a child's life
On the sidelines of a regional conference on child nutrition attended by 22 countries in Lomé, a field visit to the prefecture of Vo on May 12, 2026 highlighted a pilot project that aims to bring together nutrition, vaccination, early stimulation and civil status in a single scheme run by the communes.
A fragmented situation
In Togo, around two out of ten children under the age of five suffer from chronic malnutrition. Every year, 1,100 women and 16,496 children under five die, including 6,530 newborns. These figures, which UNICEF describes as a direct result of the fragmentation of interventions, have led the Regional Directorate of Maritime Health to initiate a structured response in the Vo prefecture.
"We are currently rolling out the first phase of what we call an integrated model of basic care and social services for children's health and development, from their earliest habitat, which is the first phase of the project.We are currently rolling out the first phase of what we call an integrated model of basic healthcare and social services for children's health and development, from their first habitat, which is their mother's womb, right through to pre-school," said Dr. Agbetiafa, Regional Director of Maritime Health, during a visit to Akoumapé on May 12, 2026. The pediatrician and medical informatics expert is the driving force behind the scheme, which has been deployed in the four communes of the Vo prefecture since February 2026.
A package of services in a single location
The community project, supported by a variety of partners including UNICEF Togo, WHO and UNFPA, covers the first 2,000 days of a child's life. It brings together in a single continuum maternal and child health, nutrition, vaccination, early stimulation, birth registration and pre-school support. Health centers, kindergartens and civil registry offices in the Vo prefecture are the places where the program is operationalized.
For UNICEF Togo Representative Erina Dia, who opened the project orientation session, the logic is indisputable. "We can't take interventions in silo because the child is a whole. He needs an integrated approach, he needs several sectors, several interventions to meet his holistic needs," she declared on May 12, 2026. In a context of budget constraints, the aim is to "do better with less".
Nutrition, from household to school
Nutrition is addressed at four levels: household, community, health center and preschool. At household level, parents are trained to compose balanced meals using locally available resources. " With 500 francs, i.e. less than one euro, you can prepare a balanced meal", illustrates Dr. Agbetiafa, adding that this skill is now present in many of the households covered by the model.
At the Akoumapé health center, Sabari Larba, midwife in charge of the CMS maternity ward, describes the cooking demonstration sessions organized for mothers. " We make the enriched porridge, which is made from corn, soy and moringa, because that's what we have here," she explains, adding that the women learn to measure, sort, dry and roast the ingredients before preparing the flour. Exclusive breast milk is recommended up to six months, before the introduction of this enriched porridge.
The community component mobilizes health workers and organized women's groups who relay nutrition education in the neighborhoods. Dr Agbetiafa also sees it as a lever for economic empowerment: "When a woman knows how to prepare soya milk, soya beer and other products, she creates her own income-generating activity," says the expert.
Digitalization as a gas pedal
One of the distinguishing features of the model is the "Naissance Kéva" application , a digital platform that links maternity wards with registry offices to speed up the issuing of birth certificates. By entering the newborn's data at the maternity hospital, the town hall is able to access the necessary information, after validation by the head of the health facility, so that parents "can have access to their birth certificate in record time".
Kanyaya Dacha, state hygiene assistant and head of the vaccination service at the Akoumapé CMS, emphasizes the tangible effect on attendance. Since the vaccination room was refurbished and the reception atmosphere improved, the number of visits has risen significantly. "The atmosphere now makes them feel at ease, they have a little patience until the work can be done," he observes. The application also serves as a reminder for vaccination appointments, to prevent people from losing sight of their appointments.
Local management
The governance of the model relies on local elected representatives. Mayors and prefects have been involved from the outset, we report. General feedback meetings, chaired by the prefects, also bring together women's associations, traditional leaders and young people.
Certification of the best-performing health centers, conditional on meeting at least 80% of the required criteria, is planned by the Ministry of Health. For the prefecture as a whole, the certification threshold requires that 90% of children born in the centers have a civil status document within eight days of birth.
The challenge of scaling up
For Driss Zinédine, Health, Nutrition and Population Sector Director for West and Central Africa at the World Bank, the challenge goes beyond Togo. " If a population is not well nourished, if there is no early childhood development, there is no good future for the country's development", he declared on the sidelines of the regional conference.
The World Bank also supports various initiatives to improve child nutrition in Togo, such as the school canteen project which, since its launch in 2008, has provided more than 75 million hot meals in public elementary school for vulnerable young learners.
Dr. Agbetiafa sets the trajectory: first to cover the entire prefecture, then to extend it to the Maritime region, before considering a national roll-out.
"We obviously need partners. Without partners, it's going to be complicated", he acknowledges, while pointing out that UNICEF, WHO, the World Bank and several other partners are already committed to the approach.
The regional conference in Lomé, which brought together some 22 countries from West and Central Africa, provided the political framework for this model to be discussed on a sub-regional scale. The question posed at Akoumapé is one that these countries are now asking themselves: can such an architecture be reproduced where vertical programs have shown their limits?
Source: www.togofirst.com
