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Togo is a country with an approximate area of 57 thousand sq. km. (UNO, 2001). Its population is 5.017 million, and the sex ratio (men per hundred women) is 98 (UNO, 2004). The proportion of population under the age of 15 years is 43% (UNO, 2004), and the proportion of population above the age of 60 years is 5% (WHO, 2004). The literacy rate is 74.3% for men and 45.4% for women (UNESCO/MoH, 2004).

The country is a low income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 2.8%. The per capita total expenditure on health is 45 international $, and the per capita government expenditure on health is 22 international $ (WHO, 2004). The main language(s) used in the country is (are) French, Ewé, Mina, Kabyé and Cotocoli. The largest religious group(s) is (are) indigenous groups (half), and the other religious group(s) are (is) Christian and Muslim. The life expectancy at birth is 50 years for males and 53.3 years for females (WHO, 2004). The healthy life expectancy at birth is 44 years for males and 46 years for females (WHO, 2004).

EPIDEMIOLOGY

There is a paucity of epidemiological data on mental illnesses in Togo in internationally accessible literature. Balogou et al (2001) used a WHO research protocol to study the prevalence of neurological disorders in two rural areas. The first survey was conducted in July-August 1989 on 19 241 inhabitants in one area. The second area was surveyed in January-February 1995 and involved 4182 subjects. The prevalence of epilepsy was 1.2% and 1.3% and that of psychomotor retardation was 0.3% and 0.8% in the two areas. The prevalence of neurological cretinism was 1.0%, while that of myxoedematous cretinism was 3.1% in the region that has a high prevalence of goiter (43% in females and 26.1% in males). Patients suffering from epilepsy commonly reported the occurrence of anxiety and depression, which led to significant interference with their quality of life (Nubukpo et al, 2004). Certain hereditary diseases (Huntington disease) that lead to dementia were reported to be relatively common in families living inshore (Grunitzky, 1995).

MENTAL HEALTH RESOURCES

Mental Health Policy A mental health policy is present. The policy was initially formulated in 1994.

The components of the policy are advocacy, promotion, prevention, treatment and rehabilitation.

Substance Abuse Policy A substance abuse policy is present. The policy was initially formulated in 1994.

National Mental Health Programme A national mental health programme is present. The programme was formulated in 1994.

National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. Details about the year of formulation are not available.

Mental Health Legislation There is a legislation on mental health. The mental health legislation as a whole will now be included in the new Health Code of Togo. The latest legislation was enacted in 1999.

Mental Health Financing There are budget allocations for mental health. The country spends 0.2% of the total health budget on mental health. The primary sources of mental health financing in descending order are out of pocket expenditure by the patient or family and private insurances. The country does not have disability benefits for persons with mental disorders.

Mental Health Facilities Mental health is a part of primary health care system. Actual treatment of severe mental disorders is available at the primary level. Primary care is available only at the district level where the staff has been trained.

Regular training of primary care professionals is carried out in the field of mental health. In the last two years, about 70 personnel were provided training. Doctors and health workers have been trained in the last 2 years. There are no community care facilities for patients with mental disorders.

Psychiatric Beds and Professionals

  • Total psychiatric beds per 10 000 population
  • Psychiatric beds in mental hospitals per 10 000 population
  • Psychiatric beds in general hospitals per 10 000 population
  • Psychiatric beds in other settings per 10 000 population
  • Number of psychiatrists per 100 000 population
  • Number of neurosurgeons per 100 000 population
  • Number of psychiatric nurses per 100 000 population
  • Number of neurologists per 100 000 population
  • Number of psychologists per 100 000 population
  • Number of social workers per 100 000 population
  • 0.4
  • 0.3
  • 0.1
  • 0
  • 0.04
  • 0.02
  • 0
  • 0.1
  • 0.2
  • 0

Non-Governmental Organizations NGOs are involved with mental health in the country. They are mainly involved in advocacy, promotion, prevention and rehabilitation.

Information Gathering System There is mental health reporting system in the country. The country has no data collection system or epidemiological study on mental health.

Programmes for Special Population The country has specific programmes for mental health for children. No specific programme exists. Some services for children and adolescents exist.

Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: carbamazepine, ethosuximide, phenobarbital, phenytoin sodium, sodium valproate, amitriptyline, chlorpromazine, diazepam, fluphenazine, haloperidol, carbidopa, levodopa. These drugs are available only in the capital.


Source: World Health Organization Mental Health Atlas