Togo, like many other West African countries, did not meet the September 2021 target to immunize 10% of its population against COVID-19, making it a major challenge to reach the 40% target by December 2021. Vaccination against COVID-19 was officially launched in Togo on 10 March 2021. The Prime Minister, government ministers, members of the national assembly, and heads of United Nations agencies in Togo set the example by getting vaccinated. Health workers were vaccinated to protect themselves and better serve the population in response to the emergency. Measures to encourage vaccination were put in place, such as obligatory presentation of the COVID-19 vaccination card before entering any public institution. Despite these different strategies, as of 17 September 2021, the proportion of the population aged 18 and above in Togo who had received two doses of the COVID-19 vaccine was only 5.6%.

To reach the vaccination targets, the WHO Country Office in Togo provided technical and financial support to the Togolese government, through the Ministry of Health, Public Hygiene and Universal Access to Health Care (MSHPAUS), in conducting community dialogues and broad awareness-raising in the Grand-Lomé region, the epicentre of the epidemic in Togo. The objectives were to:

• reduce misinformation;
• break down potential barriers to vaccine acceptance; and
• encourage community support for COVID-19 vaccination.

The community-led initiatives helped increase national immunization coverage to 25.4%.

How did Togo do it, and how did the WHO Secretariat support Togo?

• Community dialogues - The WHO Country Office in Togo provided technical support to the Ministry of Health, Public Hygiene and Universal Access to Health Care for social mobilization, namely community dialogues with strong involvement of traditional leaders. For the first round of dialogues, the Grand-Lomé region was selected since more than 80% of confirmed COVID-19 cases were located in the region. Thirty-two community dialogues took place, mobilizing approximately 1600 leaders. The dialogues started on 7 October 2021 in the royal palaces under the leadership of the 11 canton chiefs of the region. Local chiefs, priests of voodoo temples, women leaders of market vendor associations, representatives of local development committees, leaders of car and motorcycle driver unions, representatives of youth groups, and representatives of arts and crafts organizations were the main actors involved. Honest and open discussions addressed the circulation of misinformation and poor communication about the COVID-19 vaccines; concern about the speed with which the COVID-19 vaccines were produced and made available; and the location of vaccination sites in remote communities.

• Awareness-raising messaging - To facilitate broad dissemination of awareness-raising messages, the WHO Country Office in Togo provided funding for 13 vehicles equipped with sound equipment to publicize tailored messages. Repeated messages were announced by the vehicles in markets, bus stations, crossroads, and areas in front of bars and restaurants in all neighbourhoods of the Grand Lomé region under the direct supervision of mayors.

Photo Credit: © Joseph Koivogui, Consultant for risk communication and community engagement

Photo Caption: Community dialogue session in the royal palace of the township of "adétikopé”.  

• Initiatives spearheaded by traditional leaders – Following community dialogues, traditional leaders encouraged the population to adhere to COVID-19 vaccination recommendations through a number of initiatives:
  • Vaccination centres were set up in the traditional chiefs' palaces, markets and bus stations, and chiefs were vaccinated in the presence of their communities to demonstrate by example;
  • Chiefs were personally involved with the vaccination teams to dispel rumours;
  • Practitioners of voodoo cults whose beliefs made them hostile to the use of needles (syringes) were vaccinated;
  • Audio-visual messages were produced to refute false information that was creating confusion in communities. The messages were diffused through WhatsApp groups and community radio stations.

The community dialogues conducted in the Grand-Lomé region, with technical and financial support from the WHO Country Office in Togo, resulted in interventions that facilitated community acceptance of vaccination against COVID-19. The social mobilization made it possible to increase national vaccination coverage against COVID-19 by about 20% (from 5.6% as of 17 September 2021 to 25.4% as of 30 December 2021), to provide the right information to the public and, above all, to create a channel of exchange between traditional leaders and health workers in their respective areas. It is hoped that extending this experience throughout the country will contribute to reaching the vaccination target of 70% by June 2022.

Photo Credit: © Ms Fiaty, Communications Officer, WHO Country Office in Togo

Photo Caption: Representative of WHO Country Office in Togo, consultant for risk communication and community engagement, and community leaders.