Getting There: Overcoming Barriers to Reproductive and Maternal Health Services Access in Northern Togo—A Qualitative Study

Judie Arnold, Mélanie Samson, Jennifer Schechter, Alicia Singham Goodwin, Sandra Braganza, Gbeleou Christophe Sesso, Andrew Lopez, Kevin Fiori

Research output: Contribution to journalArticle

3 Scopus citations


With a national maternal mortality rate of 401 per 100,000 live births, it is clear that becoming a mother in Togo carries significant risk. In order to inform the scale-up of maternal health services, this qualitative baseline evaluation explored barriers to maternal and reproductive health in the Kozah district of northern Togo through semi-structured interviews with 21 community stakeholders and focus group discussions with four groups of six mothers. Inter-related factors including financial means, distance from health posts, gender roles, cultural beliefs, and patient–provider relations all influence women's care-seeking behavior. Lack of financial means renders the cost of crucial maternal health services prohibitive, and husbands’ resistance to family planning and health-care financing compounds the challenges women face meeting essential maternal health needs. Our findings suggest that waiving user fees, providing facility-based delivery free of cost, improving transportation options, and fostering trust in and access to health centers could significantly improve maternal health in the Kozah district.

Original languageEnglish (US)
Pages (from-to)223-244
Number of pages22
JournalWorld Medical and Health Policy
Issue number3
StatePublished - Sep 1 2016



  • maternal health
  • qualitative
  • Togo

ASJC Scopus subject areas

  • Health Policy

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