« Je suis Afiyo, âgée de 25ans je suis une femme au foyer avec 3 enfants. Je vis avec mon mari dans le village de Livé, village situé à 13km de notre Centre Médico-Social. Non seulement je vis un peu éloignée de notre CMS mais aussi la route qui y mène est presque impraticable en saison pluvieuse. Le marché cantonal s’anime chaque jeudi, dans cette optique, je fais toutes mes emplettes les jeudis au marché. Si je dois me faire suivre au centre de santé, c’est les jeudis qui me sont favorable car c’est en ce jour que je peux trouver facilement un moyen de déplacement pour m’y rendre. Aussi, dois-je me lever tôt le jeudi pour vite me rendre au centre de santé pour mes soins et profiter pour faire le marché avant de revenir le soir. Mais, je ne suis jamais venu au centre de santé au moment propice pour adopter une méthode contraceptive. Puisque les jeudis ne sont pas les jours programmés au centre pour cette activité, alors que moi je ne peux venir au centre de santé que les jeudis, jour du marché. Les conséquences qui en découlent sont les grossesses non planifiées qui surviennent. J’ai entendu parler des Agent de Santé Communautaire (ASC) dans certains villages environnants qui offrent des services de PF dans les communautés mais comme notre village n’avait pas bénéficié de ce projet, ils n’arrivaient pas à nous servir. Ça fait de cela quelques jours que le chef nous a informé qu’il y a un de nos frères du village qui sera formé par les responsables de notre CMS en appui avec le District Sanitaire afin de nous offrir gratuitement les services de PF dans notre communauté. Vous ne pouvez imaginer ma joie en ces jours-ci. C’est tout un soulagement pour moi ainsi qu’à toutes les femmes du village. Car, on sait que maintenant, même les nuits, cet agent de santé peut nous fournir facilement et gratuitement les méthodes contraceptives dont nous aurons besoin. Je profite pour remercier les initiateurs de ce projet qui va beaucoup nous être utile ».
Tels sont les propos d’une femme rencontrée lors de la tournée de supervision de l’Equipe Cadre de District dans le but de corriger les manquements dans l’exécution du projet de la Distribution à Base Communautaire (DBC) par les Agents de Santé Communautaire (ASC).
Nous rappelons que ces supervisons s’effectuent à chaque niveau : Animateur, Agent de suivi, Responsable de Formation Sanitaire, District et ONG ; afin de maintenir la qualité des services offerts à la population par les ASC.
Nous savons que la Planification Familiale est l’une des stratégies de réduction à 25% de la mortalité maternelle et infantile due aux grossesses rapprochées. Malgré la forte demande en PF, la prévalence contraceptive est encore faible au Togo. Pour réduire les besoins non satisfaits en PF et augmenter la prévalence contraceptive, il s’avère indispensable d’améliorer l’accessibilité des bénéficiaires, aux services PF à travers des stratégies. C’est dans cette optique que des projets sont élaborés afin de rapprocher les services des bénéficiaires.
Notons en passant que la prévalence contraceptive du District Sanitaire de Yoto, l’un des Districts dans lesquels s’exécute le projet de DBC, s’était améliorée grâce à ce projet. De 7% en 2012 elle est passée à 27% en 2015 puis 21% et 19% en 2016 et 2017. Cette progression est l’effort de 60 Agent de Santé Communautaire (ASC) qui au départ étaient dans 24 villages de 11 formations sanitaires. Mais à ce jour pour un meilleur résultat, le District a dû étendre l’activité à 31 villages dans 13 formations sanitaires et toujours avec les 60 ASC. Vu la saturation de l’activité dans certains villages car commencée depuis 2013 et, face à la démission de certains ASC, pour des raisons professionnelles, le District a profité pour déplacer l’activité vers d’autres zones non couvertes au début.
Si nous remarquons que la prévalence a chuté dans les deux dernières années c’est parce que les fonds alloués au projet sont réduits dans ces années, ce qui a des répercussions négatives sur les activités programmées dans le projet de la DBC et, par conséquent les résultats.
C’est le lieu pour nous de faire appel à d’autres partenaires, soucieux de la question, de se pencher sur ce volet et de prendre en compte les préoccupations des communautés à la base afin de leur venir en aide.
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