Interview with Mrs Awate Abide, President of the Association of Managers and Administrators of Health Services in Togo (AGASSTO)

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Extract from the article: On 22 November 2024, the Association des Gestionnaires et Administrateurs des Services de Santé du Togo (AGASSTO) held its elective and statutory general meeting. The event provided an opportunity to assess the progress made in the management and adm

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‘To date, most of these laws and regulations are not only obsolete, but also not applied in full. This means that a vast reform programme needs to be launched...’.

On 22 November 2024, the Association des Gestionnaires et Administrateurs des Services de Santé du Togo (AGASSTO) held its elective and statutory general meeting. The event provided an opportunity to assess the progress made in the management and administration of health services, while identifying the challenges ahead. In this interview, Mrs Awate Abidé, President of AGASSTO, explains the role of health service managers and hospital administrators in this new dynamic of improving access to care for all, and analyses the current situation of the health system, particularly in terms of the legislative and regulatory texts and the organisation of the services of the Ministry of Health.

Santé Education: What is a health services manager and administrator?

Ms Awate Abidé: It's a person with a degree in health services management or hospital administration whose job is to organise, plan, direct, coordinate and evaluate the activities of the various services and departments including hospitals.

How many are there in Togo today?And how many are currently in post?

We can estimate the number at 150 trained health service managers and administrators, of whom around 100 are currently in post. However, the new executive committee has launched a census of all health service administrators and managers of Togolese nationality, which is currently underway.

Why did you set up AGASSTO? 

AGASSTO was created at the General Assembly of 24 November 2006 by the transformation of the parent association, AHOTO (Association des Administrateurs des Hôpitaux du Togo).This was done with the aim of integrating Health Service Managers newly trained at the Ecole Nationale d'Administration (ENA), as AHOTO only brought together Hospital Administrators.

AGASSTO was set up to promote the profession of health service managers and administrators, defend the interests of its members and serve the public good.

Its aim is to create synergy between all health service managers and administrators in Togo, to defend the moral and socio-professional interests of its members and to help improve the quality of care provided in hospitals and health services.

What activities has AGASSTO already carried out?

Several activities have been launched, including: a census of all Togolese health service managers and hospital administrators; the appointment of focal points in the six economic regions; the organisation of capacity-building sessions for its members (after work every last Thursday of the month); assistance to members in the event of illness or unfortunate events.

Do you organise capacity-building sessions for members?

Yes. In its action plan, AGASSTO has devoted axis 3 to capacity-building activities for its members, promoting professional commitment and excellence through sessions called ‘after-work’ that it organises once every last Thursday of the month online.The sessions cover practical and professional topics, personal development, ethics and best practice.

In addition to these after-work sessions, the office plans to organise a face-to-face capacity-building session once a year.

It also plans to sign partnership contracts with similar associations or networks in the sub-region to facilitate exchanges of experience.

What do you think is the current state of health service management?

The health system has one particularity.It is run by multidisciplinary players.

We have several bodies: the medical and paramedical bodies on the one hand, and the administrative, technical and support bodies on the other. Not only does each player have his or her own part to play, but all the bodies complement each other to achieve effective and efficient results.

To date, most of the laws and regulations governing the organisation and operation of health services and departments are not only obsolete, but also not applied in full. This means that a vast reform programme needs to be launched to take account of the realities on the ground.We are delighted to see that this is what the current Minister for Health has begun, with a number of innovative initiatives that we warmly welcome.These include: the drafting and validation of the guide for drawing up the Hospital Establishment Project (PEH); the decree regulating the dress of staff in public, private and religious health facilities; the drafting of public and private health standards currently underway; and the decree setting up, tasking and composition of the committee to combat the proliferation of private health facilities.

Furthermore, if we refer to decree n°0021/2013/MS/CAB/SG on the organisation of the services of the Ministry of Health, we can see that to date, many posts have remained vacant, yet qualified and competent human resources are idle in certain structures or departments.The same applies to certain positions of responsibility in certain hospital structures.This would undoubtedly weaken the health system as a whole.

And what can we say about management staff who have retired but are still in post, even though they no longer have any challenges to face and are focusing on their physical and mental well-being?

Everything needs to be seriously rethought!

What contribution can AGASSTO make to the implementation of the universal health insurance programme?

Under Axis 4, AGASSTO's action plan includes raising awareness in the media or through short educational capsules, on the themes of respect for the health pyramid according to pathology ....

What are AGASSTO's main challenges?

Like any association, AGASSTO faces a number of challenges, including: mobilising internal and external financial resources to fund the association's activities; strengthening the cohesion of members to ensure unity of action; raising the profile of the association's activities; practising respect for the public good, ethics and deontology, a culture of commitment and professional excellence; enhancing the image of health service managers and administrators by having a positive impact on those around us through a culture of work well done.

Our outlook

To increase its visibility, AGASSTO plans to design its logo and website. It plans to build its headquarters. It plans to organise scientific days bringing together all hospital administrators and health service managers in the West African sub-region.

Words of advocacy for decision-makers?

A series of pleas were submitted to the Minister of Health and Public Hygiene, with whom we had a lengthy discussion on the various points raised. We would like to thank him for his openness. We hope that our concerns will be taken into account.

Interview by Game KOKO