The Togolese Healthcare System: Hospitals, Universal Health Insurance, Vaccinations and Medical Evacuation

The healthcare system of Togo rests on a public sector, which includes the university hospital centres and local health facilities, and on private facilities. It is under the authority of the Ministry of Health, Public Hygiene, Universal Health Coverage and Insurance. CLEISS indicates that the universal health insurance scheme covers care in public and private facilities, with free care for vulnerable populations and for specific services linked to HIV, malaria and tuberculosis.

The WHO reports, for Togo, a life expectancy of 61.5 years for men and 66.4 years for women, under-5 mortality of 69.5 per 1,000 live births and health spending of USD 67.40 per person, or 6.1% of GDP (WHO country page, indicators 2021-2023). For a French resident, the question is where to get treated and how to settle the costs. Our Togo country profile summarises the entry requirements, the social security agreement and the order of magnitude of costs.

The public reference establishments cited in our country profile are the Sylvanus-Olympio university hospital centre in Lomé, the largest hospital in the country with an emergency department open day and night, the Campus university hospital centre in Lomé and the Bè hospital, the reference hospital of the commune of Lomé. There is also a university hospital centre in Kara, in the north of the country. Public hospitals charge lower prices than private provision, but their technical facilities vary by speciality.

France Diplomatie does not publish a detailed assessment of the quality of Togolese hospital equipment. The embassy reminds us that the French State does not bear the health costs of its nationals abroad, whether for hospitalisation, care or repatriation. Ask the consular section of the embassy (+228 22 23 46 00) for the practical information available before choosing a facility.

First contact is with a local health facility or a general practitioner; referral to a reference hospital is then organised according to severity. The private sector complements public provision, with consultations and hospital stays whose prices and comfort vary by facility. The official sources consulted publish no price list: ask for a detailed quote for any scheduled procedure and keep an itemised invoice for reimbursement.

France Diplomatie does not publish a local emergency number on its Health page for Togo. Before settling in, therefore, note the number of your assistance provider, that of the French embassy in Lomé and the details of the facility closest to your home. A policy working with direct billing avoids advancing large sums; see also checking an approved network.

Universal health insurance (AMU) has been rolled out in stages. The National Health Insurance Institute (INAM) has managed compulsory health cover for public servants since 2011; since 2021, the AMU has gradually covered civil servants, public school pupils, children and older people; since January 2024, it has extended to private-sector workers, private-sector retirees, the self-employed, the informal economy and agricultural sectors (CLEISS). Private-sector employees and retirees are managed by the CNSS.

The general conditions published by the CNSS specify that the insured include workers governed by the Labour Code, holders of private-sector pensions, the self-employed and operators of the informal and agricultural economy, and that dependants are the legal spouse and dependent children aged 21 or under. The contribution for employees is 10% of pay, split equally between employer and employee. The insured person must observe a 3-month waiting period from registration, then cover of healthcare procedures and medicines is 80% of the reference price, with 20% remaining payable by them. Care linked to work accidents, care abroad unless otherwise provided, and cosmetic surgery are excluded.

The general conditions do not address the situation of foreign workers: confirm it with the CNSS. For a French national, the AMU does not replace cover suited to expatriation: the CFE (the French social security fund for expatriates) or expat health insurance complements local provision, as detailed on the page on healthcare reimbursement in Togo.

For long-term treatment, bring the quantity needed for the first few weeks with a prescription giving the international non-proprietary name, and ask your regular doctor for a letter summarising your file. Then have a local doctor or your assistance provider specify the equivalents available on site, and buy your medicines at a pharmacy. The general conditions of the AMU link cover to a reference tariff; essential medicines are included, but an expat finances most of their pharmacy costs through their insurance policy.

Budget for this item separately, as proposed in the guide to budgeting for health abroad.

• Yellow fever: vaccination is compulsory to enter Togo; it is given at an international vaccination centre, ideally at least 10 days before departure.
• Vaccines recommended depending on the length and conditions of the stay: hepatitis A, typhoid fever, ACWY meningitis (especially in the dry season), rabies (particularly for young children in rural areas) and tuberculosis for children under 15 on a prolonged stay. France Diplomatie recommends being up to date with the vaccination schedule, measles included.
• Malaria: preventive treatment is decided with a doctor or a travel medicine centre. Dengue, chikungunya and Zika, also transmitted by mosquitoes, call for the same protections: covering clothing, repellent, treated mosquito net.
• Meningitis and cholera: cases of meningitis are frequently reported, and cholera is transmitted through contaminated water and food. Typhoid fever and Lassa fever: avoid contact with rodents. Mpox: transmitted by close contact; wash hands and avoid infected people.
• Water and food: bottled or boiled water, peeled fruit and vegetables, well-cooked food, rigorous hand hygiene. France Diplomatie also points to the notable prevalence of HIV and the need to protect yourself against sexually transmitted infections.

France Diplomatie states that an assistance or insurance policy covering all medical costs, hospitalisation and medical repatriation is imperative, because these costs cannot under any circumstances be borne by the embassy. How an evacuation works is detailed in the guide to how a medical repatriation works and on the page on repatriation and assistance.

In the north of the country, the Savanes region is advised against except for compelling reasons: a state of emergency has been extended there until 13 March 2027 and foreigners’ movements require a written authorisation, with night-time travel prohibited. These rules make journeys, and therefore evacuations, more delicate: consult France Diplomatie’s Safety page before any trip.