Category of Staff 2013 Public 395 Doctors 1.238 Nurses (IDE+IAE) High-level healthcare 672 Technicians Midwives/ Auxiliary 753 Midwives TOTAL Tracer Staff 3.058 2014 Private 64 136 113 Total 459 1.374 785 Public 408 1.435 784 Private 136 478 261 Total 544 1.913 1.045 54 807 909 303 1.212 367 3.425 3.536 1.179 4.715 Source : Management Performance Report 2014 (Ministry of Health/Directorate of Human Resources) 185. The main health ratios (population/staff) in 2014, are as follows:  7 medical doctors per 100,000 inhabitants in 2013 as against 8 medical doctors in 2014;  21 nurses per 100.000 inhabitants in 2013 as against 28 nurses per 100,000 inhabitants in 2014;  12 midwives per 100,000 inhabitants in 2013 as against18 midwives in 2014;  12 high-level healthcare technicians per 100,000 inhabitants in 2013 as against 15 high-level healthcare technicians in 2014.  69 tracing workers per 100,000 inhabitants in 2014. 186. International standards earmark a density of 100 tracer employees per 100,000 inhabitants (1 worker per 1.000 inhabitants). In the light of these standards, the country with a density lower than or equal to 77 (doctors-nurses-midwives) per 100,000 inhabitants are countries with very low densities 4 ; which places Togo among countries with very low density in terms of tracer staff. 187. It can be inferred from this situation that wide variances exist in these standards. This lack of healthcare personnel, especially specialists, affects the quality of care and services provided to the Togolese population. An effort therefore needs to be made to improve the density of healthcare tracer staff in the health system in Togo. 188. The distribution of medical and paramedical staff (healthcare tracers) reveals not only the inadequacy of staff but also regional disparities. Thirty-six per cent (36.51%) 4 Feasibility Study: Health Sector Support Project in Togo, 15 Sept. 2009 (P. 15) 57

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