HEALTH FACILITIES IN THE DISTRICT
Govenment Hospital(Kuntanase), Medical Officer: 1, Nurses (community Health Nurses, Midwives, SRNs & Rotation Nurses): 32.
St. Micheal’s Mission Hospital (Pramso) 8 Medical officers, 84 Community Health Nurses, Midwives, SRNs& Rotation Nurses)
Divine Mercy Hospital(Esereso)-Private: 1 Medical Office: 5 Nurses, HEALTH CENTRES Jachie
Government Health Centre (Jachie) 9--nursesTetrefu GovernmentHealth Centre(Tetrefu)2--nursesPiase
Govenment CHIPS Compond (Piase) 3--nursesCLINICS Nyameani -Mission
Clinic (Nyameani) (Methodist) 2--nursesBrodekwano Mission
Clinic (Brodekwano) (Methodist) 2—nurses
Amakom Mission Clinic (Methodist) 1LBMC-Medical Office
Feyiase Clinic (Private) 4 LBMC—nurses
SDA Clinic-Mission (Konkoma) 2- nurses
St.Mary’s Clinic-Mission (Apinkra)
Jachie Eye Clinic-Mission,9 nursesMATERNITY HOMES
Sophia Maternity Clinic-Esereso(Private)1 nurse
Comfap Maternity Clinic-New Kokobriko (Private) 1 nurse
Emmanuel Maternity Clinic (Private) 1 nurse HOSPITALS
3 Health Centres
3 Maternity Homes
Amongst the top 10 diseases in the district, malaria ranks 1st and it is about 43%. This can be seen in table 1.21 below. CBS’s and all chemical sellers in the district have been trained to enable them have an idea of treating simple malaria cases in the communities. There are a number of health facilities that are in inequitably distributed in the district. The total number of health institutions in the district are 26. Out of this, 14 are public institutions; seven are mission institutions and 5 are private in the sub- districts namely Kuntanase, Jachie/ Pramso, Foase/ Trabuom, Trede and Amakom.
The major disease in the district is malaria caused by poor sanitation. To liaise with Environmental Health Unit to organize frequent spraying and encourage people to use treated bed nets will help reduce the high incidence of malaria.Publicity/ Campaign
Initially the District Health Directorate took it upon itself to organize public campaigns in almost all the communities in the district and later held a grand forum at Abono. This could not be implemented fully due to lack of funds. The District Response Initiative (DRI) took over and has started organizing programmes in the District since September 2004. Awareness about the disease continues to be created by organizing health talks and campaigns in:
- Health facilities
- Outreach Clinics
Social gatherings, particularly during festive occasions e.g. Meet- Me- There at Abono.Support for People living with HIV/ AIDS
There is a Home- Based care for about 30 victims in the district. The victims are offered free medication and financial support. This is organized by the management of St. Michael’s Hospital, Pramso and ably funded by a Danish NGO. In addition, 10 orphans are beneficiaries of the NGO support.Population Management and Family Planning Services
As part of efforts to improve upon family planning in the district, counseling is done on a daily basis through house- to- house counseling services by Public Health Nurses. In addition, publicity campaign programmes on family planning has been held in two consecutive years (2003 and 2004) at Jachie and Nyameani respectively.
Although efforts are being put in place to improve upon family planning in the District, it has been observed that the turn out for counseling and publicity programmes is very low. From what has been observed, it has become necessary to strategize efforts to improve on family planning by further targeting the men (husbands) because they have greater control of affairs and they are the key in decision- making at home. House- to- house exercise must continue on regular basis.
Upon further observation, it was found out that turn out was very low (3.1%) so strategies to be adopted in future will be to target the men in the district, continue with the house- to- house exercise by creating family planning awareness on daily basis, do follow ups, etc.Safe Water
The existing water facilities in the district are boreholes; hand dug wells and pipe borne water supplies. At the moment, there are 116 communities with borehole facilities and they constitute 72.8% of the total number of communities in the district, whilst those with hand- dug wells, are 26 and constitute 20%. A total of 21 communities have access to pipe-borne water supplies from Kumasi, the regional capital. Unfortunately, for the past 7- 10 years the taps have not been flowing. They have been provided with boreholes fitted with hand pumps. On- Going Water Sector Programmes
On- going water programmes in the district are being implemented through the Community Water and Sanitation Agency with support from KfW of Germany under the Rural Water And Sanitation Project IV. Forty-two (42) communities are expected to benefit from 87 boreholes. Again, IDA, under the Small Town Water Supply And Sanitation Project is undertaking a Small Town Water Supply Project at Jachie/Pramso and Foase. In these programmes, technical assistants (TA’s) from the private sector will be sought to undertake community education, animation and the construction of boreholes.District Assembly Experience in the Provision of Water Facilities
The experience can be traced to her participation in the European Union supported Micro Project Programme that started in 1996 and the Community Water and Sanitation Programme (CWSP) intervention in 1996. When the district was part of the Ejisu- Juaben- Bosomtwe- Atwima- Kwanwoma district, it benefited from Ghana Water and Sewerage Corporation’s 3000 wells programme that was funded by GOG/ KFW of Germany. Finally, through the district’s own development programme it has also constructed a number of boreholes in 28 communities.Mechanized Boreholes
Presently, it is only the district capital, Kuntanase that has already benefited from EU sponsored Small Town Water Project in the district. There is an on-going Small Town Water Supply Project for Jachie/Pramso and Foase, which is expected to be competed in December 2006.
However, given the population of some the settlements in the district, it would be appropriate if mechanized boreholes with pipe networks were provided in the following towns: Brodekwano, Sawua, Trabuom, Trede, Esereso and Twedie. Some of these communities have existing overhead tanks or reservoirs that can be used for such purpose.
This development should be seen as part of the water sector development in the district. The implications of inadequate and limited access to water affect the health of the people and effort in walking long distances to streams to fetch water.Findings
The ability to implement the water sector projects in the district is highly dependent on the financial resources available to the Community Water and Sanitation Agency on one hand, and the District Assembly and other external sources, on the other. Secondly, the contributions of the communities are also considered to be very crucial to the implementation of the programme.
The basic principle underlying this principle is that it is demand driven and cost sharing among three main actors. However, communities are expected to make their contributions either in cash or in kind. Under the present financial arrangement, CWSA contributes 90% of the total cost, through donors and government, DA - 5% whilst beneficiary communities contribute 5% of the total cost.
In order to meet this financial contribution, the DA would have to make their contribution from the DACF that is a non-specific grant from government to the Assemblies for development projects in the district. Secondly, a conscious effort must be made by the DA to attract external support for funding the implementation of the programme through the organization of a development seminar on water development in the district. The target for this seminar will be the International Organizations and Non- Governmental Organizations operating in the water sector. Wherever possible, the district should incorporate the water sector programme into the activities if non-governmental organizations operating in the district. Liquid and Solid Waste Management
The district has a big problem with the management of both solid and liquid waste. With liquid waste, the problem is with the inadequacy of public latrines and as a result, people have resorted to digging pit latrines anywhere. People move from one area to another and this affects the hygiene of the area. Again, community members have been practicing “free range” as many of them call it. They defecate anywhere and it is mostly seen on refuse dumps.
In terms of solid waste management, the district has no proper refuse disposal site so people dump their refuse indiscriminately. There are two towns Esereso and Aburaso that are on the periphery of the district. There are heaps of refuse that need mass evacuation.Capacity Building for Environmental Health
The Environmental Health Unit of the district lack the necessary logistics to enable them work effectively. They do not have enough vehicles, no sanitary equipments to perform their duties. So far, there has not been any training for the staff of the unit. These things when overlooked can greatly affect the environmental health of the district.
Refer to tables in pdf file below.