Health And Nutrition

Through an effective and efficient collaboration between the Local government, UNICEF, DANIDA Health Support Services Programme, World Food Programme, Global Fund for Malaria Control, Red Cross, Stakeholders and other NGOs and Donors, the health situation of the people in the district has improved for the past three years and the District Health Management Team was adjudged the best in health delivery in the whole country for 2005 but there is more room for improvement. 

Health Infrastructure

A 193-bed District Hospital, three health Training Schools, thirteen Health Centres and two Community-based Health Planning and Services (CHPS) compounds cater for the health needs of the people of the district.  

Generally, most of our health facilities are not looking attractive.  There is the need to beautify all health facilities now that the District-Wide Mutual Health Insurance Scheme has taken off.  A maintenance person went round and assessed all the health facilities and residential quarters in the District and submitted the findings.  This informed Management about the actual situation and some minor maintenance and repair works on the District Health Administration block were carried out.

In the first quarter of 2005, the region handed over five (5) single bedroom, house to the management.  This building is to serve as a transit quarters for newly posted staffs. 

HIV/AIDS Control

HIV AIDS is still escalating in the district and it is time for everybody to come on board to curb the situation.  The district hospital continues to screen people blood donors and other patients.  Training, Health Education, and meetings were planned but much was not achieved. The district has eight (8) trained counselors who offer services to those in need. However a VCT centre has been identified and renovated and put to full use in the middle of 2005. The hospital is one of the sentinel sites in the region.

In 2003, out of 171 people screened, 63 people were found positive (19.0%).  In 2004, out of 231 people screened 89 people were found to be positive - (38.0%).  This figure was more than doubled the previous year’s figure. This was the period the activities of HIV/AIDS in the District, were being given a push. 

In 2005, out of 945 people that were screened 142 people were found to be positive (19.3%).  The large attendance was due to the institution of Voluntary Counseling and Testing (VCT) centre in the middle of the year.  The positive cases for the period under review had drastically reduced to almost half. Cases continued to be seen in 0 – 4 age groups over the years.  These are purely case of mother-to-child transmission. The age groups mostly affected are the 20 – 49 years.  The numbers in these age groups keep increasing over the years.  They constitute 156 (16.5%) of the 179 positive cases in the year.

Malaria continues to be the leading cause of OPD attendance in all health facilities in the District.  It constituted about thirty percent (31.3%) of all cases in 2003; it rose to about forty percent (39.3%) in 2004; and to about forty-five percent (44.57) in 2005.  This steady rise could be due to the institution of the Roll Back Malaria Programme in 2004; where programmatic activities were put in place to create awareness and control the disease.

Malaria still constituted the most cause of deaths in the District.  However, the death rates had been declining over the years.  It was 17.6% in 2003, dropped to 14.65% in 2004 and increases slightly to 14.65% in 2005.  

Other medical conditions such as Meningitis, Hepatitis, Heart failure and Hypoglycaemia were among the cause of deaths in the district. All these conditions are serious and will be given special attention in the coming years. Most people in the communities report late at the health facilities making management difficult and cause deaths in the district. This partly was due to the inability to pay for bills for these preventable conditions.

The high anemia cases and Hypoglycemia could be due to poor feeding practices.   Efforts should therefore be made to improve nutritional status in the district. There is the need for more collaboration with other agencies such as MoFA and GES in order to reduce the level of malnutrition in the district
 
Special Initiatives To Increase Access To Services

The Community Based Health Planning Services (CHPS) initiative is a strategy to deliver community level service.  It focuses on improving partnership with households, community leaders and social groups.  The goal is to improve the health status of people living in Ghana by facilitating actions and empowerment at household and community level.  The district developed a CHPS coverage plan to cover thirty (30) zones in the district. These zones were selected based on population, distance to health facilities, inaccessibility to communities and low patronage of health services.  The District carried out orientation durbars and community entry with some achievements.
5 District-Wide Mutual Health Insurance Scheme

The Jirapa-Lambussie District Wide Mutual Health Insurance Scheme started to provide services to its subscribers on 1st January 2006.  

Nutrition

Proper nutrition, food security and care practices are the outcome of good health. However, malnutrition is a major public health and developmental challenge in the district. The vulnerable groups are children under five years, adolescents, women and the aged. Prevalence of underweight, stunting (H/A) and Wasting (W/H) in the district is as shown in the table below by sub-districts.
Rehabilitation of Malnourished Children

The district has no nutrition rehabilitation centre.  Severely malnourished children are rehabilitated at the children’s ward of the hospital. The outcome of nutrition rehabilitation of the severely malnourished children in Jirapa Rehabilitation centre of the hospital.

The set target for rehabilitation rate was 80%. Marasmus was the highest in the district and this was as a result of inadequate food in households and other childhood diseases like diarrhea and malaria.

Supplementary Feeding Programme

The district has six (6) communities under this programme, namely, Sabuli, Guo, Ullo, Ul-kpong, Ul-Tuopare and Samoa.  The programme catered for children 0 – 59 months of age. Children registered are 850 (422 males and 426 females), and pregnant and lactating mothers 720 with 12 centre attendants. The programme is in its third phase; the old communities are to be replaced with new ones.  In our district 4 communities are to be phased out namely Sabuli, Ullo, Ul-Kpong and Samoa.

We are to select 10 communities for the third phase, which we have done taking into consideration the pro-poor communities compiled by the District Assembly. In 2004, under weighed children at the feeding centre was 4% and 2005; it reduced to 2%, which had improved. Training was organized for health centre attendants to improve upon weight taking. Centre committees meeting were also held to improve on centre management.

Expanded Programme On Immunization (EPI)

The Cold Chain system is the heart of EPI and if not properly maintained will cause damage to the vaccines. As a result of this, gas, solar and electric fridges had been given to all of the sub-districts. Ullo, Hain, Lambussie, Jirapa-Sub and Hamile are using electric fridges and the rest are solar and gas.

However, there had been frequent break down of these fridges up to date. Five fridges are at the moment not functioning properly and the vaccines were conveyed to nearby sub-districts. The maintenance unit has recently not been visiting the health facilities to maintain and replace the broken down fridges regularly.  If this is not corrected early, we should expect epidemic in the near future. In 2003 and 2004 the break down was not great as compared to 2005. This situation is due to over aged batteries for the solar fridges and old electric fridges.  

The District therefore needed new batteries and new fridges to replace these old ones. The general performance in the EPI services in the District had improved considerably over the years.  However, some sub-districts did not achieve their targets in some of the antigens.  This could be due to the breakdown of refrigerator or the absence of vaccines, or breakdown of motorbike.