HEALTH CARE DELIVERY IN THE MUNICIPALITY

The overall objective of the interventions outlined in the GSGDA for that matter Jaman South Municipal Assembly, under health is to improve the health status of the population. In achieving the interventions the following focal areas guide stakeholder decision.

• Bridging the equity gap in access to health and nutritional services
• Ensuring sustainable financial arrangement that protect the poor
• Strengthening efficiency in health service delivery

Health infrastructure

The formal health system in the Municipality consists of 1 District hospital (CHAG), 9 Sub Districts Health Centres, 5 functional CHPS centers and 1 Polyclinic and no Community Nutrition Centres. There are also 3 private Maternity Homes within the Municipality. The Municipal still needs additional CHPS in the near future. These facilities complement one another to deliver quality services to the people.

Access to Health Care Facilities

The existing number of facilities in the Municipality clearly indicates that some communities have low access to health care facilities. A look at the number of facilities simply portrays that accessibility to health care facilities are mainly Health Centres, Community Clinics and sometimes traditional healers. This is in view of the fact that these facilities are to a very large extent distributed within the major communities in the Municipality. Distance to the health facility is a major challenge in the Municipality due to the fact that most of the facilities are within the Municipal capital.

It therefore calls for prudent measures to upgrade and distribute health facilities equitably in the area. Also, there is the need widen the coverage of health insurance scheme in the Municipality. This will enhance equitable access to health since it will increase equal opportunity for both the rich and the poor.

Staff situation in the Municipality

The table below indicates Staff situation in the Municipality from 2014-2017.

Table 1.19: Staff situation in the Municipality

Source: DHD, JSMA 2016

OPD Attendances in the Municipality

As attendance increases, OPD per capita also increase since the health seeking behaviour is on the increase couple the increased in insured patients. This is due to increase health education at our OPD, home visit etc

Incidence of Diseases in the Municipality

Malaria Control

Malaria continuous to be the number one (1) cause of OPD attendance and the first among the top ten diseases for the period under review. It also constitutes the first top causes of admission. This calls for more concerted efforts to reduce the situation. Table 21 shows malaria cases recorded over the years

Maternal Deaths

During the year under review, the Municipality recorded three (3) maternal deaths representing 120 per 100,000 live births as compared to one (1) maternal death representing 40 per 100,000 live births same period 2015. Emphasis on increasing EOC; improving the knowledge and skill of service providers through the safe motherhood programme as well as creating awareness on the magnitude and consequences of maternal mortality need to be intensified to accelerate its reduction in the Municipality. The Cause of maternal death includes:

• Ectopic pregnancy
• Cardiac failure
• Septic abortions
• Anaemia
• Circulatory overload
• Pulmonary Embolism
• Renal failure

Infant Mortality Rate

As indicated in the table below, a total under five mortality (0-5years) recorded for 2014 was 45 compared to 27 (2015) and 14 (2016). Even though there was a decreased, the figure is still high and therefore calls for an urgent intervention. More sensitization programmes geared towards creating awareness for pregnant women to regularly attend antenatal and post-natal must be intensified. It is particularly important because the Municipality has to contribute to the national goal and the MDG of halving infant mortality.

Table 1.21: Trend of maternal and infant mortality ratio

HIV/AIDS Control

PMTCT/testing and counselling services were carried out in all the health facilities. Over the period under review, the number of new clients who were put under care was 125. 100 of those representing 80% were started ARVs. The table below shows facility testing and counseling of HIV from 2014-2016. Females recorded more positive cases than males.

The chart below depicts HIV prevalence among pregnant women at PMTCT Centers. The Municipal recorded 1.4% in 2014 but increased astronomically in 2015 but decreased drastically in 2016. However, the district prevalence rate is still beyond the national prevalence.

Family Planning

Family Planning services were offered at all facilities in the Municipality except the District Hospital which is a catholic hospital. 11,136 both new and continuing acceptors were recorded representing 42.3 % of WIFA as compared to 1058(39%).

Major Problem of Health Delivery Despite the successes of the sector there are still some development problems that need to be addressed. These problems include:

• Some facilities lack adult weighing scale
• Inadequate staff regarding catchment areas
• Breakdown of motorbikes
• Inadequate safety boxes
• Insufficient mixing syringes
• Poor filling system
• Lack of child health records booklet

Status of the District Mutual Health Insurance Scheme

The National Health Insurance programme is a social protection programme that seeks to ensure that all residents of Ghana access quality health care without paying money at the point of service. The enrolment figure for the year 2016 under review was at 60,463. This represents 57.3% of the total projected population of the district (105,396) for 2016.

It can be deduced from the table that registration in the period under review indicates, the informal sector recorded the highest as compared to others, which is an indication that the informal sector formed majority of the population of the Municipality.

The year also witnessed the introduction of the new single technology platform and the aim of this is to ensure the integration of all the schemes at the district level and also with central authority.