The district has 8 heath centers in Bunkpurugu, Yunyoo, Kambagu, Ghingbani, Binde and Nakpanduri that offers primary health and child care services. Four of the facilities are private and the other four public. The ratio of people to a health centre is more than 22000.

Community Health

92% of women had their babies immunized against BCG, DPT, and poliomyelitis. Only few women immunize their babies against diseases other than these three. Malaria is the most common disease in all communities amongst both males and females. The incidence of diarrhoea is high at (39%) among children.

Deaths were perceived as caused by disease or through curses and accidents (during wars, etc). There were no adult deaths in the surveyed communities in 2001. For children, 10 deaths in 1000 were recorded in the communities in 2001. Ulcers, Diarrhoea, stomach disorders and heart disease are the major causes of death among children. Women usually die of malaria, old age and other courses while men die from malaria, stomach disorders, diarrhoea, ulcers and skin diseases.

Child Nutritional Status.

The results indicate a high prevalence of chronic malnutrition among children in the district. Overall, one in two babies under five years was stunted while about two in five were severely stunted. Male babies were more likely to be stunted (31%) as compared to female babies (20%). Babies within the age ranges of 6-11 months, 12-23 months, and 36-47 months were more likely to be stunted as compared to those in other age ranges.

Incidence of wasting is highest among babies within the age rage of 12 months to 23 months. Male babies were more likely than female babies to be wasted. About 33 percent of babies in the district are underweight while about 10 percent are acutely underweight. There did not appear to be any significant difference between male and female babies.

The survey shows a rise in infant mortality by 76.6% between 2004 and 2005. Whiles maternal deaths realized an increase of 100 percent from 2 maternal deaths to 4 maternal deaths. The number of supervised deliveries at the health centre points to a positive picture since the 2004 figure of 460 supervised deliveries increased to 671 showing an increase of 45.87% within the period even though the increase may not be significant if the total number of deliveries in the district were known both at the community and institutional levels O.P.D attendance due to malaria also shows an increase of 18.25% from 1,211 to 1,432 under the period of review.

The district for year 2004 had 10 nurses but had an additional number of 8 nurses’ in 2005 and this shows a significant increase of 80%. The district for the two years has only one doctor serving the entire population. Number of midwives also shows an increase of 22.2% but not withstanding the increase, 11 midwives in the district is certainly inadequate. Mothers who sought antenatal and postnatal care at various health centres in the district gives an aggregate figure of 554 in 2004 and a figure of 607 in 2005.

This is an increase of 9.56%. The patronage of health facilities by mothers thus shows an increase but not significant.

The number of new cases of HIV/AIDS in 2004 was 2 resulting in the cumulative cases of 55, whiles one (1) new case was recorded in 2005 hence the number of cumulative cases of HIV\AIDS in the district is fifty-six (56). The prevalence rate in the district may not be significant but caution cannot be thrown to the wind in fighting the pandemic.

Nutrition 2004 - 2005

Percentage of household using iodated salt 69% 71% %Of health facilities designated baby friendly 49% 56%Coverage of vitamin A for babies between 5-59 - % of Vitamin A coverage for mothers after delivery 48% 60%. An amount of sixty-one million eight hundred and ninety thousand (¢61,890,000) cedis was voted for the fight against HIV\AIDS in the district and all was spent.

The district did not make separate budgetary allocations for 2004 and 2005 respectively for the health sector even though some funds were spent in the sector. A significant 69% of all households in the district used iodated salt in 2004. The number of people who used iodated salt increased by 2% soaring up to 71% significantly. Health facilities designated baby friendly shows a figure of 49% in 2004 and a percentage of 56 in 2005. This shows an increase of 7%.

Almost all babies between (6-59) were covered with vitamin A for 2005.Their mothers also had Vitamin A administered to them for the two year period and this represents a figure of 60% in 2005, an increase of 12% from the 2004 figure of 48%. Notwithstanding the importance of good nutrition not only to babies but their mothers and the community as a whole, there was no budgetary allocation to the sector for the two years studied.

Generally a healthy people make a healthy nation. The development of every nation is therefore derived from her healthy people. All efforts and interventions towards making quality health delivery accessible to all is what must engage the attention of central Government. However the perception of people in the Bunkpurugu/Yunyoo District about the health delivery system presents a gloomy picture.

Some problems respondents enumerated include:

1. Long distances to hospitals

2. Nurses population in the district not adequate. The nurse population pointed out by the situation analysis buttresses this concern.

3. Lack of health centers, hence making a lot of rural dwellers resort to various orthodox means of health care

4. In accessible roads and poor transportation system in the entire district

5. Lack of reliable pharmacy making it difficult for people to buy prescribed drugs.

6. The whole district has no a stationed medical doctor.

Awareness Level of HIV/AIDS

The people generally, though they have heard about HIV/ADIS, but did not believe that the disease existed in the district. For a lot of respondents, they did not want to even talk about HIV/ADIS. This however contradicts the figures recorded at the various health centres on the deadly HIV/ADIS as the situation analysis shows. Policy makers and organisations must therefore redouble efforts at awareness creation on the prevalence of the disease in the district in order to win the war against the pandemic.

State of NHIS in the District

The National Health Insurance scheme is a policy introduced by Government to place quality health delivery at the doorstep of every Ghanaian. It is important to note that the implementation of this important national policy has not been easy across the country since it first appeared on the national policy document on health. It’s meant to replace the cash and carry system, which has been in operation since independence, but placed quality health beyond the reach of ordinary Ghanaians.

The Bunkpurugu/Yunyoo district is not of an exception in as far as the operational difficulty of the scheme is concerned. All communities visited by the research team in the district were at the photo taking stage. Even that many people in the district have not registered due to lack of interest or enough education and sensitisation on the scheme has not taking place. A huge responsibility therefore rests on the publicity division to sensitise communities to the importance and relevance of the NHIS.

Key Development Issues

• Inadequate access to Health facilities

• Low capacities of District Health Administration, Health personnel and DMHIS

• Poor performance of the District Mutual Health Insurance Scheme to make health affordable and accessible

• High level of malnutrition

• High incidence of malaria

• Prevalence of HIV/AIDS