The limited number of health facilities implies that the unorthodox health service delivery will be patronized with its attendant consequences. The table below indicates delivery by the GHS and that of the TBAs. The table shows an increase in TBA delivery over GHS for the period due to the fact that majority of the communities are distance from the limited health centres.

As indicated in the table the district is faced with high level of malnutrition. This is attributed to lack of complementary feeding, non adherence to exclusive breast feeding and lacking of incoming generating ventures for the women. This implies that the physical and mental development of children will be adversely affected. Women should therefore be supported to increase their disposable income. This would help improve family diet. The attitude of mothers needs to be changed through vigorous educational campaign on exclusive breast feeding.

Community Based Health Planning and Services (CHPS)

Over the years, access to health service has been low due to far distances between communities as well as poor road network in the district. To overcome these problems, the Ghana Health Service is implementing what is known as Community based Health Planning and Services (CHPS). The district has been zoned into 14 CHPS zones. Under the CHPS programme, the district has been able to construct a CHPS compound at Buo and a staff has been trained and designated to the Buo CHPS programme.

Major Diseases in the District

The disease pattern of the district is similar to that of many rural districts and the country at large. The table below shows the top ten diseases of the district. As shown in the table above, malaria continues to be a major disease in the district. The high incidence of water and sanitation-related diseases implies that, when water and sanitation as well as behavioral issues are tackled, then over 60% of the diseases would have been eradicated.

In 2004, ARI was not a major disease. However in 2005 ARI appeared as the second predominant disease in the district. Efforts should be made to curb the control the cases of ARI and malaria. Moreover, safety campaign should be carried out to reduce the cases of Road Traffic Accidents. The figure below gives a pictorial presentation of the incidence of diseases in the district.

Staffing

The analysis considers the medical staff, Para-medical as well as other supporting staff of the various health institutions. From the table it is clear that the district is faced with inadequate staff both at the DHMT and the four sub districts. This results in effective service delivery. At the DHMT 14 additional staff will be required to augment the existing number. On the other hand, the four sub district will need 30 additional staffs.

National Health Insurance Scheme

As part of measures to provide affordable health care service to the people, the district started implementing the Mutual Health Insurance Scheme ran by the Sissala East scheme management. However, plans are under way to establish the scheme in the SWD. An 11 member board has been put in place for the take off of the scheme. The scheme has duly registered with the Registrar General Department and has been issued with a Certificate of Incorporation and a Certificate of commencement of business. The scheme has thus been benefiting since November, 2005. For the purpose of the scheme, the district has been zoned into 52 communities out of which 51 have had their committees formed and trained. Sensitization on the scheme covers about 70% and the district target is 90% coverage by the end of 2006.

The problems confronting the NHIS include;
• Lack of permanent office accommodation for the scheme.
• Inadequate funds to run the scheme.
• Inadequate logistics for effective operation of the scheme.

HIV AIDS

As an infant District data on HIV/AIDS is non-existent. This is partially due to fact that, there is no standard Health facility to detect the state of HIV/AIDS. Patients which exhibit symptoms of HIV/AIDS are referred to Tumu Hospital but there is often no feed back therefore managing the disease is difficult. However, the District Assembly has taken measures to combat the situation. Focal Person on HIV/AIDS has been put in place. The District Assembly has provided 1% of its share of the DACF into MSHAP Account for the implementation of the MSHAP which is the current National Strategy to combat the HIV/AIDS pandemic.

Key Health Problems

1. Lack of office and residential accommodation
2. Inadequate Transport ( Vehicle, Ambulance, Motorbikes, Bicycles) for the institutions
3. Inadequate Clinic s/CHPS compounds
4. Inadequate Staff ((Midwifes, CHN, SRNs)
5. Inadequate equipments in the health centres.
6. High incidence of malaria and malnutrition.

Low community participation in health programmes