• 4 Hospitals

• 7 Clinics/CHPS Compounds

• 6 Clinics

• 2 Maternity Homes

• 2 Training Institutions

• 2 RCH Centres

The district has 52 outreach points where Reproductive and Child Health Services are rendered. Four of these outreach sites were opened during year 2010. One of the strongest strengths of the district is the community based surveillance programme. Sixty six (66) functional and active Community Based Surveillance Volunteers (CBSVs) have been trained to support community health activities. They record and report on monthly basis diseases, deliveries and deaths in their various communities. Currently, the district is running the Community TB Care programme with the support of the CBSVs. There are other non-orthodox treatment centres in the district. Prominent among them are Nana Oboanipa at Kuntanase, Osofo Serwaa Prayer Camp (Kuntanase), King Jesus Miracle Prayer Camp (Toamfom). There is currently collaboration between the Health Directorate and some of these centres to enhance health service delivery. This has resulted from several advocacy sessions with some of these centres to discuss health issues and each other’s contribution as well as limitations.

Public Health Activities Disease Control
Communicable Diseases

The district organized health talks on TB/HIV, CSM Cholera, Ebola and other communicable diseases prevention at the various churches, OPDs, communities and outreach centres in the district. These talks were aimed at educating the public on signs and symptoms of the diseases, as well as their preventive measures, Know your status campaign was also highlighted. There were trainings on TB/HIV management, care and control for all categories of staff. There were health talks at the local information centers to create awareness on TB disease and the need for early reporting and several other diseases of public health importance.

Again, Better Ghana Management Service and Health Promotion Agents in the District also partake several health education and promotion activities in the district. Most especially of these activities include hand washing demonstration in schools, registration of pregnant women in the communities and enrolling pregnant women on the National health Insurance Scheme.

Case search on some selected communicable diseases like AFP, Buruli Ulcer, Guinea worm. Leprosy and Yaws was conducted by CBSVs in all the communities in the district to enable them detect early and report suspected conditions to health facilities for management.

Measles cases have reduced significantly over the years. Sixteen (16) samples were taken as suspected measles cases. However, one of them was positive, whilst three (3) cases of suspected Yellow Fever were picked which also turned out to be negative.

The figure 1.27 below depicts the trend of malaria cases as presented at the OPD in the Bosomtwe district. The presentation is based on the percentage of malaria cases out of the total morbidity cases, and is relative to total OPD attendance.

IPT Implementation Monitoring

IPT implementation is ongoing in all facilities in the district. IPT supply was not very regular during the year under review. This notwithstanding, Percentage usage of IPT 2 increased from 45.1% in 2014 to 48.8% in 2015 and increased to 49.1% in 2016. ITN use during second visit increased from 40.2% 2014 to 50.9% in 2015 but shot up to 51.6% in 2016

Table 1.56: IPT Implementation Monitoring

Community TB Care Programme

Community TB Care Programme (CTBC) has been a major innovation in the district’s health care delivery. Objectives of the Programme among other issues are to;

• Use Community Based Agents to carry out TB Programme

• Improve IE&C/BCC on TB

• Enable Treatment Supporters to carry out home visits to TB patients

• Enable TB Patients to complete their treatment regimen.

Reported cases of TB decreased to 66 in 2015 but increased to 78 in 2016, with new smear positive cases forming 43.59% of total new cases. Males have always formed a greater proportion of TB cases over the past 3 years contributing over 67.9% of cases in 2016.

Enablers package was given to 57 TB patients who were on treatment, even though there were 78 cases recorded. This is because there were other additional patients who were still on treatment in 2015 that was added to the 2016 patients.

Case detection rate for tuberculosis was 57.8% in 2015 and then increased to 72.2% in 2016. Cure rate also increased to 76.9% in 2015 however, treatment success rate increased 83.8% in 2015 to 84.7% in 2016. The district recorded 1 death caused by TB. Defaulter and failure rates for both 2015 and 2016 were zero. This achievement is attributed to the community based TB management strategy that ensures frequent visit to the patient by the health workers and the community based treatment supporters.

Diseases Targeted for Elimination and Eradication

Importance continued to be attached to institutional and community based surveillance with the support of 66 active CBSVs. There was 1 case of suspected AFP found in the year 2016.

Expanded Programme on Immunization

The Expanded Programme on Immunization (EPI) has proved its place as a cornerstone in health care delivery. Objective of the programme is to protect eligible children from vaccine preventable diseases by the age of one year so that at least 90% of the children born would be fully immunized against the nine (9) common childhood diseases, that is, Tuberculosis, Poliomyelitis, Diphtheria, Pertusis, Neonatal Tetanus, Hepatitis B, Haemophilus Influenza type B, Measles and Yellow fever.

Major activities included maintenance of the cold chain, logistics support, routine static and outreach immunization and strategic mop-up campaigns with the support of HIRD funds, mop up was undertaken in all of the four (4) sub-districts.

During the year under review, most of the coverage for most of the antigens increased as compared to the year 2015.

Integrated Disease Surveillance and Response

Several activities were undertaken during the year under review including case search, clinician sensitisation, CBSV training on some selected diseases.

Community based surveillance is one of the major components of the Integrated Disease Surveillance and Response (IDSR) systems in which persons residing in various communities keep watch to detect and report occurrences of infectious diseases and other unusual health events that might indicate the presence of disease to the health authority for timely and appropriate action to be taken. The key players of this component are the Community Based Surveillance Volunteers. The Bosomtwe district has sixty six (66) CBSVs with at least one in each of the 63 communities in the district. During the year under review, CBSVs reported a total of 212 deliveries. On disease surveillance, a total of 10 diarrhoeal cases were reported as well as 2 measles suspected cases which all turned up to be negative.  The CBSVs participated in the Integrated Maternal and Child Health Campaign that was held. Currently, the CBSVs are the main treatment supporters at the community level to the districts’ TB care programme.

Reproductive Health

The year under review saw the district providing Antenatal care for 4,913 pregnant women who registered at the various ANCs. This represented about 113.38% of total expected deliveries which explains a decrease in terms of percentages as compared to 144.8% recorded in 2015. The high ANC coverage can be attributed to the fact that people come from outside Bosomtwe District and access ANC services, especially at St. Michael’s Hospital. All the sub-districts recorded averagely over 62% with Pramso Sub-district recording 48% coverage. Teenage pregnancy was 587 in 2015 but decreased significantly to 358 to 2016. This represents percentage coverage of 7.3% on the total ANC registrants. TT2 coverage decreased from 85.7% in 2015 to 81.15% in 2016. Skilled delivery accounted for 3,982 (112.01%) of total deliveries, a decrease from the previous year of 3,994 (135.3%) whilst TBA delivery was 8 a decrease from 10 in 2016. There were 57 cases of still births made up of 42 macerated and 15 fresh.

There was an increase in Post Natal Care from 3,045 (102.3%) in 2015 to 3,095 (103.5%) in 2016. Family Planning Acceptor rate increased from 50.1% in 2015 to 50.4% in 2016. Couple Year of Protection increased from 2,021.8 in 2015 to 2031.2 in 2016. Male condom was the major family planning commodity which clients accepted so well during the year under review, recording 57.4%and Norigynon recording 22.1%  It is hoped that as midwives are now being used in the CHPS implementation programme, access to reproductive health care will improve significantly. In the year under review, there were a lot of activities to promote the long term.

Adolescent Health

Only the Kuntanase Hospital and St Michael’s Hospital render adolescent health friendly services. Clients are counselled on STIs, HIV/AIDS, abortion, family planning and other general health issues. The facilities have adolescent friendly units equipped with TV, Video Player and other games to attract the youth.

School Health

A total of 230 schools out of the 248 schools in the district were visited. Eighteen thousand nine hundred and eighty nine (18,989) school children, representing 57.6% of enrolled children, were examined in the year. Health conditions including eye, ear, tooth decay, sore/ulcers on the body and scabies as well as some ring worm cases were detected and referred to the Kuntanase District Hospital, St. Michael’s Hospital and Jachie Eye Clinic. In all one hundred and nineteen (119) children were referred. Generally, environmental sanitation in schools has improved. Parents and guardians are also responding positively to the health needs of their pupils through their early response to referrals.

                            Health Promotion

Sensitization meetings were held with organised women groups in the district. A team from the directorate in the District Health Promotion Officer also visited second cycle institutions and vocational schools in the district to discuss Safe motherhood lessons. The directorate mostly relied on the P/A system and the various information service centres in the communities in the dissemination of public health information and carried out series of IE&C programmes on the Community based TB Care programme and home based care strategies in the new anti-malaria drug policy.

Other health promotion activities aired out were child health issues during the child health week celebration. The directorate again went on to educate the populace on Poliomyelitis, Measles, Vitamin A and the importance of ITNs in the malaria control strategy during the Integrated Maternal and Child Health campaign exercise in the year under review.

As part of efforts aimed at promoting the health status of the people in the district especially the youth, there were number of health educational activities that were carried out in the district by the health promotion team in collaboration with the Youth Employment Agency (YEA). They were mostly involved in proper hand washing demonstration which aimed at preventing diarrhoea and cholera outbreak especially at the school going age. They also engaged in registration of birth and death, registration of pregnant women, assisting Community Health Nurses (CHOs) on home visits activities, and report certain disease of public health importance for referrals

As part of the HIRD programme an advocacy meeting was held with practitioners of herbal and non-orthodox medicine and spiritual and psychic healers to find means of educating them on recognising diseases and knowing when to refer.

The GSCP also organised training sessions on communication skills on breastfeeding, complimentary feeding and malaria. There were several health talks on malaria and TB in the communities, health facilities, churches and other social clubs in the course of the year.