The health care delivery system is built around one (1) district hospital in the district capital serviced by four (4) Reproductive Health Clinics, seven (7) completed CHPS compounds, sixty-two (62) outreach points, ten (10) feeding centres and one (1) rehabilitation centre. The district health administration is managed by a District Health management Team (DHMT) headed by the District Director of Health Services (DDHS). The team is supported by Sub-district Health Management Teams (SDHMTS) in all six sub-districts.

Incidence of Diseases

Malaria has remained the number one public health problem in the district as in most parts of the region and the country as a whole. The incidence of malaria between 2003 and 2005 went up each year. In 2003, 242 were admitted at the hospital. It rose to 688 in 2004 and reduced slightly by 597 in 2005. Percentage of OPD attendance due to malaria between 2003 and 2005 are 62%, 54% and 51% respectively. Below are the top causes of Admission and death in the District.

From the above table, it is obvious that malaria is leading the ten courses of admission and deaths in the district even though malaria is a preventable disease. Conscious efforts should therefore be made to reduce the incidence of malaria in the district.

Health Personnel And Infrastructure

The biggest challenge facing the health sector in the district is inadequate health personnel and infrastructure. Currently, there are two (2) doctors in the district. The District Medical Superintendent who is in charge of the District Hospital and the Director of the District Health Management Team (DHMT) There are sixty-five (65) nurses in the entire district. It is obvious that this number is woefully inadequate compared to a population of almost 90,000

The health infrastructure especially nurses accommodation is very critical to quality service delivery. However, this is a serious problem in the District. Some of the nurses have no accommodation and those who have, it is simply inadequate.

For the District to achieve quality health care delivery, conscious efforts should be made to improve the staffing and infrastructure situation of the health sector. Surface accessibility to health care in the district is also a big challenge. This is as a result of poor road network and several unbridged streams and rivers. This makes it difficult for most people to access health care in the district and even if they do, they get to the facility late. Income accessibility is another big challenge due to the high poverty levels in the district; most people find it difficult to access health care in the district. However, with the introduction of the National health Insurance Scheme (NHIS) quite a number of people have breathed a sigh of relief.

Below is the current situation on the health Insurance Scheme in the District;

1. Number of people Registered - 18,621
2. Number of Indigenes - 2,868
3. Number of people accessing Health Care - 10,915
4. Contribution from premium - 130,300,800
5. Subsidy from Health Insurance Council - $327,110,000

From the above, it is obvious that a lot of people have not registered for the health insurance scheme considering the district’s population of almost 90,000 and the number of registrants of 18,621. The proportion of registered population is about 24%.A lot of work would have to be done to encourage more people to enroll in the Health Insurance Scheme.

Indicators Of Health Care Delivery

The infant and maternal mortality rate is good. From the period 2003 - 2005, percentage of supervised deliveries was 12.8% in 2003, 20.0% in 2004 and 53.3% in 2005. For maternal deaths, in 2003 there was only one (1) in 2004, two (2) deaths and in 2005 no death.

Percentage of Health facilities designated baby friendly is 62.5% in the district. A lot more health facilities would need to be designated baby friendly. The quantity of bed nets distributed in the district between 2003 and 2005 was 25,000. Considering the high incidence of malaria in the district, more bed nets would have to be acquired and distributed especially to pregnant women and children.

Major Challenges To Health Care Delivery In The District

• Inadequate Health Infrastructure such as residential accommodation
• Inadequate behavioural change among the people
• Inadequate Health personnel
• Inadequate logistics and equipment
• Security