Health

Health care services in the Municipal are provided by both public (including mission) and private health care institutions which include health centers, clinics, maternity homes, and Community based Health Planning and Services (CHPS) compounds. Traditional health practitioners, such as traditional birth attendants, herbalists also play some role in health care delivery.

The Tano North Municipal has no government hospital. The St. John of God Hospital which is the largest hospital in the Municipal is a CHAG institution and it is the only referral hospital in the Municipal. The Municipal has 1 Hospital, 1 Polyclinic, 4 Health Centers, 4 functional CHPS Compound and 25 CHPS Zones.

Staffing

Health care services in the public health institutions are provided by staff of the health directorate. The directorate has staff strength of 150 this shown in the table (Tano North Municipal Health Directorate, Annual Report, 2016). The nurse – patient ratio of 1:887 (one nurse to 887) is considered high and must therefore be improved upon in order not to over burden health workers and at the same time compromise the quality of health care to the population.

Top Ten OPD Cases

The predominant cause of diseases both OPD and admissions is Malaria. Malaria cases recorded in 2015 was 30,336 as against 28,012 in 2016. The represents 8.29% decrease in Malaria cases. Upper Respiratory Tract Infection case however increased from 22,229 in 2015 to 27,632 in 2016

Mental Health Conditions

The Municipal established a mental health Unit in 2015. The tale below shows the recorded cases from 2016- 2017

Nutrition

Nutrition plays a pivotal role throughout the life cycle of an individual; from infancy to old age. One in three people is malnourished in one form or another (IFPRI, 2015). Adequate nutrition is thus, essential in maintaining optimal quality of life throughout the life span. It contributes to reproduction, human capital formation, education, productivity and the development of every nation. It is also critical in achieving the Sustainable Development Goals (SDG’S).

Malnutrition

Nearly half of all deaths in children under 5 are attributed to undernutrition. This translate into the unnecessary loss of about 3 million young lives per year (UNICEF, 2016).

Malnutrition may occur in people who are undernourished or over -nourished.  Under-nutrition is an aspect of malnutrition that is as a result of the deficiency of energy, protein, and other nutrients. It is most leading cause of death seen in children in developing countries, particularly during complementary feeding. A child suffering from under-nutrition may have features of marasmus, kwashiorkor or both (marasmic-kwashiokor). The table below shows the number of children rehabilitated over a three year period. A total of seven, eight and four cases were recorded in 2014, 2015 and 2016 respectively.

Challenges

- Lack of basic equipment such as, stadiometer, food scale among others thwarts the smooth running of the unit.

- Under reporting of vitamin ‘A’ doses by some sub – Municipals.

- Inability to follow up all children rehabilitated especially those outside the Municipal capital

- Low coverage in vitamin A supplementation for 12-59 age bands

HIV/AIDS

Major HIV/AIDS Activities Carried Out

1. Health durbar and screening at the community level.

2. HTC and PMTCT services at the health facilities. And outreach clinics.

3. Administration of Antiretroviral Therapy.

4. Monitoring and Supervisory visits to sub-Municipals

5. Sensitization of Students on the first 90 day campaign

6. Celebrated World AIDS Day at Duayaw Nkwanta.

7. Distribution of HIV health education materials to sub Municipals and stakeholders.

8. Distribution and demonstration of male condoms to community members.

Facilities Providing PMTCT Service

1. St John of God Hospital, Duayaw Nkwanta

2. Bomaa Health Centre, Bomaa

3. Yamfo Health Centre, Yamfo

4. Tanoso Health Centre, Tanoso

5. Adrobaa Health Centre, Adrobaa

6. Mankranho CHPS Centre, Mankranho.

7. Dwenase CHPS Centre, Dwenase.

8. Terchire Health Centre

9. Buokrukruwa Presbyterian clinic

A total of 2,724 anti-natal clinic (ANC) registrants with 2,250 tested given a coverage of 82.5%. 77 positive cases (3.4%) were recorded in which 25(32.4%) were treated.

HIV Testing and Counseling

HIV Testing and Counseling (HTC) which was formally referred to as Counseling and Testing or Voluntary Counseling and Testing was conducted at all the seven facilities in the Municipal to provide clients the opportunity to know their status. The information is summarized as follows.

A total of 1,558 clients comprising 690(44.2%) males and 868(55.8%) females were tested of which 121 positive cases recorded in the year 2016. Out of the positive cases, 77(63.6%) were females whilst 44(36.3%) were males.

STI Municipal Report

Challenges

a. Difficulties in getting data from facilities and other stakeholders working on HIV/AIDS

b. Most of the health facility staffs not trained on HIV/AIDS activities

c Discrepancies in HIV/AIDS returns

d. Lack of funds to implement HIV/AIDS activities

e. High cases attributed to the female population.

f. High syphilis cases

g. Low treatment of syphilis cases.

h. Irregular supply of   oral quick from the region

i. Lack of computer for the storage of HIV data

Municipal Health Insurance Scheme

The NHIA was established under National Health Insurance Act, 2003 (Act 650). Later, a revised law (Act 852) was passed in October 2012 to replace Act 650 to consolidate the NHIS, remove bottlenecks, introduce transparency and make effective governance of the schemes among others.

The Tano North Municipal office was opened in 2004. Currently, the scheme has 19 permanent staff and service personnel that help in the day to day activities of the office. The Tano North Municipal is one of the many schemes operating nationwide whose performance is tracked, monitored and graded in terms of our ability to maintain and increase membership in order to provide access to health care to every inhabitant of the Municipal. The table below shows the membership drive for 2016 and 2017.

Tano North Municipal office is currently working with a projected annual membership of 41,857 which is usually broken down into quarterly, monthly, weekly and daily targets. The Office has mapped out zones and identified the following communities as “ leaking clients” out of our basket of membership on the western corridor of Municipal such as Yamfo, and its surrounding communities, Tanoso, Terchire and others potential candidates for the Sunyani schemes.

Other communities including parts of Bomaa, Subonpang and Dwenase etc are comfortable registering and renewing their membership at Tepa because of proximity. This is because in their transportation arrangement, it is economically easier and cheaper to pay to this preferred destination than come down to Duayaw Nkwanta which is relatively further away or which they find quite inaccessible due to geographical location. Measure need to be put in place to get a temporary registration centre in some other parts of the Municipal. This would enable the membership drive to grow and meet targets as well discourage clients from patronizing the schemes in Sunyani just as communities in and around Adrobaa, Subriso No.1, Mankraho etc who conveniently patronize the registration centre located at Chiraa also, a Sunyani Scheme.

Challenges

• Office Accommodation, the scheme is currently housed in a rented apartment

• Operational challenges i.e. down time effect of Vsat network and BMS application, poor MTN connectivity in most parts of the Municipals, shortage of consumables (ribbons, ID cards), delays in replacement of hardware (ID cards printers)

• Government directives

• Delayed in claims payment, co-payment and its impact of registration

• High operation cost