The Municipality is divided into ten (10) health zones.  Considering the size of the Municipality and the population distribution, health facilities are well distributed and majority of the population have high access to health facilities within the Municipality.  Again, this condition is boosted by the fact that most of the major towns are located along the trunk roads, which makes it easy for people in those areas to access health facilities, especially referred cases to the Holy Family Hospital at Techiman.  

It is only the Buoyem Community and its environs that has a low access to health facilities due to multiple factors, such as chieftaincy, bad roads, etc.  Though the Community has a clinic, it is not being utilised because the facility is occupied by the Police, who are there to maintain law and order.   Looking at the spatial distribution of health facilities, the Techiman Municipality is endowed, since majority have high physical access to these facilities

Health Care

Even though success has been achieved in different aspects of the health sector, however this is inadequate especially for the poor and other disadvantaged groups in the municipality.  The main objectives of the sector are geared towards enhancing efficiency in service delivery and increased access to health care services, ensuring financial arrangements that protect the poor and improving access to safe water in rural and peri-urban communities.

The health sector is however faced with challenges including issues of access to health care services, quality of service and issue of affordability. The issue of affordability especially for the poor brings to fore the urgent need to tackle the policy issues of the Municipal Health Insurance Scheme.

Health care facilities.

The Municipality has twenty four (24) health care facilities; including two (2) mission hospitals at Techiman, that is Holy Family Hospital (with 138 beds) and Ahamadiyya Hospital (with 69 beds). Nine (9) Government Health Centres, four (4) Private Maternity clinics and three (3) Private Clinics.

Staff Distribution

As at 2005 the staff distribution in the health sector was 8 Doctors, 134 Nurse, 6 Dispensing professional (including one Pharmacist) 5 Laboratory Technicians, 6 Medical Record Technicians and 9 Disease Control Officers. The Doctor: Patient ratio for the Municipality is therefore 1:25,300 as compared to the national ratio of 1:20,000 .The Nurse: Patient ratio is however 1:1,510.

Access and use of health care facilities

The Techiman Municipality is relatively more endowed in terms of health facilities. Using results from the Core Welfare Indicators Questionnaire Survey, 2003 about 69.4% of households in the Municipality takes less than 30 minutes to reach the nearest health facility as compared to the regional average of 53.85 and 57.6% for the nation. Where as 11.2% needed medical services only 9.5% of those sick or injured consulted a health practitioner or used medical services.

The level of satisfaction with medical services was 74% which is lower than the regional average of 82.3%. Most women (94.8%) aged 12-49 years who had live births received prenatal care. Birth assisted by trained health professionals was 68%. The tables 1.14 below indicate the trend of Antenatal Care and outcomes of delivering in the Municipality from 2003-2005. Still birth rate for the 2005 was very high 3.5% compared to 2.4% in 2004.  There is the need to re-strategise to reverse the trend. Maternal deaths reduced from 19 to 15 in 2005, this need to be further reduced. Neonatal death also shows a decline from 75 (1.56%) in 2003 to 36 (0.64%) in 2005.

Disease trend

Malaria has been identified as the major disease in the Municipality.  Tables 1.16 and 1.17 indicate the trend of top ten diseases in the Municipality. From the table, it is evident that malaria continues to be the leading cause of OPD attendance. It is worth noting that Road Traffic accidents for the 1st time in three years appeared on the Municipality’s top ten morbidity chart. This indicates the growing importance of the Municipality as an accident/ emergency centre in the country, due to it’s strategic location. 

The issue of road traffic accident should therefore be given the necessary attention. The introduction of the new anti malaria combination therapy and strengthening of the Home-Based Care component of the malaria control programme, as well as other environmental sanitation measures, it is hoped that there will be a decline in malaria cases.

The Municipality would also need to take a serious look at strategising on non-communicable diseases. Already a diabetic clinic is functional at the Holy family Hospital in Techiman. There is the need to promote healthy lifestyle behaviours in the Municipality’s health drive.

From the Table above it shows clearly that there has been a reduction in cases of complicated malaria in the municipal.  Analysis of the outpatients/ inpatients data in 2003 and 2004 shows clearly that even thought lower OPD cases reported (compared to 2005) there was high in patient malaria cases.  This provides us with some hope that the RBM programme is gaining grounds as fewer cases of malaria are being recorded.  

This represents 14.8% of the total admissions as compared to 17.6% in 2004. For the first time, in 2005, HIV/AIDS featured in the top ten causes of admission. This indicates the rising trend of the HIV/AIDS pandemic in the Municipality, which calls for urgent and appropriate response.   The table above shows how positive the Global Fund support for malaria has contributed towards reduction in malaria deaths in the municipality.  There is the need to address the issue of TB.

HIV/AIDS

The strategic location of Techiman as a commercial centre and transit point attract a large number of migrants in and out of the Municipality. There is therefore a high rate of commercial sex activity and high risk behaviours. These among others has resulted in the high prevalence rate of HIV/AIDS of 4.2% as compared to the regional rate of 4.7% and national rate of 2.7% as at the year 2005.

Techiman has been identified as a high HIV prevalence Area. A study conducted by the GAC in 2005 (PLACE) revealed that out of 1,180 people interviewed 54% of men and 52% woman reported having had two sexual partners in the past four weeks. 50.5% of the people socializing at the hotspots reported never used condoms. 

Techiman as a commercial centre attracts people from all walks of life to trade at its bustling food market every week. Its strategic location also makes it a transit point for long truck drivers and the destination for a lot of migrant population. High risk behaviour is therefore common, facilitating the spread of HIV.   As can be seen from tables 1.17 and 1.18 HIV/AIDS featured for the first time as one of the top ten causes of admission and death in 2005. 

This indicates the growing trend of the pandemic in the Municipality. Tables 1.19 and 1.20 presents the distribution of reported cases of HIV/AIDS by sex and age from 2002 – 2005. The above trend is horrifying since those who tested positive showed no sign of the disease. The Municipality’s AIDS control measures have focused on the following areas;

1. Prevention, Behaviour change communication
2. Stigma Reduction
3. Home based care
4. Psychological counselling
5. Nutrition and livelihood support for PLWHA a orphans
6. Treatment(ART, STI, OI)
7. Referral (VCT, STI, OI)
8. Voluntary Counselling and Testing (VCT)
9. Condom distribution

Prevention of Mother to Child Transmission (PMTCT, is also available at the Holy family Hospital Techiman)  The growing trend of the sexually transmitted diseases especially HIV/AIDS in the Municipality calls for intensive and concerted effort to stem the disease from spreading further to the wider population. This calls for a shift from the general approach in the past, to targeting of people with high risk behaviours especially Female Sex Worker (both seaters and roamers), Male Sex Workers (MSW) and PLWHA. There is the need to coordinate the implementation of HIV/AIDS interventions and strengthen the synergies among implementing partners in the Municipality for high impact and improved quality of service delivery.

Mutual Health Insurance Scheme

The objective of the Techiman Mutual Health Insurance Scheme is ti offer affordable and quality heath care services to its members. The scheme started providing benefits to its registered clients in September, 2005. As at 2005, the scheme had 58,339 registered people, representing 30% of its target population. Table 1.17 indicates the breakdown of the enrolment by mode of payment and category.

The scheme operates with fifteen (15) health providers within the Municipality. It has also a contract with the Brong Ahafo Regional Hospital at Sunyani as well as the Teaching Hospitals in the country, for the treatment of referrals and major cases.

Total premium and registration fees realised was ¢1,686,478,000.00. However total claims paid as at December was ¢1,859,823,662.00.
The inability of the scheme to achieve its target of 50% coverage in 2005 was due to the following reasons among others;
•    Inadequate finance for major activities of the scheme (Publicity/Logistics).
•    Negative perceptions, lack of trust/confidence in the entire policy.
•    Political interference and involvement thus preventing people from registering.
•    General poverty: most people are single parents taking care of the whole family hence making it difficult to premium.

It was observed that the commencement of claims payment have sent positive signals of the usefulness of the scheme to both members and non-members alike. A significant increase in new membership is anticipated in the coming years. There is therefore the need to intensify public education and membership drive to ensure wider coverage. This would lead to improved health status of the people and increased productivity.
The major challenge confronting the scheme however, includes multiple attendance or over utilisation of benefit, absence of rate-keep system and delays in settling provider’s bills. This bring to fore the issue of sustainability of the scheme. These need to be addressed to ensure the schemes continued operation.