Health Care Facilities/Services

The district has only one (1) Hospital; with the current population of 113,302 the district required about three (3) hospitals. The current hospital gap is being managed by four (4) Health Centres, six (6) Private Maternity Homes and four (4) private clinics. The location of these health facilities are located in the below table.

Health Professionals

The number of Medical Doctors in the district has increased from 3 in 2010 to 5 in 2013. The Doctor/Population ratio has therefore improved from 1: 51,013 in 2010 to 1: 37,969 in 2013. The number of nurses in the district has also increased from 51 in 2010 to 80 in 2013. The nurse/population ratio has also improved from 1:3,00 in 2005 to 1:2,373 in 2009.Whiles the Doctor /population ratio is still below the required standard of 1:25,000, the Nurse /Population ratio is above the required standard of 1:3000. There is still some pressure on the doctors, and this has implications for quality health care delivery in the district. The District Hospital now has an Anesthetist and Physiotherapist whose services augment the work of the Medical superintendent. The district health sector also requires more accounts staff to cope with the work load as a result of the implementation of the National Health Insurance scheme.

Incidence of Diseases

The trend of ten top out-patient morbidity in the district is shown in table 1.28. Most of the diseases are due to poor environment and diet. A lot need to be done on our bad environment –refuse disposal sites, places of convenience, overgrown weeds which breed Mosquitoes and eating habits.

Hypertensions normally do not come under the top ten diseases. Its current inclusion in the top ten means most inhabitants are getting this affluent disease, which we should be worried about. The eating habits of the people in

the district have changed and people are taking in more of high cholesterol foods than the local fiber foods. Buruli Ulcer, though not one of the ten top diseases is endemic in the district with high reported cases of 85 in 2013. All these diseases are of public health importance.
The ten main causes of hospital admission in the district are shown in the table 1.29 below.

A most of the causes of hospital admissions are environmental and diet in nature. This means that a lot need to be done about environmental sanitation.

Maternal Health Services

Antenatal service coverage increased from 43.3% (3,102) in 2005 to 110% (8,736) in 2009 with average visit of 3 per client. Coverage for late teenagers increased from 12.3% (382) in 2005 to 24.8% (1,006) of the total antenatal registrants in 2009. Pregnant women registered with Anaemia reduced slightly from 22.7% in 2005 to 21.7% (1,722).The women who delivered in health facilities increased significantly from 25.6% in 2005 to 50.4% in 2009. Out of this, 1.4% (55) had still births (babies died at birth). Women in labour still report to health facilities late and others use all sorts of herbal preparations during labour before seeking health care and others never visited the health facilities during pregnancy. Measures are still required to encourage pregnant mothers to patronize pre-Natal and post-natal health care services to improve their health status and that of their babies.

Immunization

Immunization coverage for BCG, Measles, OPV and Yellow Fever has increased from about 81 % on the average in 2010 to 89.1 in 2013. The table 38 shows Immunization coverages in the district in 2013.

There is low community involvement in health programmes in the district. The reasons are ignorance, apathy to mention a few. During immunization sessions most women stay at home with the pretext of having forgotten the date. The rate of child malnutrition in the district is has reduced from 2.8%in 2005 to 0.1% in 2009
Infant and Maternal Mortality

The District did not record maternal death or infant death in the health facilities. Not much information is captured by Community Based Surveillance volunteers (CBSV) in the area of infant and maternal death. There is the need to strengthened and motivate the CBSVs for them to be effective.

District Health Insurance Scheme

The District in its efforts to make health care services accessible to majority of people has established a District-Wide Mutual Health Insurance scheme. The Scheme is fully operational. The total number of registered members has as at the end 2013 was 86977 representing 75% of the total estimated population of the District. The Atiwa West District Health Insurance Scheme has its full complement of staff and office equipment. The secretariat is well accommodated and has acquired a Four Wheel Drive Pick-up which is being used for educational campaign to increase participation rate in the district. Key problems and challenges in the health sector include the following:

• Low patronage of antenatal health care services.
• High doctor/population ratio
• Inadequate In-patient infrastructure and equipment (wards, beds etc.)
• No residential accommodation for health staff in all the health facilities.
• Poor community involvement in health programmes.
• High level of sanitation related diseases
• People travel long distance to access health care
• Poor data capturing from institutions and outreaches
• Poor security at some health facilities