A qualitative improvement in the health status of the people is an important component of social development programmes. In this regard, an analysis of the existing social situation for planning purposes should consider the health of the people and the efficiency of the health delivery system in the district. This is covered in the sections that follow with emphasis on the health facilities, prevalent diseases, access to potable water and sanitation.

Health Facilities

Health infrastructure in the district comprises of health centres, clinics and maternity homes. These facilities are manned only by nurses and medical assistants, and considering the size of the district and the locations of these health facilities, it cannot be denied that health delivery is rudimentary and highly inadequate and inaccessible.

The District, with a population of 152,401 currently and over 191 settlements within a total land area of 1250 sq km, is without a district hospital. The nearest hospitals are located at Nkawkaw, Kade and Akim Oda which are 37km, 36km and 69km respectively away form the district capital. Access to these hospitals is by extremely un-motorable trunk roads, which constrain health delivery from these facilities to the Birim North District.

The problem of unsatisfactory health delivery system in the district is further exacerbated by inadequate personnel in the few existing center of health delivery. In certain instances, various attractive incentives, including good accommodation and water have been provided and yet facilities in such areas as Tweapease and Gyaha are not operational due to the inadequacy of personnel. Table 1.34 indicates the Health Service delivery situation in the District.

Doctor/Nurses-Patient Ratio

The District also lacks the services of a dentist, a qualified pharmacist and other specialist medical personnel. With a total of 35 nurses, 50 birth attendants and only 12 general beds and 19 maternity beds, the district has a population per nurse ratio of 4354:1. It is therefore clear that the district health personnel are over stretched.

Maternal and Child Health/Family Planning (MCH/FP) Activities

The main thrust of Maternal and Child Health/Family Planning (MCH/FP) activities carried out are geared towards child survival and development. Antenatal clinic as a component of these activities recorded a coverage of 83.3 per cent and an average visit of 2 per client in a month. Immunization (EPI) activities are held daily in all health institutions. These are in addition to outreach clinics undertaken bi-weekly, due to these methods, immunization coverage in BCG, MEASLES, DPT 3, and OPV3, far exceeds the regional average.

On disease prevalence, malaria recorded the highest reported cases out of 10 most outstanding cases as evident in table 1.36. In 2005, for example 73.5 per cent of the cases are malaria related. Diarrhoea followed malaria, constituting 11% out of the 10 reported cases of communicable diseases in 2005. Next is yaws and the age group mostly affected in both sexes is 5-19 years; inferring that children of school going age are mostly affected.Problems of

Health Delivery in the District

Major constraints which militate against the district’s programme to achieve high coverage in the health care delivery include inadequate trained health personnel, inadequate and irregular supply of logistics and unavailability of reserve stock of emergency drugs during outbreak of epidemics such as cholera.

Nutrition

The Nutrition Division collaborates with the Medical Care and Maternal and Child Health/Family Planning (MCH/FP) staff in educating patients and attendants at Out Patients Department, CWC and antenatal clinics and outreach clinics. Visits are also made to identify goitre cases for the administration of iodized drugs. Activities in this area of nutrition include education on the importance of exclusive breastfeeding, wean mix preparation and use, diet in pregnancy and the importance of growth monitoring and its interpretation in malnourished children. High coverage of nutritional activities in the district has been constrained by the inadequacy of nutrition personnel and inadequate logistics.

Development Implications

The absence of a district hospital and at least a resident doctor has obvious negative implications on the human resource development of the district. This is due to the fact that the preparation and implementation of every development plan depends greatly on the human resource (expertise of the people). The inadequacy or lack of health facilities in the district therefore means people will have to travel quite some distance to secure medical attention. The resultant effect of this is low productivity as people might not be medically fit all the time to contribute effectively to the development of the district and for that matter the nation as a whole.