Health delivery in the district is carried out by 27 government institutions, 8 private institutions, One (1) mission institution and 3 private medical laboratories.

The district hospital is situated in Akyem Oda the district capital while three (3) health centers are in Achiase, Akroso and Aperade. There are also 12 RCH centres and 7 community health and planning services (CHPS) throughout the district. Others include maternity homes and 8 private clinics.

In addition to these orthodox institutions, the district has trained about 63 traditional birth attendances (TBAs) who provide maternal service in various communities. There also traditional herbal practitioners (THPs) who also contribute towards the health needs of the people in one way or the other.

The District Assembly (DA) as mentioned in the performance review has also constructed 4 additional clinics which are yet to be utilized. This has improve upon the infrastructure needs of the people and will also go a long way to increase access to health care in the district.

HEALTH PERSONNEL

The District has 6 medical doctors, 2 medical assistants at the government hospital in Oda and other health centres. The doctor population ratio is 1:22,419. There are also 127 nurses working within the district.

In addition to the doctors and nurse, the district also boast of a quality pharmacist, 5 dispensary technicians, 4 dispensary assistance, 3 laboratory technicians, a radiologist and 2 administrators.

Despite the Assembly effort at providing adequate health facilities in the district, the district health administration still battle with the problems of limited number of health personnel to man these facilities. There is therefore the need for the district Assembly to help solve this problem by sponsoring nursing trainees who would be trained and retained to work in various health institutions in the district.

MORBIDITY AND MORTALITY PATTERNS

The trend of top ten (10) diseases are reported at the health institution in the district over the past 4 years (2002-2005) is shown in the table below.

Between 2002-2005, malaria has being ranked first (1st) among the top ten(10) diseases and also a leading cause of death in the district. This situation calls for pragmatic steps to be taken by the authorities to control mosquitoes and in prove the sanitation situation in order to reduce the incidence of the disease to the barest minimum as reported in the above tables.

A part from malaria, Non-communicable diseases such as CVA, Hypertension, anemia, diabetes mellitus and HIV/AIDS are the leading causes of death in the adults.

In children under 5 years, malaria, anemia, bronchopneumonia and diarrhea are the top 5 diseases and major causes of death as shown in the table below.

OPD in all health facilities in the district increased from 70,596 in 2002 to 81,145 in 2005. There were 6821 admissions at the district hospital in 2005 as compared to 6239 in 2002. Total increase in admission was 11.7% in 2005. The average bed occupancy also increase from 65.37% in 2004 to 76.4 % in 2005. However, average lengthy of stay decreased from 4.55% in 2004 to 14.09% in 2005.

Maternal, Child health and Family Planning (MCH/FP)

The District has 15 static points out of these points there are 103 outreaches in the 6 sub-District. The sub-district and their static and outreach points are shown in the table below

The MCH/FP unit in the district is manned by public and community health nurses.

Immunization

The district did well in the area of immunization over the past few years but there is the need to intensify the programme to achieve 90% target. The following table 1.21 looks at performance of expanded programme in immunization (CEPI) from 2002-2005.

NUTRITION

i. Nutrition Surveillance

Nutrition surveillance in the form of growth monitoring involves regular weighing of children 0-5 years. This is to facilitate early detection in growth anomalies and to intervene promptly to prevent serve malnutrition. The table below shows the nutrition status of the children examined.

Malnutrition is prevalent among the children in the district especially after the first year. The prevalence rate is 18.5% emphasis will be placed on improved complementary feeding practices, good nutrition and regular deworming of children in the coming year.

ii. Nutrition Rehabilitation

Nutrition education in the form of talks, durbars and training of mothers and food vendors were carried out in schools, churches, hospital, child welfare clinics and in the communities.

Constraints

1. Inadequate staff ( only one nutrition officer mans the unit)

2. Supplementary feeding programme was not received by the district.

All expectant women are given folic acid iron tablets supplementation.

HIV/AIDS

Statistics from Oda Government Hospital from 1998 to date indicate that there has been an increase in HIV/AIDS infected cases from 20% to 50%. In all, the years there were more female infected persons than male. This increasing number of infected persons and females are what the district would have to grapple with.

Prevalence among voluntary blood donors is 2.06%. However, the actual HIV/AIDS prevalence rate has not yet been determined since there was no sentinel site in the district over the past years. Efforts are now been made to established a sentinel site in the district as an addition to the few sentinel site in the district. The table below indicates the trend of HIV/AIDS reported cases in the district.

Key determinants of HIV/AIDS in the District

The key determinants in the district include mining, transport, unemployment and underemployment and social functions.

Mining plays a key role in the economic life of the people as well as the spread of HIV/AIDS epidemic in two major ways. Migrant labour especially the youth travels in and outside the district to engage in mining activities either in the few mining companies or engage in small scale (galamsy) mining activities in search of “quick” money. Other also travels outside the district to the nearby district such as Tarkwa in the Wassa West District. These men frequently move to and from the district sometimes as often as weekly.

This result in high incidence of HIV/AIDS cases in the areas where they operate

The strategic location of the district is another key determinant point for many long haulage drivers especially those carrying timber for processing at the numerous sawmill located in the district. Nearly all such drivers pass at least one might in the district and often having just receive their wages engages in high risk behaviours such as alcohol consumption and casual sex.

Other determinants of the deadly disease include social functions such as funerals, festivals and other social gathering which are on weekly and annual basis.

Many people who patronize these functions meet sexual partners and engage in casual sex promoting the spread of the disease.

Additionally, unemployment and underdevelopment cannot be left out as a determinant. While the district attracts those working for skilled and semi-skilled job in the mines and sawmills. It similarly attract on increasing number of low or unskilled laborers seeking unemployment.

However jobs in these areas are few and this growing number of young people are often force to adopt survival strategies to meet their basic needs. Such strategies increase their vulnerability and frequently promoting high rise behavours. The key vulnerable and high risk groups therefore are as follows.

Impact of HIV/AIDS

Data available indicate that greater percentage of the HIV/AIDS infections fall within the age group of 15-49 which forms the potential labour force of the district. This has very serious implications because of the economically active group who are suppose to provide for the whole population are the most infected, vulnerable and high risk group if care is not taken the situation has the potential of having serious implications on the district economy. This because most labour force will be lost leading to high labour cost, low productively, low income level, high dependency ratio and poverty.

This situation if not controlled can also affect health delivery by putting pressure on the existing health facilities, diversion of limited resources to support the control and prevention of the disease and reduction in life expectancy.

With families, this could lead to stigmatization, pressure on incomes, increase in the number of orphans and street children and its related high dependency ratio and high poverty level.

iii. Response Analysis

The District Assembly in collaboration with other stakeholder such as District Health Administration (DHA), NGO, CBO and FBO in and outside the district is undertaking series of programmes to reduce the incidence of the disease. The District HIV/AIDS Committee is charged with the responsibility of coordinating and monitoring HIV/AIDS activities in the district.

All these activities in the district have been carried out with support from Ghana Aids Commission, ADRA and World Health Organization (WHO) as mentioned in the performance review.

Several activities have been carried out in the area of sensitization, prevention and control, counseling and support for people leaving with Aids (PLWAS).

The problem however has been insufficient funds to ensure regular monitoring at all levels. There has also been lack of collaboration among stakeholders providing care and support for PLWAs making it difficult to assess their needs and provide the need support.

There is therefore the need for the compilation of adequate data on those infected and affected by the disease for proper planning, care and support services for them.

District Mutual Health Insurance Scheme (DMHIS)

The Birim South District Mutual Health Insurance Scheme became operational in August 2005. So far the total number of people registered has increase from 19307 at the inception stage to 32,708 as at June, 2006. This represents about 17% of the total population of the district.

Educational campaign and registration is still on-going and looking at the trend, it is envisage that more people will join the scheme with time.

The scheme has signed agreement with eleven (11) health service providers within and outside the district with the view of making it accessible to people in all part of the district.

The following are the health institutions where the scheme is being operated.

h) Akim Oda Government Hospital

i) Akim Swedru Catholic and Maternity Home

j) Aperade Health Centre

k) Achiase Health Centre

l) Akenkansu Health Centre

m) Anamase Reproductive Child Health Centre

n) Saint Dominic Hospital-Akwatia

o) Asene Reproductive Child Health

p) Asamankese Government Hospital

q) Akroso Health Centre

r) Akim Apoli Reproductive Child Health Centre

s) All Health Institutions render NHIS Services.

Problems In The Health Sector

The problems of the health sector include the following:

1. Barriers to geographical and financial access to health care services

2. Inadequate staff

3. Limited staff accommodation

4. Inadequate equipments

5. Lack of permanent office accommodation for District Mutual Health Insurance Scheme

6. Dwindling and irregular cash flow

7. Inadequate/overage and broken down motorbikes

8. High maternal death and children under 5 year’s deaths

The DHMT also complains of the fact that, the health component of the GPRS and MDGs are virtually left to the OHMT to managed alone.

Other major issues to be addressed include the following:

1. Strengthen reproductive and maternal and child health activities

2. Provision of staff accommodation and additional CHPs

Compounds

3. Promotion of quarterly assurance policy in all health institutions

4. Increase access to health insurance scheme

5. Strengthen disease surveillance and response

6. Sponsorship of student nurses to support staffing problems.

Target set by the health sector to improve health status of the people include the following:

1. Reduce maternal mortality to zero (0) from 3.7/1000 in 2005

2. Reduce infant mortality by 2/3

3. Reduce TB and malaria mortality by 50%

4. Increase supervision delivery by 50%.