The infrastructure of health delivery system consists o Mission hospital at Nkawkaw, 3 private hospitals all located at Nkawkaw and 6 Reproductive and Child health Centers at Danteng, Apradn, Jejeti, Asuboni Rails, Nkawkaw RCH and Holy Family PHC. There are 5 private maternity clinic all located at Nkawkaw, 2 homeopathy clinics and over 94 Traditional Birth Attendants of which 68 have been trained and 77 Herbalist and spiritual Healers wide. The can boost of 21demarcated CHPS centers of which one is operational and one under construction.

The Municipal mission hospital, located at Nkawkaw, has a 227-bed ward including emergency, an X-Ray department, a theatre, a medical laboratory, pharmacy department, a Mortuary and Out Patients Department and an Eye Clinic. The hospital lacks a dental clinic therefore all dental cases are referred to Atibie Akim Oda, Koforidua or Accra.

The hospital has only 3 doctors and assisted by a number of professional doctors who visit the hospital regularly. The municipal has unfavourable Doctor -Population ratio of 1:14308 as against national average of 1:25000 and WHO standard of 1:10,000. Thee Nurse Population ratio is also relatively unfavourable - 1:1353 as against the national figure of 1:900.

In addition to the doctors and nurses there are 3 dispensing technicians and 1 pharmacist. A threshold analysis indicates a short - fall of 19 CHPS Centers 5 health centers and 4 RCH Clinics . The Municipality has no Municipal Hospital and this must be given a higher priority within the plan period

Reproductive and Child Health (RCH)

The main activities of the Unit carried out are geared toward child survival and development and the health of mothers. Ante-natal Clinic is a component of health delivery recorded coverage of 84% in 2005. Immunization activities are held daily in the Hospital and health facilities in the district. In addition to this bi~week!y/monthly outreach clinics are held by the mobile team in the smaller settlements to attend to mothers and children.

Causes of Admission

On the incidence of diseases in the municipality, as obtained from the MHMT Office, Malaria topped the list with 1561 cases constituting 25.5% of all reported diseases. This was followed with Pneumonia with 3955 constituting 7.5%, Gastro enteritis - 373 constituting 6.0 %, and Hypertension with 273 cases constituting 4.4%.The table below depicts Top 10 causes of admission

Causes of Death

As indicated in the table below, the major causes of death , year 2005, is Septicaemia followed by HIV/AIDS.

OPD Attendance

The table below presents the Top 10 Causes of OPD Attendance recorded in the year 2005 of which Malaria continues to top the race

Nutrition

All staff are involved in educating patients and attendants at the outpatient department, child welfare clinic, Ante -Natal and outreach clinics. At the clinic, mothers are educated on the importance of exclusive breast feeding, diet during pregnancy and the importance of growth monitoring and its interpretation in malnourished children., Inadequate personnel and logistics have hampered high coverage of nutritional activities in the district.

Constraints to Health Delivery System in the Municipality
Municipal Hospital

The Municipal Hospital operates from a mission hospital (Holy Family Hospital). It is however proposed that a municipal hospital be constructed within the First two years of the plan period.

Transport: - The MHMT Office at Nkawkaw has one 16 year old Toyota Pick-up vehicle from Kwahu South DHA. The frequent breakdown is due to old age and this hampers the effective running of the .

Personnel: - The health personnel: - Doctors, Nurses and Paramedics are inadequate. Two specialist doctors preferable a surgeon and a gynecologist are urgently needed. In addition a qualified pharmacist is also needed to cope with the load of work at the Hospital. Other paramedics and nurses are also required to raise the standard of health delivery in the district.

Financial Resources: - Inadequate funds to ensure smooth operations of the health institutions .

Infrastructure: - Lacks staff accommodation for Doctors, Nurses and other paramedical staffs. At the moment, there is no permanent MHMT Office and this need to be considered as a priority within the Plan Period

High Incidence of Malaria

In view of the facts that malaria tops the Top Ten Cases of out patient department (OPD) attendance and admissions, much emphasis have been focused on educating the public on good sanitation, reconstruction of drains desilting of existing choked gutters and weeding g environs. Attention must also be focused on strengthening the Roll back malaria programme and promote the use of impregnated bed - nets.