Human Resource Development

One of the key indicators of the level of well being of a District or a nation is the quality of its human resource and their access to basic services.  This section of the report provides analysis of the situation of the human resource development and the basic services of Manya Krobo District.  This covers the areas of education, health, water and sanitation, among others.  The effect of these on the overall socio-economic development of the District is also presented.

Equity

Equal access to basic health care through outreach clinics, provision of  equipment and staff to man community clinics. 

Poverty Alleviation Beyond Exemption

The management of diseases like tuberculosis, Buruli ulcers, snake and Dog bites was free.  Four community health compounds to be opened under the CHPS concept in the    district at Sutapong, Brepaw and Akokomasisi and Samlesi.

Objectives

• To implement approved national and regional policies for Health in the district.
• To increase access to good quality health services.
• Manage prudently resources available for the provision of the Health services.

KEY ACTIVITIES
Sub-Districts-Access

1. No of staff                                                            -82
2. No of static outreach points                                 -12
3.  No of outreach points                                        -119
4.  No of communities                                            -371
5.  No of trained TBAs                                             -83
6. No of trained CBS volunteers                             -195
7.   No of Community Chid Growth Promoters     -108
8. No of HBC volunteers                                       -109
9.  Lay counsellors for HIV/ AIDS                          -21
10. No of Mop-up immunisations                                -4

Quality
Training of in

• Management of OIs and HIV related diseases.
•  VCT/PMTCT counselling.
• Counselling Supervision in HIV/AIDS
• HIV/AIDS Counselling for Lay Counsellors
• Lactation Management
• Home-Based Care in HIV/AIDS
• New Anti-Malaria Drug Policy
• Intermittent Preventive Treatment for Pregnant Women
• Facilitative Supervision
•  Integrated Eye workers Training
• Community Eye workers Training

Refresher training in

•   Community-based growth Promotion
•  Refresher training in VCT/PMTCT counselling

Efficiency

• Weekly core DHMT meetings
• Monthly meetings, Supervisory visits
• Quarterly DHMT/SDHMT meetings
• Procurement Committee in place
•  Disciplinary Committee in place
• PPM schedule

Priorities For Year 2006

• To strengthen monitoring and supervision
• To strengthen HIV/AIDS educational activities through collaboration with key stakeholders.
• Strengthening the capacity of midwives by training them in Life Saving skills. 
• Behavioral Change Communication for teenagers to reduce teenage pregnancy
• Implementation of IMCI activities in the districts (to reduce Infant morbidity) and mortality
• Training of more Community Child Growth Promoters
• IMCI training for Prescribers
• Training of Community Health Officers
• To have in-service training in various areas to improve health care delivery
• To conduct in-service training on data reporting system/timeliness of submission of reports
• To intensify monitoring and supervision
• To intensify Health Education and Counseling on HIV/AIDS
• To establish incentive package to motivate staff.
• To strengthen disease surveillance and response activities

The District Health Administration provides technical and administrative support to health service providers. These include resource mobilization and distribution, training and research programmes. The District Health Administration ensures that services provided are in line with the national policies. Planned activities revolved around the 5 main objectives of the Ministry of Health, which are:

• To increase geographical and financial accessibility in health to all Ghanaians

• To provide better quality of care in all health facilities.

• To improve efficiency at all levels.

• To foster closer collaboration with communities and other partners

• To increase resources and to ensure equitable and efficient resource distribution.

The core DHMT is made up of:   - District Dir. Of Health Services

- A nurse acting as Nutrition Officer
- Disease Control Officer
- District Public Health Nurse
- District Accountant

Health Institutions

There are 6 sub-districts; Odumase, Asesewa, Otrokper, Sekesua, Anyaboni, Kpong/Akuse sub-districts which provide mainly preventive services. They are supposed to be the first point of contact of the community with the health delivery system. There are three government hospitals and one mission hospital in the district.

There are four Hospitals, which serve as the first referral points namely: Atua Government. Hospital, Akuse Hospital, St. Martin’s Hospital (Catholic) and Asesewa Hospital. There are 9 private clinics and maternity homes.  Chemical sellers, traditional healers, traditional birth attendants and community-based volunteers as well provide health services in the district.

Objectives:

The objective of the Unit for the year 2006 was to institute integrated disease surveillance systems and rapid response in the 6 sub-districts in order to determine the trend and to curb any impending outbreak of diseases in the population.

Key Activities:

The disease control unit has been responsible for the following activities:

• Epidemic management
• Disease surveillance
• Logistics and cold chain management
• Research and coverage surveys
• Eradication and elimination of the following:
• Acute endemic malaria
• Chronic endemic diseases especially HIV/AIDS
• Non-communicable disease

Ket Issues and Priority Focus

For epidemic prone disease the focus was on:

1. Meningitis
2. Cholera
3. Yellow fever
4. Measles
5. AFP

The district was also committed to specific control activities with respect to

1. Guinea worm eradication
2. Malaria with Global fund support
3. TB   with Global fund support
4. HIV/AIDS

The district surveillance unit in collaboration with the Public Health unit in the hospitals and disease surveillance personnel in the periphery undertakes routine surveillance activities in the district. The district has a composite report format that captures data on all priority diseases.

All surveillance activities are coordinated and streamlined, rather than maintaining separate vertical activities, resources are combined to collect information from a single focal point at each level. For example surveillance activities for Acute Flaccid Paralysis (AFP) can address surveillance needs for neonatal tetanus, measles and other diseases. 

Thus health staff that routinely monitors AFP cases also review district and health facility records for information about other priority diseases. Surveillance focal points at the district and sub-district and community levels collaborate with epidemic response committees at each level to plan relevant public health response action.

No case of Yellow fever was confirmed in the district.  Health facilities continued to report cases to the district office. With the introduction of the case-based form after the Supplementary Immunization As all suspected measles cases were confirmed through laboratory investigations.

Guinea Worm

No indigenous case was reported in the district in the period under review.  The programme continued to receive assistance in terms of funds to support the district officer to undertake routine surveillance activities.

Malaria

With the introduction of Global fund support for Malaria concept, the district has been implementing malaria programmes in the sub-districts and communities. The aim is to reduce the impact of Malaria in the vulnerable groups. 

The district has also distributed about 3261 nets for sale in the year under review at a subsidized price to antenatal mothers and children under five years. In total the district in collaboration with PLAN Ghana has distributed many nets.

HIV / AIDS

AIDS and poverty are intricately linked through ill health and associated costs for victims, families and society along with the exclusion and loss of income earners.  With the present rate of HIV in Ghana, it has become expedient that any effort at reducing poverty should take into consideration the damaging and multiplier effect it has on the future population.  
 

The case of HIV/AIDS in Manya Krobo District leaves much to be desired. The District is rated in terms of reported case of AIDS in the Eastern region. Table 1.1c4 shows the number of reported cases between 2002 - June 2006.

2002 was the year with the least number of reported cases.  The figure continues to increase each year.    The year with the highest number of reported cases is 2005.  It is also evident from the table that between 2002 and 2006 with the exception of 2003 where the data was not available the trend of the disease continue to increase.  

From the foregoing analysis, if measures are not put in place to reduce the rate, the productive capacity of the District will be greatly hampered.  Several campaigns and publications on the causes and effects of HIV/AIDS have been organized by several NGOs and CBOs in the communities and in the schools.  All of these efforts are aimed at ameliorating the high prevalence rate. 

The level of HIV/AIDS awareness in the District is quite high.  At least 60% of both men and women identified sexual intercourse as the main mode of transmission.  However, misconceptions about the mode of transmission of the disease still exist.  Although more people perceive that they are at risk of becoming infected, they are still practicing high-risk behaviours.

Problems in the Health Sector

Health service delivery in the District is hampered by some factors.  The major factors are inadequate financial resources for maintenance and running cost of official vehicles and lack of telecommunication system to link the health facilities with the numerous communities.  Furthermore, the poor nature of most of the access roads also adversely affects the health service delivery in the District.   Most communities like Tsledom and Oborpa-Djekiti can hardly be reached.

Indiscriminate buying and selling of drugs by some people in the District also affect health delivery.  Many people do no report to health facilities when they are sick, but rather resort to self-medication.  This usually leads to drug abuse and its subsequent effects.