Mr. Frederick Kwame Ofosu
Premier District Director of Health Services

The District does not have a Hospital. However due to the proximity of the Atibie Government Hospital and the Nkawkaw Holy Family Hospital, people from Kwahu East District sometimes access medical services at these centres. Plans are affot to construct a 250 bed District Hospital at Abetifi.

The District however has 15 public health centres, clinics, Reproductive and Child Health Centres (RCH) as well as Community Clinics/CHPS and 5 private health facilities comprising of Maternity Homes and CHPS. These facilities provide outpatient services to people within and outside the district.

Health care delivery is dominated by the public sector even though it is complemented by private facilities and to a larger extent, the Traditional Medicine Practitioners (TMPs). However, majority of the traditional medicine practitioners remain unregistered and operate especially within the rural communities in the district. The contribution of NGOs such as JOICFP, PPAG and Rhode Foundation, Traditional Birth Attendants (TBAs) and Community-Based Surveillance Volunteers (CBSVs) is equally worth acknowledging in the health care delivery system. The type of health service infrastructure in the district is provided in Table 1.42.

Table 1.42: Status and Condition of health facilities

Source: KEDA-DHMT, 2014

Health Infrastructure Requirement

To improve on access to quality and affordable health care, the Asembly requires one hospital and seven additional CHPS Compounds to supplement the work of the existing facilities. The Oframase-Miaso Area council is one of the underserved areas in the district interms of health services and therefore needs urgent attention. Table 1.43 gives details of facility requirement and their locations.

Table 1.43: Health infrastructure requirement

The District has health staff strength of 130 with 136 shorfall which calls for the need to improve the staffing situation in the district. This comprise medical assistants, mid wives, CHNs, nurses, health assistants, laboratory technicians among others. These health personnel are working in the various health facilities in the District. The type of health personnel with their respecting staff strength and places of posting is illustrated in Table 1.44.

Table 1.44: Current Staffing Situation (District Wide)

Statistics from OPD records indicate an upsurge in Sexually Transmitted Diseases (STIs) and HIV and AIDS has been quite considerable in the district. According to the District Health Directorate, actual prevalence of HIV and AIDS in the district cannot be established because there is no sentinel site for HIV in the district. Voluntary counselling and testing should be encouraged whilst the necessary support is given to the people living with HIV and AIDS. However, the trends of reported HIV and AIDS cases from 2011 – 2013 have been presented in Table 1.45.

Table 1.45: HIV AND AIDS Situatution (2011– 2013)

Source: KEDA-DHMT, 2014

Risk Factors for HIV and AIDS in the District

A number of factors may be considered as potential triggers for the infection and spread of HIV and AIDS in the District particularly, Abetifi, the District Capital.

The establishment of the Presby University College as important as it may, posses a major risk factor in the spread of HIV and AIDS. This is because the Institution is patronised by people from all walks of life who may pose danger not only to their school mates but to the locals as well. The Assembly must therefore collaborate with the University Authorities to strengthen awareness creation on the pandemic in both the Campus and at the community level.

The numerous constructional works in the District is also another major risk factor. The labour force of Contractors who are brought from outside the District may pose a great danger to the youth in beneficiary communities as they tend to engage in high risk behaviours when they take their wages. To this end, the Assembly must make the implementation of HIV and AIDS education as a pre-contract activity, mandatory in its Tender and Contract Documents and must ensure compliance by prospective contractors. Many of the workers on projects in the various communities Constructional works has brought key determinants in the district include mining, transport, unemployment and underemployment and social functions.

Other determinants of the deadly disease include social functions such as funerals, Easter festivities 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. There is therefore the need for annual and periodic awareness creation, councilling and testing of revelers at especially Easter Celebrations (Tab. 1.46).

Table 1.46:  Key Vulnerable and High Risk Groups in the District

Source: District HIV and AIDS Strategic Plan, 2010.

Impact of HIV/AIDS

Even though there is no empirical data on the impact of HIV and AIDS exclusive to Kwahu East, data available to the district, 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 the economically active groups who are supposed 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. As most labour force will be lost leading to high labour cost, low productivity, low income level, high dependency ratio and increase in 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.

Response Analysis

The District Assembly in collaboration with other stakeholder such as District Health Management Team (DHMT), NGOs, CBOs and FBOs 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.

Funding for HIV and AIDS related programmes has been predominantly by the Ghana Aids Commission and the District Assembly. The Assembly’s contribution is funded from the mandatory 0.5% of its share of the District Assemblies’ Common Fund (DACF).

The District is yet to establish data on People Leaving with HIV and AIDS and those affected by the pandemic such as OVCs. It is therefore important to commission a survey to identify such vulnerable groups to enable the Assembly provide the needed support to them.

Institutions involved in HIV and AIDS Programmes in the District

The fight against HIV and AIDS in the Kwahu East District has been structured in line with the National Strategic Framework. The District has a 15 member multi-disciplinary District AIDS Committee (DAC) and a 5 member District Response Management Team (DRMT) team in place.

At the district level, the District Assembly is the main body responsible for monitoring NGOs/CBOs providing HIV and AIDS activities in the District. Other institutions that support in the promotion of HIV and AIDS related issues include the Department of Social Welfare/ Department of Community Development, Ghana Health Service, Ghana Education Service and National Commission on Civic Education. Additionally, there are four NGOs and one Community Based Organization currently working in the area of HIV/AIDS in the District as indicated in Tab. 1.47.

Table 1.47: HIV/AIDS related Institutions

The district does not have an autonomous Scheme. It continues to operate as an agency under the Okwahuman South Health Insurance Scheme located in the Kwahu South District. This has made it difficult to segregate the data for the two districts. However, indications are that patronage for the Scheme is high as new people continue to register. It is the hope of the Assembly that everything possible will be done to make Kwahu East autonomous from Kwahu South Insurance Scheme in the near future to facilitate effective monitoring.

High prevalence of non-communicable diseases such as hypertension and diabetes

Low TB detection rate

Low family planning acceptor rate

Low coverage of service interventions in difficult and underserved areas

Low supervised delivery coverage

Low IPT coverage

Inadequate human resource of all categories

Limited CHPS compounds

Poor response to surveillance activities and late reporting of epidemic prone diseases

Limited staff accommodation

Inadequate equipment

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