| This report looks at the structure of the health system including service delivery (both curative and preventive services) the availability of health facilities and health manpower levels.
The report also examines trends in the prevalence of HIV/AIDS and TUBERCULOSIS.
Regarding environmental sanitation, the means and facilities available for both solid and liquid waste disposal are also dealt with.
The information available in this report is expected to facilitate the monitoring and the evaluation of the service delivery and associated issues by stakeholders in the Health sector.
Executive Summary
The health, nutrition, and environmental sanitation of any people are linked to the general state of development in the country. The Government of Ghana, for that matter, seeks to improve the health of all people living in Ghana regardless of age, sex, race, ethnic origin, religious conviction, political affiliation, or socio-economic standing. This is believed can only be achieved through strengthening the health system by improvement in its access, quality, efficiency and financing.
The structure of the health system consists of national, regional, district, sub-district and community health systems and is built on the Primary Health Care (PHC) System.
Services are provided by many partners including the private health care services, the religious bodies’ health facilities, the parastatal health system and private clinics. Additionally, traditional herbal and spiritual centres provide services to many Ghanaians.
This report collects information from the 2000 Population and Housing Census (PHC), periodic survey reports of the Ghana Statistical Service, as well as secondary data from Ghana Health Service (GHS) and other Ministries Departments and Agencies (MDAs) to describe trends in the health, nutrition and environmental sanitation at regional level.
The main results indicate a general increase in health facilities nationwide from 251 in 1991 to 286 in 2003 for hospitals and 1138 for health centres and clinics in 1991 to 1487 in 2003. These are increases of 13.9% and 30.7% respectively over a period of 12 years. The number of hospitals for Greater Accra region almost doubled within the period while those in Ashanti region increased by only 6.6%. On the other hand, the number of hospitals in the Central, Volta, Northern and Upper East regions decreased. With regards to health centres, however, substantial increases occurred in all the regions except Central and Greater Accra regions which experienced a fall in the number of health centres and clinics. One major concern is the equitable distribution of health resources. Regions in the northern part of the country have fewer health facilities and lower coverage in preventive health services resulting in high hospital admission rates per capita for the people in those regions.
Health manpower levels specifically for medical doctors and auxiliary nurses showed very little increase for Western and Central regions between 2002 and 2003 but with a fall for the other regions. However, apart from Eastern and Upper West regions all the other regions experienced very little increases in the level of professional nurses from 2002 to 2003.
Health care services provided to the people both as curative and as preventive services showed improvements. The per capita out-patient visits rose from 0.42 in 2000 to 0.52 in 2004. Hospital admissions per 1000 population also increased from 32.1 to 35.3 during the same period. Coverage of immunization has been increasing over the years and the yearly target for immunization of 85% has been exceeded in some of the regions.
The pattern of the incidence of diseases in the population has not shown any appreciable change. Malaria continues to top the list of diseases managed at the out-patient departments of hospitals and clinics (44%), followed by upper respiratory track infections (7.2%), diarrhoeal diseases (4.3%), skin diseases (4.1%) and hypertension (2.7%). The major causes of morbidity and mortality in the country are preventable or communicable diseases such as malaria, tuberculosis and HIV/AIDS
The trends in the prevalence of HIV/AIDS and tuberculosis are alarming. HIV/AIDS prevalence rate rose from 2.9 in 2001 to 3.1 in 2004. Tuberculosis detection rate per 100,000 population continued to fluctuate around 58.4% with a cure rate of 61% in 2003.
The means and facilities available for both solid and liquid waste disposal need much attention as its implications on the environment is mostly hazardous. Only 4.8 per cent of refuse was collected by local authorities and about 20% of the population still had no toilet facility in 2003.
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