Health Care Delivery

Health delivery system in the Municipality even though is still faced with some problems just as it pertains in most rural communities in Ghana, the status of health in the Municipality over the years has improved significantly in several areas. Prominent among the major issues to be discussed in the health delivery system in the Municipality are incidence of disease, availability of health professionals, health infrastructure, status of the District Mutual Health Insurance Scheme (DMHIS), access to health facilities, and infant mortality rate and maternal mortality rate, etc.

Health service delivery in the Municipality is under the management of the District Health Management Team (DHMT) and is made up of eight main units. The main responsibility of the DHMT is to plan, coordinate, monitor and evaluate all health activities implemented in the Municipality.

The DHMT also mobilizes resources needed for effective health delivery in the Municipality. It collaborates with all stakeholders in health locally, nationally and internationally to bring quality and affordable health care to the people in the district. It serves as the technical advisor to the district assembly on health issues and ensures the implementation of health policies in the Municipality.

The Municipality is divided into five sub-districts for easy implementation of health programs, each headed by seasoned medical personnel. The five sub-districts have about 119 communities under them and they include Bibiani, Anhwiaso, Chirano, Awaso and Bekwai

i. Incidence of Diseases

The top ten diseases, which are prevalent in the Municipality as at December 31, 2013, are indicated in Table 26. However, there are other diseases that are also featured prominently in the district such as Diabetes Mellitus, Asthma, Snake bite, Infectious yaws, etc. which reported 35, 27, 16 and 35 cases respectively.

Even though malaria is still the number one top ten diseases, the number of reported cases has increased considerably to 95,678 as compared to 61,027 2011. It is also still the number one cause of death in the district followed by HIV/AIDS and Anaemia from 2011 to 2013 as shown in table 27. With the exception of malaria, HIV/AIDS and Anaemia which threatens the health of the people and causing death, the general population/inhabitants of the Municipality are relatively healthy as portrayed by the number of reported cases of top ten diseases above which is very significant for increased productivity and production in the Municipality. Like in the country, malaria is the number one cause of morbidity in the Municipality.

ii. Infant and Maternal Mortality

Available records from the District Health Directorate indicate that in the year maternal mortality/death was recorded in 2011 (2 deaths), 2012 (6 deaths) and 2013 (3 death) respectively in the Municipality. This could be attributed largely to a number of factors such low skilled delivery, inadequate ANC, superstition, etc. On infant mortality, the Municipality recorded a quit high figure but all efforts are being employed the Municipality to reduce it in order to achieve the MDG 4 and 5 by 2015.

iii. Health Infrastructure/Facility

Even though the health sector is under the direct management of the DHMT, other stakeholders from the

public, private, Christian Health Association of Ghana (CHAG), NGOs and the mining companies have over the years contributed in diverse ways to the improvement of the health of the populace by providing out-patient, in-patient and outreach services to the people in the Municipality. The category and ownership of health facilities providing health services as well as spatial distribution in the district are as shown in tables 28, 29 and figure 12.

These facilities which are almost evenly distributed four hospitals are capable of providing effective and efficient health care to the people.

vi. Health Personnel /Professionals


Even though the existing health personnel situation in the district has improved tremendously, the Municipality still lacks the required personnel to man the health facilities in the Municipality. Most categories of health personnel required are available and are at post as indicated in Table 30. However, the Municipality has lacks the following key personnel as Doctor, Pharmacist and Hospital Administrator.

Majority of the critical staff are located in the hospitals in Bibiani with a lot of the other staff like the Community Health Nurses widely distributed in all the health facilities and CHPS compounds. The table below captures the human resource of the Municipality.

The Municipality has no accommodation to attract staff. Private accommodation cost so much that the average workers cannot afford to pay. This has put the Municipality into a perpetual staff shortage situation.

vii. Status of the District Mutual Health Insurance Scheme

The Bibiani-Anhwiaso-Bekwai Municipal population according to the 2010 population and housing census stood at 123,272 with an annual growth rate of about 3.2%. Based on this, the District projected population as at December 31, 2013 stood at 217,126.

The District National Health Insurance Scheme in 2013 registered 13,297 subscribers made up of 5,831 males and 7,916 females including 4,291 pregnant women to join the scheme.

However, the total subscribers or active membership of the scheme as at the end of 2013 stood at 48, 541 representing 39.37% of the district’s total population of 123,272. This is made up of 20,173 males and 28,368 females and 41.56% and 48.44% of the total membership respectively.

The total number of pregnant women who were registered and benefited in 2013 under the President’s Special Free Maternal Care policy which implementation started in July 2008 was 4,291.

The total number of clients who did not renew their cards particularly in 2013 was 3,214. This represents 24.17% of the registered clients. The total number of membership renewals for the year 2013 was 35,244.

The claims received for processing for payment during the 2013 was 281,322. The total claims bills in respect of the clients who visited various health facilities for treatment within the same period amounted to GH¢6,320,292.82. On the average, the per visit cost charged by service providers in 2013 and 2014 are GH¢22.46 and 23.59 respectively.

The total payment made to service providers as claims on behalf of the scheme’s clients who attended various health facilities during 2013 was GH¢ 5,913,615.50.The scheme’s indebtedness to service providers amounted to GH¢2,533,960.33 in the same period.

The amount of money the scheme mobilised in for instance 2013 was GH¢ 6,074,743.66. This included GH¢252,816.00 as internally generated funds (IGF) and GH¢5,821,927.00 as support from NHIA (GOG) respectively.

Below are some of the major challenges that affected the growth of the scheme in the district. They included:

  • Low education and sensitization coverage due to inadequate resources and poor accessibility.
  • The nature of occupation of the people in the Municipality. The major occupation in the district is farming and most of the farmers are into subsistence farming and as such they find it difficult to raise funds to pay for their families particularly during the off cocoa seasons.
  • High cost of tariff and medicines for treatment
  • Low premium and administration fee
  • Politicization of the policy as divergence views are usual expressed by various political parties as to how the scheme would be operated if they win political power. This affects the enthusiasm of the residents who have already subscribed and are yet to join the scheme.
  • Inadequate logistics particularly computer sets for the scheme office as only six and one laptop computer sets are available.
  • Seasonal period of registration.
  • Delays in processing the new I.D Cards.
  • Inadequate staff
  • Late submission of claims by service providers
  • Late release of funds for reimbursement

Health insurance scheme in the Municipality will afford the majority of people to access quality health care.

vii Accessibility to Health Facilities

The geographical accessibility to health facilities by the people who are mostly farmers which was low when the Municipality was created in 1988, as a result of inadequate health facilities in the Municipality and their location long distances from the already scattered communities has improved tremendously within the last 10 years. The average distance in kilometres to the health facilities is 1.6 km and the distance in time is 50 minutes.

Theses compare favourably with the planning standard of a maximum of 5km. the major implication is that there is a high physical access to the facilities and using accessibility to access the poverty situation, they are not poor in terms of health physically. With the introduction of National Health Insurance Scheme (NHIS) by the Government with free maternal care/delivery, OPD attendance has increased appreciably.


Date Created : 11/19/2017 3:36:49 AM