The Municipal is divided into five sub-districts with unit heads and sub district leaders. The sub-districts are Konongo-Odumasi, Agogo, Juansa, Dwease-Praaso and Amanteman.  The Municipality has 12 operational health facilities serving 154,574 people. 7 of these health facilities are public while 5 are private (Table 1.2.24). It should be noted that the Bebome Health Centre is not functioning and the Nyamebekyere facility is closed.

The Municipality also has a number of traditional health service providers (herbalists and spiritualists) who are not well organized into formidable association. However, they have been licensed to practice by the Assembly and are paying the necessary taxes. They claim to address ulcers and pregnancy-related diseases, boils, breast abscesses and mental disorders.

Key Health Issues
Most health facilities in the Municipality are concentrated mainly in the south with communities in the north (Afram Plains) having little access to such facilities. However, in the remote areas Community Based Surveillance (CBS) volunteers have been trained by the  Municipal Health Management Team (DHMT) to detect, educate and inform health staff of any disease occurrence in the communities.

Traditional Birth Attendants (TBAs) have been trained to bring health care services to the doorstep of the people. There are also plans to train Community Health Officers (CHOs) to service 21 Community Based Health Planning Service (CBHPS) Zones in the Municipality. However, this has not been undertaken to date.

Most prevalent diseases in the Municipality (e.g. malaria, diaarhoea, buruli ulcer, and typhoid) tend to be linked to environmental conditions (sanitary related) in the district. Buruli ulcer is a major problem particularly in the Afram Plains area, while severe malaria cases have been reported in Odumase. Table 1.2.25 gives a distribution of prevalent diseases and their recorded cases in the municipality.

Malaria and Typhoid Fever continue to be one of the challenges facing the  health care. The Assembly as a pilot  in the GAIT’s Malaria Control Programme has trained eighty-seven (87) Advocates to embark on educational programmes aimed at educating the community members about the cause, mode of transmission, prevention and control of malaria. Currently, the advocates have trained about five thousand people.

The Municipality is also challenged with high maternal mortality rate. Table 1.2.26 gives a trend in maternal mortality in 2002-2005. Causes of maternal mortality include:

• Severe Post partum Haemorrhage
• Cardiac failure
• Eclampsia with failure
• Chemical poisoning from herbal concoction (attempted abortion)

HIV/AIDS
The HIV/AIDS menace  is on the rise with an increase in the number of cases from 2002-2005 as compared to 1996-2001. Specifically, a total of 761 HIV/AIDS (Table 1.2.25) cases were reported between 2002 and 2005 (4 years). This number is high when compared with 521 HIV/AIDS reported cases between 1996 and 2001 (6 years).

The Municipal Health Administration in collaboration with the Municipal Response Initiative (MRI) is under going a sensitization programme for the youth in the district. The Queen Mothers Association (with their secretary as a member of the MRI) has also embarked on Health Educational Programmes to create awareness among artisans in the district.

Some CBOs (Community Based Organizations) in the Municipality have under gone a workshop for educational programmes on HIV/AIDS while Agogo-Presby Hospital has trained volunteers who are embarking on the home based care for the people living with HIV/AIDS in the Agogo Sub district. Plans are under way to extend the home based care to other parts of the Municipality.

Expanded Programme on Immunization (EPI)
The Expanded Programme on Immunization has been the strategy of the Government of Ghana and Ghana Health Service to protect children against the child hood killer diseases. The programme has achieved its aim of reducing morbidity and mortality caused by vaccine preventable diseases. Table 1.2.27 gives the EPI coverage for the year under review and their percentage coverage (2002-2005).

Findings show that there was generally a drop in EPI coverage in 2004 as compared to that of 2003. This was as a result of heavy down pour of rain making access to the Afram Plains highly impossible. Other factors include shortage of some Antigens (BCG and TT) and other logistics like BCG needles. However, in 2005, EPI coverage increased significantly in all categories.

As part of the National Health Insurance Scheme, the Assembly has been selected among the pilot districts for the establishment of a Health Insurance Scheme. The project is at its second phase of completion. The project when completed will provide communities with equal access to affordable health care service delivery.

With its attendant achievements, the Municipal health sector is faced with the following constraints:

1. Lack of office and residential accommodation for staff: The Assembly is in need of offices and accommodations particularly in the Afram Plains area to help serve as incentives to attract health personnel to the Assembly
2. Low immunization coverage due to shortage of vaccines and logistics
3. Delay in release of funds from the regional and national level for programmes
4. Inaccessibility to the Afram Plains particularly during the rainy season
5. Inadequate motor bikes for outreach programmes
6. Staff inadequacy in the district which hampers the delivery of quality health care especially Anaesthetist

For tables refer to pdf file attached.