The Health of a people cannot be overlooked since a healthy population is essential for development. We are all convinced that all school-going-age pupil, the active labour force and the aged must be healthy as a crucial determinant for poverty reduction especially in terms of our comparative advantage in export of traditional crops, cocoa, fishing and tourism. Importantly, ill-health affects sanity and decision making which are vital for good governance. To sustain these priorities for improved life expectancy in the human capital base, and through proper income orientation of the large population The Ghana Health Service, DHMT, Sub¬committees of the Assemblies, School Health Education Planning and the Gomoaman Health Insurance scheme in collaboration with non state partners have come a long way in achieving Health for all.
The district has only one hospital namely; St Jude’s Catholic Hospital at Apam. It has been upgraded through the last twenty (20) years of this district’s Administration. St Jude is accessible within thirty (30) minutes drive across a radius of 45 kilometres from the Accra -Elubo Highway, Ankamu (Apaa Junction)in Gomoa West. In spite of this, it is usually stretched to its limit during the raining seasons, with patients from the Buduburam camp, far East of Gomoa. St Jude, has one hundred and five (105) beds, four (4) wards; one (1) male, one (1) female and maternity ward, one (1) isolated ward and one (1) children’s ward, a theatre, laboratory and X-ray units.
Other complementary health facilities presently in operation in the private sector, specifically clinics that are accessible in the west include one at Dawurampong and another at Ankamu. The bottom-line of the practices, in order of ranking are homeopathic one at Gomoa Dominase and the other in the west, at Gomoa Tarkwa. In addition, Gomoa district has two (2) health centers situated in each constituency at Gomoa Oguaa and Gomoa Ebuduatta in the east. Refer to map on the distribution of health facilities in the district.
Besides, there are eight (8) community clinics, situated at Gomoa Onyadze, Gomoa Potsin, Gomoa Ojobi, Gomoa Nyanyano, Gomoa Buduburam, Okyereko, Obuasi and Gomoa Ngyiresi all in the east which is deprived of relevant public infrastructure, although there is rapid population growth. The health facilities in the district is presented in table 1:10 in pdf file below.
The staff strength of the hospital and other public health facilities include doctors, Medical Assistants, midwives, nurses, paramedics and trained Traditional Birth Attendants (TBAs). Before 1994, the doctor- patient-ratio was 1:150,000. By 1999/2000, the ratio had improved, falling to 1:97,396 owing to capacity strengthening of resident staff. The district is divided into four sub-districts for health delivery services. Namely Apam, Gomoa Oguaa, Ebuduatta, and Ojobi-Nyanyano. Available statistics suggest that there have been considerable increase in hospital attendance and bed occupancy rates since 1990. Health delivery services at Apam and Gomoa Obuasi are quite satisfactory but the overall utilization of health services in the district could be said to be low.
The causative factors of low utilization levels are of economic and socio-cultural in nature. Some of the factors, which have affected performance over the last twenty years, have been:
(1) Poor accessibility to higher order health services.
(2) High transport costs from remote parts of the district.
(3) Inconsiderable charges at the highest order health centre
(4) Unavailability of Drugs.
Diseases that are prevalent in the district are shown in the table 1.11 in pdf file below. Although there has been general improvement in the health conditions in the district with Apam Hospital exhibiting tremendous success in its programmes, malaria continues to be the fundamental cause of sickness, which is basically due to poor sanitation and general environmental untidiness. The problem is more pronounced and distressing in the coastal towns and villages and is spreading fast in spite of efforts to minimize the incidence. About 55% of the disease pattern in the district continues to be made up of malaria after 20 years, followed by Acute Upper Respiratory Infections, skin diseases, diarrhoeal diseases and Gastro Intestinal Tract Disorders. Most of the five topmost diseases in the district are related to extreme poverty and poor environmental hygiene. Sexually transmitted diseases (STDs) with IDS as the most killer disease is spreading fast in spite of efforts to minimize the incidence.
Generally, the nutrition of the people, to a large extent, is dependent on the food crops they grow and the fish landed in the district annually. The nutritional status of children in the district can best be described as quite poor. There are still many cases of severe anaemia that requires blood transfusion. Kwashiokor and Marasmus are also prevalent. There is a programme in place involving distribution of additional nutrients to the affected children. This programme can be enhanced by the construction of a nutritional rehabilitation centre.
Maternal mortality rates increased significantly in year 2000 from 1/1000 in the year 1999 up to 1.6/1000. This trend had to be minimized and reversed. Nevertheless, the district ratio is less threatening than the national ratio which was 2/1000 in the year 2000. Strangely enough, there were 1162 cases of teenage pregnancy which resulted in 18% fatal Anti-Natal cases.
The major cause of infant morbidity and mortality is anaemia followed by malaria- related diseases. Diarrhoeal diseases are also common among children. Children are more prone to environmental parasitic infection than adults because the former play around and are susceptible to coming into contact with parasites on the ground. The situation of anaemia in children in the district is quite alarming. It perpetuates the low income situation and assists further in the already poor nutritional status of affected pre-school children.
The HIV/AIDS challenge is a millennium agenda like the uncontrollable malaria pandemic. HIV/AIDS is a menace and traumatic to agricultural based economies like ours. Available statistics indicate clearly that by the end of the year 2001, Central Region had recorded 3290 reported cases. Out of these, St Jude’s recorded 538 cases representing about 16% of reported cases in the region. The situation is unacceptable and therefore need an urgent intervention to surmount. Importantly, the district is emerging as a tourist attraction, which has propensity to spread the diseases.
The District Assembly has instituted and continues to support the District Response Initiative (DRI) by setting aside 1% of DACF (approximately 016,000,000) to support all HIV/AIDS related programmes. The DA with support from the DACF, ESRP and SIF, is also trying to empower the women to minimize their vulnerability. It is also an objective of the DA to ensure that 60% of all HIV/AIDS patients are provided with adequate medical/social and psychological care by the end of the 2009. However, the main problems confronting he health sector are stigmatization, poverty and unwillingness of people to volunteer to undergo HIV test.
For tables refer to pdf file