Health Care - 2
CHPS - 3
Traditional Birth Attendants - 22
The distribution of Health facilities in the municipal is not only unfair but also very inadequate and tends to be concentrated within the southern sector. Most of these Health Centres operate under stress due to inadequate logistics and qualified Health Personnel. This should be addressed by provision of adequate logistics and Personnel to all Health Centres in the District as well as creating the necessary enabling environment to attract and retain Health workers especially to deprived areas in collaboration with other stakeholders in the municipal.
Health Personnel and Services
The Municipality has 2 Doctors and 56 Nurses on a ratio 1:15240 respectively which is relatively low as compared to the national ratio which is 1:20,000, however there 22 TBAs in the Municipality who play very important role in the Health Services.
Malaria has been identified as the major disease in the Municipality. Other common diseases reported are anaemia and diarrhea. Analysis of the causes of Admissions versus mortalities confirmed that generally, malaria is still not only the leading cause of mortality and admissions but also of deaths. The high incidence of malaria, diarrhoea diseases and intestinal are due to poor water and sanitation situation in the Municipality. Planning for health in the Municipality should therefore, as a matter of urgency, include the improvement of safe water and sanitation coverage. Diseases like elephantiasis, guinea-worm and goiter are common in the Municipality and affect the poor most as they are environmentally related.
The HIV/AIDS prevalence rate of 2.3 for the Municipality is high compared to the National average of 3.2. It is however worth noting that these are only the reported cases at the Axim Government Hospital. With the limited access to medical facilities coupled with the high illiteracy rate and the fear of stigmatization, the real magnitude of the problem may be under estimated. The plight of the municipal is worsened by its close proximity to La Cote D’ Ivoire, a high prevalence area, and the regular interactions between their peoples. A lot of cases might have been hidden in the Nakaba and other faith based healing places. The real magnitude of the problem might be under estimated.
The influx of fishermen and farmers into the Municipal compounds the problem.
Addressing the problems so far are limited to seminars, and fora to sensitize various target groups on safe sex. There is a Municipal Co-ordinator which coordinates the activities of other district i.e. Jomoro, Ellembelle and Nzema East.
The table below depicts the current trend HIV/AIDS cases diagnosed at the Axim Government and confirmed at the Regional Public Health referral laboratory.
Efforts at addressing the problem has so far been limited to publicity campaigns, fora and seminars to sensitize various target groups on responsible sexual behaviour and safe sex. The Municipality has a Municipal Population Advocacy Team which undertakes advocacy on Population and Development issues including HIV/AIDS. There is also a District Aids Committee under the Municipality Response Initiative which co-ordinates HIV/AIDS Programmes and activities in the Municipality.
Lack of funding for HIV/AIDS Programmes in the Municipality has constrained efforts at addressing the challenge. Nonetheless, as the problem has now assumed the dimension of a development issue, the Municipality would solicit for assistance from its Development Partners and other Agencies in confronting the issue. Advantage would also be taken of the establishment of the GARFUND to provide additional funding to combat the HIV/AIDS menace in the Municipality. CHALLENGES& PRIORITIES
Key Challenges of the health Sector
- Reversing the high patronage of service at Eikwe to other health facilities in the district especially normal deliveries.
- Getting additional doctors to Eikwe hospital.
- Staffing and expansion of Nkroful health center.
- Promoting community support for health.
- Very hard to reach communities in the northern sector of the Municipality.
- New district with no permanent accommodation for office and DDHS residence.
Main Problems of the sector:
- Poor road net work to certain communities in the district especially the northern part.
- Aged vehicle which needs major repairs.
- No permanent office for the District health directorate.
- In adequate residential accommodation for staff especially DHA staff.
- Poor data capture from the sub districts portraying low performance in certain indicators.
- No furniture for the DHA offices.
- Lack of basic equipment in some facilities.
- No computers for administrative work.
Key priority Areas:
I. Improving the status of one health center to a district hospital level and construction of DHMT offices.
II. Improving access to reproductive services in the area of safe motherhood, adolescent reproductive health, family planning and prevention of maternal deaths through CHPS.
III. Provision of Child Health Services with much attention on school health, Childhood nutrition (breast feeding practices); Establishing MSGs and baby friendly institutions (at least 2 this year) EPI and prevention of neonatal, infant and childhood deaths.
IV. Health promotion and education aimed at promoting healthy life style and prevention of non communicable diseases promoting the use of ITNs, iodated salt.
V. Disease surveillance, malaria, TB and HIV and control of other NTDs.
VI. Data management.
VIII. National Health Insurance: Encouraging more registration
IX. Promotion of safe environmental and hygienic practices. E.g. clean environment.
Common endemic diseases:
i. Malaria: Due to poor sanitation and frequent rain falls. Malaria is the number one endemic disease in the Municipality. It is always the number cause of OPD attendance in all the health facilities and among all age groups. It also accounts for most of the admissions and deaths especially among children at the only hospital in the district, St Martin de Pores at Eikwe.
ii. TB and HIV are also diseases which are commonly detected at the hospital. However one cannot tell the magnitude of the situation in the Municipality currently, since most of the cases of Eikwe Hospital are from neighboring districts and La Cote D’Ivoire.
iii. Other diseases like Yaws and Schistosomiasis are found to be common among school children.
Common endemic diseases:
Malaria: Due to poor sanitation and frequent rain falls. Malaria is the number one endemic disease in the district. It is always the number cause of OPD attendance in all the health facilities and among all age groups. It also accounts for most of the admissions and deaths especially among children at the only hospital in the Municipality, St Martin de Pores at Eikwe.
TB and HIV are also diseases which are commonly detected at the hospital. However one cannot tell the magnitude of the situation in the district currently, since most of the cases of Eikwe Hospital are from neighboring districts and La Cote D’Ivoire.
Other diseases like Yaws and Schistosomiasis are found to be common among school children.
Health Financing had, for a long time, been a major problem with the people in the District. The main employment are fishing and farming which are very seasonal with low average income levels. The ‘Cash and Carry” policy of the Health Sector further worsened the affordability of Medical Services, especially to the Poor and Vulnerable.
Now thanks to the abolition of this system and the introduction of the new Mutual Health Insurance Scheme in all Municipality throughout the Country. Medical Services is now more affordable to the majority of the people in the District. This is reflected in the attendance rate at most Medical Facilities in the Municipality which has improved tremendously. For example Axim Hospital recorded an Average Monthly OPD Attendance of 12,559 patients in 2004 which has reduced to 11,048 for 2005.
Still a greater number of People, especially those in the Rural Areas, continue to rely on alternative Health Care Systems or delayed till the situation gets complicated. This is evidenced by the trend of Malaria, a preventable and curable disease always topping not only the cause of morbidity and admissions but also deaths. This has service health and economic implications for development.
Health Insurance Scheme
The District has no substantive Health Insurance Office. However all registrations are done through the Axim Mutual Health Insurance Scheme Office. This situation has made accessibility to the Facility very costly, considering the transportation expenditure to Axim.
Refer to pdf file attached for tables