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Hon. Paul Evans Aidoo
Hon. Alfred Ekow Gyan

The region’s 3.2 per cent inter-censual growth rate makes its population growth the third fastest after Greater Accra (4.4%) and Ashanti (3.4%). The growth rate is also higher than the national average of 2.7 per cent. The regional total fertility rate (TFR) of 4.4 is also higher than the national figure of 4.0 and is the fourth highest in the country.

The total fertility rate of 6 of the 11 districts is higher than the regional average. These factors, coupled with the young age structure (high proportion of population less than 15 years) of the region, imply a rapidly growing population, which is estimated to double in 22 years.

An implication of the growth rate is the high proportion of the population aged 0-14 years, which affects the level of dependency, with fewer people working to cater for more people. New jobs also have to be created for an ever-increasing number of new entrants into the labour force, thus putting a severe strain on the economy, and the development of the region. Another source of concern is the impact a rapidly growing population has on the environment.

In trying to cope with an ever-increasing number of people in the region, virgin forests in the Juabeso-Bia and Sefwi-Wiawso areas are being increasingly converted into agricultural lands, thus further depleting the already threatened forest cover of the region. Improper and unsustainable management of these forests therefore poses a serious threat to the country’s long-term economic growth. If therefore the country allows short-term economic interests to dictate mining and logging policies in the region, the long-term effects on the entire country could be more disastrous than any short-term economic gains the country might derive.

If exploitation of the forest resources is not managed efficiently and regulations strictly enforced, areas once covered by tropical forest could be converted into sparse grassland or even deserts in the near future. Scientific evidence should be carefully weighed and pitted against any economic considerations, and no matter what decisions are taken, the long-term effects of any activities should prevail, and the mistakes of the past, as well as the mistakes of other countries, should be completely avoided.

One of the very important indicators of social development is the level of literacy and educational attainment. The highest level of educational attainment for most women in the region is primary education. The level of fertility is generally inversely related to women’s educational attainment; with women of higher education bearing fewer children than those of lower education. Hence the relatively low level of educational attainment of the women in the region may be contributing to the relatively high fertility rate of 4.4, which is above the national average. For males, the highest level of attainment for most of them is middle/JHS. This has serious implications on the kind of job one does. Thus throughout the region, there are only a few people in the professional, technical, administrative and managerial positions, regarded as higher status occupations.

Houses in the region have mainly corrugated metal or thatch/palm leaves as roofing material, and sun-dried mud bricks for walls. There is the need for the region to evolve policies and take measures that will result in the provision of appropriate but affordable house construction and roofing materials that can withstand the severe rainfall patterns experienced in the region.

In this regard, the use of concrete and ceramic tiles for roofing is likely to grow in the Shama-Ahanta East metropolis and other urban areas, but is not likely to make much of an impact on rural housing in the foreseeable future. In most districts the pit latrine and public toilet are used by majority of households. Human waste can pollute the natural sources of water used for drinking by many of the households. Polluted water can also alter marine, riverine and wetland life, killing fish, birds and other wildlife.

Electricity is also not widely distributed across the region; the rural districts are particularly affected. The government’s rural electrification programme has not made much impact on the region. With the region now expected to be the largest producer of electricity in the country, plans have to be developed to make the various districts benefit more widely from the electrification programme.

Other indicators of development are access to health, education and other community facilities. Inhabitants of more than 60 per cent of the communities in districts such as Nzema East and Mpohor-Wassa East may have to travel more than 30 kilometres before visiting a hospital.

This has serious implications, since referral cases may need ambulance services, which are non-existent. With a very poor road network, most of which is unusable during the heavy rains of the major rainy season, many needless deaths, particularly maternal and child deaths may occur frequently.

But for the services of traditional healers and traditional birth attendants, the situation could be really disastrous. There is therefore an urgent need to improve the road network and the primary health care facilities and make them more accessible.

Delivery of an ordinary letter to a recipient can take several weeks. This therefore affects every facet of economic and social life. The current communication and information situation in the region is therefore unacceptable. It also affects effective communication and dissemination of government policies and directives in the region. There is no alternative to finding long-term and lasting solutions to these problems. Rural development should be holistic, and should not be sacrificed for over-concentration on the urban localities.

Control Of Birth And Fertility Rates
The region’s total fertility rate (TFR) of 4.4 is higher than the national average of 4.0, and is the fourth highest in the country. It is as high as 7.1 in Mpohor-Wassa East. The districts with rates lower than the regional and national averages are Shama-Ahanta East (3.1) and Wassa West (3.8).

It is known that lower fertility rates make money and other economic benefits more available to families and the community as a whole, and ensure better maternal and child health, as a result of proper spacing of births. Fertility rates therefore need to be reduced through deliberate policy interventions.

Poverty Reduction And Wealth Creation
The main consequence of rapid population growth is poverty, which comes in the form of unemployment, environmental degradation, low standard of living, large family size, low income, etc. These may be reduced by the application of the following and other appropriate measures.

  1. The economy of the region is largely linked to agricultural production. In order to improve soil fertility, farmers need to be encouraged to use improved highyielding crop varieties, which is a more viable option, to increase yield per acre and apply livestock or solid waste manure, which are cheaper and help to reduce soil erosion and check nutrient loss, rather than artificial chemicals, which lower crop productivity in the long term.

  2. More females in rural areas should be encouraged to go to school to improve their status, since studies have shown that educated females are economically more productive.

To achieve the objective of providing appropriate housing for people in all the districts, a. The Department of Rural Housing and Cottages should be properly resourced to provide affordable housing units in the rural areas using appropriate technology. Burnt mud bricks instead of sun-dried bricks, could be used.

  • The old system of building simple low cost houses, as exemplified by the State Housing Corporation’s housing estates at Tarkwa, Takoradi, as well as some of the housing units built by the Railway Mining companies at Tarkwa, Prestea, Nsuta and Takoradi for their workers during the pre-independence period, should be critically re-examined as a possible viable alternative for the provision of good housing for both the rural and urban communities.

  • In order to improve the durability and quality of rural housing there is the need for the region to evolve policies and take measures that will result in the provision of appropriate but affordable roofing materials that can withstand the severe rainfall patterns experienced in the region.

  • Proper drainage systems should also be constructed to prevent the rapid destruction of small towns and villages through erosion. The shallow and weak foundations of many rural houses are destroyed by erosion as a result of the region’s heavy rainfall pattern.

  • The rural electrification programme should be intensified and extended to all districts. Other sources of energy, such as solar must be given more attention in such areas.

  • Households, particularly in the urban and peri-urban areas, should be encouraged to use gas as fuel for cooking to reduce the over-reliance on wood and charcoal. This could be done through development of more affordable forms of gas cookers. Several suitable prototypes and commercial products are already available. Organizations such as the Energy Commission, Tema Oil Refinery, energy-oriented NGOs such as KITE, and the oil marketing companies could assist in this regard.

  • Households in Jomoro and Ahanta West should be assisted by District Assemblies to construct their own places of convenience. Using the beaches and the bush as toilet facilities may kill the tourism industry in these districts.
  • The Community Water and Sanitation Agency (CWSA) should be resourced financially to provide more deep wells and bore-holes in the rural communities to save the streams and rivers from further pollution and degradation, and reduce the incidence of water-borne diseases in the rural areas.
  • The nature of the school buildings and lack of teachers in all the districts is a major problem. Although recent application of HIPC and other donor funds to the provision of school infrastructure facilities has improved the situation in some districts, a lot still remains to be done. Local authorities and NGOs could channel some resources in upgrading the educational infrastructure of the region.
  • For a region with several industrial establishments in Shama-Ahanta East, Wassa West and Mpohor-Wassa East, it is unacceptable that there are only 3 Government Technical and Vocational institutions. The region needs to tackle this issue to absorb the many junior secondary(high) school leavers who do not enter senior secondary (high)schools, to be trained to provide appropriate middle-level manpower for the region’s industries. With only about 20 per cent of those who complete junior secondary(high) school moving on to the senior secondary (high) school level, an expansion in technical and vocational education will be one of the best ways of absorbing those who do not move on to the senior secondary (high) level, and preventing them from prematurely joining the job market with no marketable skills.
  • Employment levels could also be increased by seriously considering resuscitation of some of the abandoned industries in the region, such as the Bonsa tyre and Aboso glass factories, the Railway Location Mechanical workshop and Foundry near Sekondi, the Gold Refinery at Tarkwa, and the abandoned timber processing mills at Takoradi, Sefwi-Wiawso and Samreboi. Abandoned agricultural ventures such as the coffee plantations near Huni Valley and in the Aowin-Suaman districts should be re-examined.
  • Poor health facilities, particularly in the rural areas, could be addressed if the Ghana Poverty Reduction Strategy (GPRS) on health care is implemented fully by placing emphasis on district and community-based quality health care, which is essentially a programme for reaching a majority of the poor in the rural areas.

Since traditional healers are readily available to over 90 per cent of the population of all districts, the region should evolve deliberate policy measures within the framework of the new law on traditional medical practice, to strengthen and improve the quality of service provided by these healers, since they help to reduce the burden on the orthodox hospitals and medical practitioners, even if there are problems associated with their practice.

The number of medical personnel (doctors and nurses) who work  in hospitals and clinics is inadequate. This has created high doctor-patient and nurse-patient ratios in all the districts. Public education on primary health care, environmental sanitation and disease prevention will therefore need to be intensified while long-term plans for the provision of facilities and retention of personnel are evolved and executed.

The 3.2 per cent inter-censal growth rate makes the region’s population growth the third fastest after Greater Accra (4.4%) and Ashanti (3.4%). It is also very high compared to the national average of 2.7 per cent. This, coupled with the young age structure (high proportion of population less than 15 years) of the region, implies a rapidly growing population, which is estimated to double in 20 years. This high proportion of the population aged 15 years or younger would affect the level of dependency, with less people working to cater for more people, thereby reducing savings amongst the population.

Also, new jobs have to be created for an ever-increasing number of new entrants into the labour force, thus putting a severe strain on the economy, and the development of the region.

The regional total fertility rate (TFR) of 4.4 is higher than the national average (4.0), and is the fourth highest in the country after Ashanti (4.8) Northern (4.9) and Upper West (4.9). Although the total fertility rate is lower than the national rate (4.0) in two districts, Shama- Ahanta East (3.1) and Wassa West (3.8), in 6 out of the 11 districts, the TFR is higher than the regional rate, which itself is high.

The highest total fertility rate is in Mpohor-Wassa East (7.1), which is 3 children per woman higher than the national average. It is known that a lower fertility rate enhances the availability of economic and social benefits to families and the community as a whole, and ensures better maternal and child health, as a result of proper spacing of births. Fertility rates therefore need to be reduced through deliberate policy interventions.

Another source of concern is the impact a rapidly growing population has on the environment. In trying to cope with an ever-increasing number of people in the region by feeding and raising their standard of living, virgin forests in the Juabeso-Bia and Sefwi- Wiawso areas are being increasingly converted into agricultural lands, thus further depleting the already threatened forest cover of the region.

There are also plans to enter some of these precious forests for gold and other mineral prospecting and mining activities, a decision that has resulted in considerable public debate as to its wisdom or viability.

The region has the largest share of the country’s rainforest reserves, rich in primary tropical hardwood and very rare species of flora and fauna, which could be threatened with extinction if not properly managed and preserved.

It has been argued by scientists, conservationists and environmentalists that the region’s forest cover and wetlands are extremely important in maintaining the climatic and ecological balance, not only of the region, but also of the country as a whole.

Improper and unsustainable management of these forests therefore poses a serious threat to the country’s long-term economic growth. Such conversion of land to agricultural and mining activities alters the entire ecosystem, resulting in actual destruction of the land and diminishing of soil fertility needed for future productivity.

If therefore the country allows short-term economic interests to dictate mining and logging policies in the region, the long-term effects on the entire country would be more disastrous than any short-term economic gains the country might derive. People in the region, including traditional rulers and the youth, have also argued that mining activities in the past have not benefited their communities in any way.

They have rather enriched others and resulted in other regions being more developed both economically and infrastructurally, while farmlands have been destroyed and water bodies polluted with mining waste and effluent. Virgin forest, once destroyed, can never be reclaimed to its original self.

Rare species of flora and fauna, once made extinct, can also never be reclaimed. It has also been argued that timber and logging operations in such areas have led to deforestation, which invariably has altered the rainfall pattern in these areas, and probably the entire country, affecting natural water bodies in the form of rivers, lakes, springs, and streams used as the main source of drinking water, and the groundwater table.

The highly valuable and delicately balanced mangrove and other wetlands of the region are also under threat by persons seeking short-term and uncontrolled economic gains, including illegal gold and diamond mining.

If exploitation of the forest resources is not managed efficiently and regulations strictly enforced, areas once covered by tropical forest would be converted into sparse grassland or even deserts in the near future. This has already happened in the once lush tropical rainforest areas of Ashanti and Brong Ahafo, and it could easily happen to the Western Region, with probably the last bastion of a true rain forest belt in Ghana.

The frequent drying of the Brong Ahafo section of the Tano River, which also drains a substantial portion of the Western Region before entering the sea in Côte d’Ivoire, has been attributed to the indiscriminate and uncontrolled exploitation of the forest cover of Brong Ahafo and efforts should be made to avoid the same fate befalling the Western Region.

The contrary view, as articulated by the business community and the Government, is that the forest reserves designated for mining activities are already degraded through illegal logging activities over the years, and that with rigidly enforced regulations for potential miners to reclaim every forest area mined, these degraded forests will rather be resuscitated after the mining. Regulations will also be put in place to ensure that the communities in which such mining or logging activities take place benefit economically and socially from these activities. This is therefore a very important and delicate issue that will need to be carefully handled to avoid possible social unrest as happened in parts of Wassa West  in the past.

Scientific evidence should be carefully weighed and pitted against any economic considerations, and no matter what decisions are taken, the long-term effects of any activities should be paramount, and the mistakes of the past, as well as the mistakes of other countries, should be completely avoided.

One of the very important indicators of social development is the level of literacy and educational attainment, a high level of which is considered to be an important factor in the process of development. Education is known to bear a direct relationship with fertility rate.

Normally, the higher the level of education of a woman, the lower her fertility rate. The highest level of education attainment for most females in the region is primary education. Hence the relatively low level of educational attainment of females in the region may be contributing to the relatively high fertility rate of 4.4 of the region, which is higher than the national average. For males in the region, the highest level of attainment for most of them is middle/JHS. This has serious implications on the kind of job one does. Thus throughout the region, there are only a few people in the professional, technical, administrative and managerial positions, regarded as higher status occupations.

Housing is one of the social indicators advocated by the United Nations for developmental goals, and a good housing unit must consist of strong walls of dwelling which can withstand normal adverse weather conditions, good materials of roofing, and a proper floor, to be considered as fit for human habitation.

Houses in the region have mainly corrugated metal or thatch/palm leaves as roofing material. Thatch/palm-leaf roofing materials are used extensively in Jomoro and Aowin-Suaman. If well made, these thatch roofs are believed to be very suitable for the hot tropical weather, because they are very cool, since they do not radiate heat as metal sheets do. Badly made thatch, however, cannot adequately protect the users from bad weather.

Though the corrugated metal sheet (usually aluminium or galvanised iron) can be said to be a good material for protection from storms, there have been several instances nationwide where during very heavy storms it is the corrugated roofing sheets that are usually blown off by strong winds while the thatch roofs normally survive. This is mainly due to poor and outdated techniques of construction of these roofs, and the absence of tree covers around buildings as wind breakers.

The problem with the thatch and palm roofs is that they need to be frequently renewed or patched to prevent leakage or rot; corrugated metal sheets also develop leaks through rusting or other forms of corrosion.

There is therefore the need for the region to evolve policies and take measures that will result in the provision of appropriate but affordable roofing materials that can withstand the severe rainfall patterns experienced in the region.

In this regard, the use of concrete and ceramic tiles is likely to grow in the Shama-Ahanta East metropolis and other urban areas, but is not likely to make much of an impact on rural housing in the foreseeable future.

The average household size for the region is 4.7. Though lower than the national average, this is still quite high, since most households live in only one or two rooms. This creates overcrowding, which can expose members of the household to communicable diseases, and put undue pressure on social amenities such the availability of potable water, waste (liquid, human and solid) disposal, and toilet facilities.

In most districts the pit latrine and public toilet are used by majority of households. Human waste can pollute the natural sources of water used for drinking by many of the households in the region. Polluted water can also alter marine, riverine and wetland life, killing fish, birds and other wildlife.

Electricity is also not widely distributed in the region. The rural districts are particularly affected. The government’s rural electrification programme has apparently not made much impact on the region.

With the region now expected to be the largest producer of electricity in the country, the necessary infrastructure needs to be developed to make the region benefit more widely from the electrification programme. The situation, where a region or area produces facilities but does not benefit commensurately from the facilities, needs to be redressed.

Other indicators of development are access to health, education and other community facilities. There are hospitals in all the districts, except Juabeso-Bia, although these are situated mainly in the district capitals. The situation where people from more than 60 per cent of the communities in Nzema East and Mpohor-Wassa East have to travel more than 30 kilometres before visiting a hospital is not the best.

This has serious implications, since referral cases may need ambulance services, which are non-existent. With a very poor road network most of which is unusable during the heavy rains in the major rainy season, many needless deaths, particularly maternal and child deaths occur frequently in the region. But for the services of traditional healers and traditional birth attendants, the situation could be really disastrous. There is therefore an urgent need to improve primary health care facilities and make them more accessible.

Access to basic education in the region is relatively high, but there is dissatisfaction with the quality of education in the region (CWIQ 1997). This is attributed to poor quality of school facilities and the lack of teachers.

Communications facilities are a luxury to the people of the region. Most households have to travel more than 15 kilometres before they can post a letter or make a telephone call. In the case of telephone facilities, the region seems to have benefited considerably from mobile telephone operations, coming close after Eastern and Greater Accra in the extent of coverage, though not in the number of telephones per head of population.

Delivery of an ordinary letter to a recipient can take several weeks. This therefore affects every facet of economic and social life. For example, delayed or non-delivery of mails could cause a successful candidate to miss out on school admission or a job interview or even the job itself, especially if they do not take the risk of travelling to look for school places or check on the job application themselves. Ironically, in the pre-and immediate post independence eras, it was possible for a person in a remote area, school or workplace to receive a letter from a school or government organisation in the district, regional or national capital within a maximum of one week and intact too.

The current communication and information situation in the region is therefore unacceptable in this age of information and communication technology (ICT). It also affects effective communication and dissemination of government policies and directives in the region.

As a temporary measure, district assemblies and other local government authorities could channel their civic education programmes through Christian, Islamic and other religious bodies. There is no alternative to finding long-term and lasting solutions to these problems, so rural development should be holistic, and should not be sacrificed in favour of over-concentration on the urban localities.

Interventions
Control Of Birth And Fertility Rates

It is known that lower fertility rates make it possible for money and other economic benefits to become more available to families and the community as a whole, and ensures better maternal and child health, as a result of proper spacing of births.

Fertility rates therefore need to be reduced through deliberate policy interventions. District Assemblies and local government authorities can do this by initiating and implementing policies such as the following:

1. Even though there is evidence that even the rural population is beginning to accept certain artificial birth control methods such as contraceptives and voluntary sterilisation, making contraceptive and other birth control methods available at all health centres and through community pharmacies is likely to impact only the small urban population.

In the rural areas, the best form of contraception to reduce fertility, short of total abstinence, is known to be breast-feeding for a longer period, at least nine months. Breast feeding also increases both child and maternal survival, as it gives the child natural immunity to certain diseases and reduces the risk of diseases such as breast cancer in the mother.

2. The capacity of the National Population Council (NPC) will need to be strengthened to enable them undertake effective public campaigns to promote knowledge and usage of birth control, child survival and good maternal and child health practices. Through such measures, the population growth rate of the region could be reduced or controlled at manageable limits, even if the considerable in-migration for economic reasons continues.

Poverty reduction and wealth creation

The main consequence of rapid population growth is poverty, which comes in the form of unemployment, environmental degradation, low standard of living, large family size, low income, and so on. These may be reduced by the application of the following and other appropriate measures.

  1. The economy of the region is largely linked to agricultural production. In order to improve soil fertility, farmers should be encouraged to use improved highyielding crop varieties, which is a more viable option, to increase yield per acre, and apply livestock or solid waste manure, which are cheaper and help to reduce soil erosion and check nutrient loss, rather than artificial chemicals, which lower crop productivity in the long term.
  2. More females need to be encouraged to go to school to improve their status in society, since studies have shown that educated females tend to be economically more productive. The region should collaborate with Parliament and the Ministry of Women and Children’s Affairs to undertake intervention measures to improve the status of women in the region, which will positively impact the economic and social advancement of the region. To achieve the objective of providing appropriate housing for people in all the districts
  3. The Department of Rural Housing and Cottages should be properly resourced to provide affordable housing units in the rural areas using appropriate technology. Burnt mud bricks instead of sun-dried bricks, could be used.
  4. The old system of building simple low cost houses, as exemplified by the State Housing Corporation’s housing estates at Tarkwa, Takoradi, as well as some of the housing units built by the Railway Mining companies at Tarkwa, Prestea, Nsuta and Takoradi for their workers during the pre-independence period, should be critically re-examined as a possible viable alternative for the provision of good housing for both the rural and urban communities.
  5. In order to improve the durability and quality of rural housing there is the need for the region to evolve policies and take measures that will result in the provision of appropriate but affordable roofing materials that can withstand the severe rainfall patterns experienced in the region. Proper drainage systems should also be constructed to prevent the rapid destruction of small towns and villages through erosion. The shallow and weak foundations of many rural houses are destroyed by erosion as a result of the region’s heavy rainfall pattern.
  6. The rural electrification programme should be intensified and extended to all districts. Other sources of energy, such as solar, must be given more attention in such areas.
  7. Households, particularly in the urban and peri-urban areas, should be encouraged to use gas as fuel for cooking to reduce the over-reliance on wood and charcoal. This could be done through development of more affordable forms of gas cookers. Several suitable prototypes and commercial products are already available. Organizations such as the Energy Commission, Tema Oil Refinery, energy-oriented NGOs such as KITE, and the oil marketing companies could assist in this regard.
  8. Sanitation is a major problem in many districts. Waste disposal, particularly human waste disposal, is yet to be holistically tackled by the various district assemblies. As an immediate urgent measure, households in Jomoro and Ahanta West should be assisted by District Assemblies to construct their own places of convenience. Using the beaches and bushes as toilet facilities may kill the tourism industry in these districts not to mention the health hazard it poses to the local inhabitants themselves. Simple, relatively inexpensive but very hygienic methods are available for adoption.
  9. The Community Water and Sanitation Agency (CWSA) should be resourced financially to provide more deep wells and bore-holes in the rural communities to save the streams and rivers from further pollution and degradation, and reduce the incidence of water-borne diseases in the rural areas.
  10. The nature of school buildings and the lack of teachers in all the districts is a major problem. Although recent application of HIPC and other donor funds to the provision of school infrastructure facilities has improved the situation in some districts, a lot still remains to be done. Local authorities and NGOs could channel some resources in upgrading the educational infrastructure of the region.
  11. For a region with several industrial establishments in Shama-Ahanta East, Wassa West and Mpohor-Wassa East, it is unacceptable that there are only 3 Government Technical and Vocational institutions. The region needs to tackle this issue to absorb the many junior secondary school leavers who do not enter senior secondary schools, to be trained to provide appropriate middle-level manpower for the region’s industries. With only about 20 per cent of those who complete junior secondary school moving on to the senior secondary school level, an expansion in technical and vocational education will be one of the best ways of absorbing those who do not move on to the senior secondary level, and preventing them from prematurely joining the job market with no marketable skills.
  12. Employment levels could also be increased by seriously considering resuscitation of some of the abandoned industries in the region, such as the Bonsa tyre and Aboso glass factories, the Railway Location Mechanical Workshop and Foundry near Sekondi, the Gold Refinery at Tarkwa, and the abandoned or run-down timber processing mills at Takoradi, Sefwi-Wiawso and Samreboi. Abandoned agricultural ventures such as the coffee plantations near Huni Valley and in the Aowin-Suaman districts should be re-examined and resuscitated if found viable.
  13. Poor health facilities in the rural areas could be addressed if the Ghana Poverty Reduction Strategy (GPRS) provisions on health care are implemented fully by placing emphasis on district and community-based quality health care, which is essentially a programme for reaching a majority of the poor in the rural areas. Since traditional healers are readily available to over 90 per cent of the population of all districts, the region should evolve deliberate policy measures within the framework of the new law on traditional medical practice, to strengthen and improve the quality of service provided by these healers, who help to reduce the burden on the orthodox hospitals and medical practitioners, even if there are problems associated with their practice. Improving the quality of their services should therefore enhance the general health profile of the population.
  14. The number of medical personnel (doctors and nurses) who man hospitals and clinics is inadequate. This has created high doctor-patient and nurse-patient ratios in all the districts. Public education on primary health care, environmental sanitation and disease prevention will therefore need to be intensified while long-term plans for the provision of facilities and retention of personnel are evolved and executed.
  15. In the region as a whole, only 32 per cent of houses have access to treated pipe-borne water with only 8.5 per cent having this available within the dwelling place. This is not good enough, and programmes to intensify provision of potable water, particularly in the rural areas, will need to be intensified to minimise the prevalence of water-borne diseases such as diarrhoeal diseases including cholera, filariasis, guinea worm, schistosomiasis, and typhoid, which are all very common in the region. It will in the long run cost a lot less to institute environmental health programmes and disease prevention measures than to spend huge sums of money on curative health measures.

 

 

 



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