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        Background Information of Western Region

The Western Region is situated in the south-western part of Ghana. It shares borders with La Cote d’lvoire on the West, the Central Region on the East, part of Ashanti and Brong Ahafo Regions in the North, and the Gulf of Guinea in the South. It has an area of 23,760 sq. km. with a coastline of 192km.

These were old districts that were divided, creating new districts:

{C}v  {C}Sefwi Wiawso – Wiawso & Akontombra

{C}v  {C}Nzema East – Axim & Ellembelle

{C}v  {C}Wassa West – Tarkwa Nsuayem & Prestea H. Valley

{C}v {C}Shama Ahanta East – Sekondi Takoradi & Shama

 General Information

 

Population

The 2009 population of the region as projected from 2000 population census is 2,555,363 with a growth rate of 3.2%.                                                  

 

Geography

Climate

The southern part of the region is the wettest part of the country. There are two distinct rainfall seasons, occurring in June and October. Temperatures are on the average about 270 C.

Relief

The region generally has low lying lands with heights below 222 metres above sea level except in the extreme northwest. The highest elevation is 660 metres at Atayemikrom.

Drainage

There are ten (10) main rivers in the region. These are Bia, Sui, Tano, Tawya, Bonsa, Yannery, Butre, Whin, Ankobra, and Pra. Rivers Ankobra and Pra drain into the sea in the region.

Vegetation

The region lies in the equatorial rainforest belt. It has a total forest area of 19,406 sq. km which constitute 25% of Ghana’s 77,625 sq. km forest area.

Consequently, the region produces a large proportion of the country’s timber requirements for domestic use and export.

 

Mineral Resource

The Western Region is probably the richest area in Ghana so far as mineral deposits are concerned. Some of the minerals found in the region and their locations are:

{C}·         {C}Gold                      -           Tarkwa, Aboso, Prestea, Bogoso,

Bibiani, Chirano and several other places.

{C}·         {C}Diamond              -           Bonsa Basin

{C}·         {C}Manganese         -           Nsuta

{C}·         {C}Bauxite                -           Awaso           

{C}·         {C}Limestone           -           Nauli (Half Assini)

{C}·         {C}Iron Ore                -           Oppon Valley

{C}·         {C}Glass Sands       -           Tarkwa

Forestry

The concentration of high forest accounts for the large number of timber firms in the region. Western Region leads in the production of timber in the country, producing an average of about 42% of Ghana’s timber annually.

 

 

 Socio Economic Activities

Agriculture

 

The region has soil types that are suitable for a wide range of crops – mainly Cocoa, Coffee, Rubber, Oil Palm, Coconut, Black Pepper and Rice.

Industry

The region is one of the three most industrialized regions in the country. According to industrial classification, there are three major groupings as follows:

{C}i.              {C}Mining and Quarrying

{C}ii.            {C}Manufacturing

{C}iii.           {C}Electricity, Gas and Steam

The industrial capacity of the region is due to the industrial centers namely Sekondi/Takoradi Metropolis and the Mining area around Tarkwa.

About 60% of all the industries are located in the Sekondi/Takoradi Metropolis.

Transport and Communication

It is estimated that about 30% of the trunk roads in the region are not tarred. The road network is however fast improving.

 

A 1,272 km of railway line links the mining areas in the Wassa West District to the port cities of Sekondi/Takoradi in the Shama Ahanta East District. Other major infrastructure in the region includes the Takoradi Habour, Thermal Plant at Aboadze and the Sekondi Fishing Harbour (Bosomtwi Sam Fishing Harbour).

 

 

SECURITY SERVICES

 

Navy / Naval base; Military; Police and Prisons

There is an airstrip in the regional capital

 

 Administrative Districts

There are seventeen (17) Administrative Districts in the region. All the District capitals have pipe borne water and electricity connected to the national grid.

The region has eighty nine (89) Health Sub districts as shown below:

 

Administrative Districts and Health Sub Districts 2009

District

Population

Area Of

Districts Sq. Km.

No. Of

Health  Sub

District

 

Sekondi-Takoradi

367,621

 

337

4

Shama

122,541

3

Mpohor Wassa East

162,776

2,628

5

Ahanta West

126,322

576

4

Axim municipal

85,364

 

2,149

5

Ellembelle

104,334

5

Jomoro

147,842

1,344

4

Tarkwa Nsuayem

148,304

 

1,832

8

Prestea Huni Valley

160,663

7

Wassa Amenfi East

116,999

1,502

7

Wassa Amenfi West

194,205

3,164

5

Aowin Suaman

158,179

2,699

5

Bibiani Ahnwiaso Bekwai

137,098

835

5

Sefwi Wiawso

108,773

 

2,518

5

Sefwi Akontombra

88,996

3

Juabeso

159,419

1,807

7

 Bia

165,926

2,296

7

Region

2,555,363

23,760

89

 Health Infrastructure

There are a total of 325 health facilities made up of 26 Hospitals,

2 Polyclinics, 55 Health Centres (HC), 92 Clinics, 114 functional CHPS compounds and 36 maternity homes (MH). The breakdown is as follows:

 

HEALTH FACILITIES BY OWNERSHIP & TYPE  2009 WESTERN REGION

 

 

 

 

 

 

 

 

OWNERSHIP

HOSP.

POLY. CLINIC

HEALTH CENTER

CLINIC

CHPS

MAT. HOME

TOTAL

GOV’T.

12

2

53

35

114

0

216

MISSION

4

0

2

17

0

1

24

QUASI -GOVT.

3

0

0

1

0

0

4

PRIVATE

5

0

0

39

0

35

79

INDUSTRIAL

2

0

0

0

0

0

2

 

REGION

26

2

55

92

114

36

325

 

 

 

 HIGH IMPACT RAPID DELIVERY (HIRD) PROGRAMME

 

The HIRD approach combines the key principles of vision and data-driven methods to develop a plan for attaining universal (at least 90%) coverage for interventions which have proven to have a high impact on maternal and child mortality.

To achieve universal coverage one needs to ensure that interventions are available and utilised by all those who need them 

Since the middle of 2007, under the HIRD approach, the Western region has gone through several stages of HIRD planning and implementation 

a) Stakeholders’ sensitisation, situational analysis, planning and budgeting meeting at Busua from 25 to 28 June 2007

b)) Release of first tranche of funds from the National level in October 2007

c)) Plan prioritisation meeting at Aboadze on 26 October 2007

d) Release of funds from the Regional to the district level late October 2007

e) Initial implementation of HIRD activities in districts

f) Regional review meeting on HIRD in December 2007.

g) Continuation of implementation of HIRD activities

h) Regional monitoring of activities in districts in December 2007

i) Dissemination of findings of Regional monitoring trips at 2007 Annual review in February 2008

j) Three rounds of Activity Monitoring and two rounds of financial monitoring trips to all districts from teams from the National level in 2008

k) Periodic release of further funds from the Regional to district level

l) Collation of HIRD plans from the district level

m) Collation of quarterly updates from districts

n) Regional Monitoring of HIRD activities in districts

 

 

 

Clinical Data

Outpatient attendance registered in 2009 was 2,535,149 which showed an increase 15.7% over 2008 attendance of 2,190,361. Sekondi-Takoradi Metropolis contributed the highest outpatient attendance of 436,271(17.2%) of the regional total excluding the regional hospital (Effia Nkwanta) contribution of 131,235 (5.2%) of the regional total. The second highest contribution was Tarkwa- Nsuaem 334,013 (13.2%), with Sefwi Akontombra contributing the least 43,597 (1.7%) but higher than the previous years.

OUTPATIENT ATTENDACE BY DISTRICT 2007-2009

 

DISTRICT

2007

2008

2009

1

AHANTA WEST

71,166

83,379

93,584

2

AOWIN SUAMAN

66,835

88,968

120,459

3

AXIM MUNICIPAL

167,429

95,602

49,539

4

BIBIANI A. BEKWAI

139,026

158,875

155,890

5

JOMORO

62,197

109,396

144,106

6

MPOHOR WASSA EAST

47,379

57,157

82,512

7

SEFWI WIAWSO

100,275

149,733

150,969

8

STMA

402,461

387,572

436,271

9

ENRH

182,037

135,763

131,238

10

TARKWA NSUAEM

198,964

235,899

334,013

11

WASSA AMANFI EAST

54,928

70,960

87,142

12

WASSA AMANFI WEST

83,822

138,601

154,112

13

BIA

53,709

77,349

73,410

14

JUABESO

97,303

125,087

142,820

15

SHAMA

New Districts

49,506

93,358

16

ELLEMBELLE

144,165

169,067

17

PRESTEA H. VALLY

49,527

73,112

18

SEFWI AKONTOMBRA

32,822

43,547

 

GRAND TOTAL

1,727,531

2,190,361

2,535,149

 

Outpatient attendance per capita recorded in 2009 was 0.99 which showed an increase of 0.11 over 2008 per capita of 0.88. Five districts (Bibiani A. Bekwai, Sefwi Wiawso, STMA including the regional hospital, Tarkwa Nsuaem and Ellembele) all recorded per capita of more than one (1) during the period.  Axim district which registered per capita of 1.16 in 2008 decreased to 0.58 in 2009. Tarkwa-Nsuaem registered the highest (2.25) in the region whilst the lowest was Bia district (0.44).

 

HOSPITAL ADMISSIONS

Hospital admissions were 115,958 in 2009 which showed an increase of 15.2% over 2008 (100,689), there had been a gradual increase of admissions over the past three years.

Admission rate per 1,000 population increased from 37.70 in 2008 to 45.38 in 2009.  The highest rate was registered in Sefwi Wiawso (144.22) whilst the lowest was in Shama district (4.07).  Bia and Sefwi Akontombra do not have admitting facilities.

 

 

 

 

 

 

MALARIA CASE FATALITY RATES

Table: Malaria case fatality rate, 2007-2009

Indicator

2007

2008

2009

under 5

above 5

under 5

above 5

under 5

above 5

Malaria admission

11,041

11,546

11,428

12,924

17,304

18,543

Malaria death

328

258

244

225

309

210

Case Fatality per 100

3.0

2.2

2.1

1.7

1.8

1.1

 

There has been a gradual decrease in malaria case fatality rate for both the under fives and above fives during the past three years though absolute figures showed an increase of 0.27% in 2009 over 2008 for the under fives.

 

DEATH RATE BY AGE GROUP

Table: Death rate per 1,000 admissions by age group, 2008-2009

Indicator

2008

2009

Admission

Death

Death Rate

Admission

Death

Death Rate

Under 1year (infants) deaths

6,791

352

51.8

7,459

337

45.2

Under 5years deaths

21,517

686

31.9

29,500

715

24.2

Above 5years deaths

74,764

1,938

25.9

79,252

1,834

23.1

Death rates among the infants were higher than other age groups though it showed a decrease of 6.6 in 2009 compared to 2008. The overall death rate in 2009 was lower than 2008.

BEDSTATE STATISTICS

Bed states statistics assess the efficiency of the utilization of beds in a facility; it shows the demand for service

The bed occupancy rate (a measure of percentage of bed occupied by patients) in 2009 recorded by the hospitals in the region ranged between 93.0% and 2.0%.

ST. Martins de Porres hospital in Eikwe in the Ellembele district registered the highest occupancy rate of 93.0% in 2009 and 90.6% in 2008, whilst A.G.B.L hospital in Bibiani Anhwiaso Bekwai recorded the lowest (2.0%) in 2009 and 1.4% in 2008.

St. John of God hospital mission hospital in sefwi wiawso recorded the second highest (77.6%) in the region in 2009.

The region recorded percentage bed occupancy of 50.3% in 2009 as compared to 55.4 in 2008.

 

Hospital bed statistics, 2007-2009

 

INDICATORS

2007

2008

2009

Patient Days

305,071

363,557

372,367

% Occupancy

42.4

55.4

50.3

Average length of Stay (ALS)

4.0

3.5

3.3

Turn Over per bed (TOB)

38.8

52.8

56.5

Turn Over Interval

5.4

2.8

3.2

 

SURGICAL OPERATIONS

General operations performed in the various hospitals for the year 2009 was 16,028, out of which minor surgeries contributed 7,601 and major surgeries 8,427. Caesarean Section was the highest major surgery contributing 3,303 and the minor highest surgery was EOU for abortion (2,139).

 

TOP TEN CAUSES OF OPD, ADMISSIONS AND DEATHS

Malaria continuous to be the number one cause of outpatient attendance, admissions and deaths, contributing 46.2%, 40.7% and 18.1% respectively in 2009.    

Fibroid emerged among the top ten causes of admissions contributing 737 (1.1%) in 2009. Since 2007 Anaemia had been the second cause of all reported deaths, contributing 212 (9.8%) in 2009

 

TOP TEN CAUSES OF OUTPATIENT MORBIDITY, 2007 - 2009

2007

2008

2009

Condition

cases

%

Condition

 cases

%

Condition

 cases

%

Malaria

635,228

46.9

Malaria

645,796

44.9

Malaria

411,915

46.2

ARI

160,039

11.8

ARI

119,622

8.3

ARI (Acute Respiratory Infection)

84,210

9.4

Diarrhoea Diseases

120,769

8.9

Skin Diseases

61,656

4.3

Diarrhoea Diseases

41,698

4.7

Anaemia

72,688

5.4

Diarrhoea Diseases

60,021

4.2

Skin Diseases & Ulcers

41,321

4.6

Skin Diseases & Ulcers

58,509

4.3

Rheumatism/ Joint Pain

34,816

2.4

Rheumatism and Joint Paints

24184

2.7

Pneumonia

21,076

1.6

Pregnancy & Related Complication

34,337

2.4

Acute Eye infection

21000

2.4

Acute Eye Infection

15,708

1.2

Hypertension

31,075

2.2

Hypertension

17748

2.0

Intestinal Worms

8,910

0.7

Intestinal Worms

25,187

1.8

Intestinal worms

14753

1.7

Meningitis

8,305

0.6

Home Accidents

20,126

1.4

Home Accidents and Injuries

11120

1.2

Malnutrition

7,975

0.6

Aneamia

19,918

1.4

Anaemia

10647

1.2

All Other Diseases

246,062

18.1

All Other Diseases

385,503

26.8

 All Other Diseases

212972

23.9

Total

1,355,269

100

Total

1,438,057

100

Total

891,568

100.0

 

 

TOP TEN CAUSES OF ADMISSION, 2007-2009

Condition 2007

Cases

%

Condition 2008

Cases

%

Condition 2009

 Cases

%

Malaria

19,587

38.7

Malaria

12,840

39.0

Malaria

27,003

40.7

Pregnancy  related complications

3,210

6.2

Anaemia

2,210

6.7

Anaemia

3,494

5.3

Anaemia

2,610

5.1

Abortion

1,525

4.6

Diarrhoea Diseases

2,968

4.5

Gastro Enteritis

2,585

0

Diarrhoea Diseases

1,222

3.7

Abortion

2,500

3.8

Abortion

1,858

 

Hernia

1,264

3.8

Hypertension

1,622

2.4

Hernia

1,673

3.2

Hypertension

967

2.9

Hernia Inguinal

2,060

3.1

Hypertension

1,444

2.8

Pneumonia

627

1.9

Malaria In Pregnancy

776

1.2

Gynaecological disorders

912

1.8

Cellulitis

330

1.0

Fibroid

737

1.1

Pneumonia

889

1.7

Road Traffic Accident

308

0.9

Road Traffic Accident

712

1.1

RTA

701

1.4

Malaria in Pregnancy

295

0.9

Chest Infection

662

1.0

All Other Disease

15,719

30.5

All Other Diseases

11,363

34.5

All Other Diseases

23,834

35.9

Total

51,560

100

Total

32,951

100

Total

66,368

100

 

 

 

 

 

TEN TOP CAUSES OF DEATH, 2007- 2009

C ondition 2007

 Cases

%

Condition 2008

 Cases

%

Condition 2009

 Cases

%

Malaria

587

30.5

Malaria

469

30.9

Malaria

393

18.1

Anaemia

171

8.9

Anaemia

159

10.5

Anaemia

212

9.8

Hypertension

96

5.0

Hypertension

102

6.7

CVA

108

5.0

HIV Infection

73

3.8

CVA

96

6.3

HIV/AIDS

89

4.1

Gastro Enteritis

68

3.5

HIV Infection

83

5.5

Hypertension

86

4.0

Pneumonia

55

2.9

Diabetes Mellitus

61

4.0

Pneumonia

81

3.7

CVA

52

2.7

Pneumonia

55

3.6

Diarrhoea Diseases

69

3.2

Hepatitis

38

2.0

Cirrhosis of Liver

42

2.8

Septicaemia

56

2.6

Diabetes

36

1.9

Gastro Enteritis

39

2.6

Diabetes Mellitus

40

1.8

Meningitis

34

1.8

Tuberculosis Pulmonary

32

2.1

Meningitis

30

1.4

All Other Diseases

713

37.1

All Other Diseases

381

25.1

All Other Diseases

1,003

46.3

Total

1,923

100

Total

1519

100.0

TOTAL

2,167

100

 

 

 

 

 

 

PERFORMANCE INDICATORS, 2007 - 2009

Sectorwide Indicators

2007

2008

2009

Total Population

2,399,348

2,476,127

2,555,363

Expected pregnancies / children under 1

95,974

99,045

102,215

WIFA

5,758,435

5,942,705

6,132,871

Indicator

 

 

 

Number of Institutional infants deaths

357

310

337

Number of Infants admissions

6,733

5,292

7,459

Number of  under five admissions

 

 

29,500

Number of institutional under five deaths

737

596

715

Number of Under five years who are under weight presenting at facility & Outreach

 

 

 

Total number of outpatient visits

1,727,531

2,190,361

2,534,760

Number of OPD visits by insured clients

862,997

1,330,900

1,663,155

Outpatient visits per capita

0.72

0.88

0.99

Number of cases seen and treated by the CHOs.

85,394

96,366

 

Number of admissions

88,332

93,238

166,211

No. of TB patients Detected

1,761

1,870

1,898

Total number of TB cases on treatment who were cured

809

919

959

No. of  new HIV positive cases diagnosed

1,787

1,404

 

Number of HIV+ cases receiving ARV therapy (cummulative)

338

674

 678

No. of guinea worm cases seen

2

0

0

Number of guinea worm cases contained

2

0

0

No. of AFP cases seen

29

29

21

Total number of malaria cases (OPD)

635,228

645,796

941,897

Total number of admissions due to malaria (all ages)

22,587

24,352

35,847

Total number of deaths due to malaria (all ages)

586

469

519

Total number of admissions due to malaria (under 5 years)

11,041

11,428

17,304

Total number of deaths due to malaria (under 5 years)

328

244

309

Reproductive & Child Health

 

 

 

Number of ANC registrants

87,975

97,892

95,897

Number of clients making 4+ visits

49,501

51,448

62,364

Registrants receiving IPT1

 

60,691

73,067

Registrants receiving IPT2

 

43,373

53,510

Registrants receiving IPT3

 

26,254

33,739

Total Deliveries

46,996

50,056

54,606

Number of deliveries by skilled attendants (by doctors and nurses only)

31,965

38,752

43,741

Number of deliveries by TBAs

15,031

11,304

10,865

Number of maternal deaths (institutional)

108

99

79

Number of institutional maternal deaths audited

73

8

67

Total number of still births

1,176

1,272

1,294

Total number of freshstill births

543

522

473

Number of PNC registrants

36,085

45,209

50,614

Number of Family Planning Acceptors

87,859

113,137

111,925

Total Couple Years of Protection (CYP)

42,410.10

75,021.90

72,787.00

  CHPS

 

 

 

No. of functional CHPS zones

88

92

107

Total population living within functional  CHPS zones

 

 

 

   Child Survival

 

 

 

Number of children immunised BCG

102,610

101,223

102,978

Number of children immunised Penta 1

90,549

87,982

92,641

Number of children immunised Penta 3

89,707

87,711

90,728

Number of children immunised OPV 3

88,834

87,401

90,129

Number of children immunised Measles

87,639

87,606

87,229

 

 

Number of children under 5 years receiving at least 1 dose of Vitamin A

431,292

466,799

428,999

Number of children under 5 using ITN

 

 

 

Clinical Care

 

 

 

Total number of beds

1,973

1,955

2,028

Total admissions

88,332

93,238

166,211

Total Patient-days

305,071

363,557

372,367

Total number of discharges

73,819

100,402

111,617

Total number of deaths

3,007

2,778

2,886

Number of patient days

305,071

363,557

372,367

Major operations performed

 

7,115

8,427

Minor operations performed

 

4,739

7,601

Human Resources for Health

 

 

 

Number of doctors

57

68

71

Number of medical assistants

14

11

36

Number of nurses (all categories)

733

1,210

1,280

Number of midwives

162

132

260

Number of Community resident Nurses (CHOs)

 

 

645

Transport and Estate

 

 

 

Proportion of vehicles road worthy

58

65

70

Number of vehicles from 0-5 years

50

53

22

Number of vehicles from 6-10 years

23

16

37

Number of vehicles  more than 10 years

29

32

18

Proportion of motorbikes road worthy

154

176

216

Number of motorbikes 0-3 years old

149

165

425

Number of motorbikes 4-5 years old

21

24

118

Number of motorbikes more than 5 years old

80

88

74