2012 Holistic Assessment of Health Sector POW - Ministry of Health

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Figure 10: NHIS coverage (active members), 2010-2012, source NHIA 2.3 Health Objective 3: Improve access to quality maternal, neonatal, child and adolescent health and nutrition services 2.3.1 Maternal health The total fertility rate has worsened from 4.0 to 4.3 since the previous survey compared to target of 3.8. Meanwhile the contraceptive prevalence rate for the same period has improved significantly, increasing to 23.4% from 16.6% in 2008. Unmet need for family planning reduced from 34.0% in 2003 to 26.4% in the 2011 MICS. These factors indicate that access to family planning is improving and raise concern that the increase in fertility may be a statistical variation that is not a true reflection of performance, and there might be the need to investigate this further. The consistently increased use of modern family planning methods and reduced unmet need for family planning presented in the surveys is consistent with routine figures from the public sector. While long-term CYP saw minimal increase from 2011 to 2012, short-term CYP increased markedly, and total CYP increased to 1,922,290 years in 2012. Analysis by GHS shows that an increasing proportion of family planning clients are accessing the services from the private sector including pharmacy shops, since this is more convenient for the clients. The non-collection of data from some private facilities, chemical sellers and pharmacy shops can lead to underestimation of routine Family Planning utilisation figures. Some of the long-term methods can only be administered by midwives and doctors. Since both midwives and doctors are likely to be occupied with other activities, these methods cannot be administered to meet the demand. The ministry is currently considering the possibility of shifting the task of administering these long-term family planning methods to other health personnel. Moreover, the calculation and understanding of CYP at the service delivery and data collection points also need to be investigated. 26
The proportion of pregnant women attending four or more antenatal care visits increased slightly to 72.3%. For the 2011 MICS report, the corresponding figure was 86.6%. The definition of this indicator presents challenges for some of the Regions with their figures being consistently above 100%. In the previous review the figures from Ashanti, Brong-Ahafo Volta and Greater Accra were omitted from the Analysis because of these errors. It is only in 2012 that all the regions have been able to get reasonable coverage for this indicator. This shows an improvement in the data quality. Figure 11: Antenatal care registrant and 4+ visits 2008-2012, source GHS Over the past 3 years, supervised delivery coverage has increased by 28.2%, and over the past 5 years by 66.5%. Coverage of supervised deliveries in 2012 was 58.5%, based on the estimated expected delivery of 4% of the population and 77.9% based on 3% estimate. The 58.5% represents a relative increase of 6.7% over 2011. The MICS gave the country a skilled attendant at delivery coverage of 68.4%. With improvement in the data collection on skilled attendant delivery, the routine data will be aligning reasonably well to the survey data from MICS and DHS. The good performance may be attributed to improved financial access from the free maternal health care policy, and improvement in the data collection. 2.3.2 Infant and Child Health The national Infant Mortality Rate (IMR) increased by 6% over the DHS 2008 figure from 50 to 53. This national average does show some large regional variations. IMR is highest in Volta, Upper West, Northern and Brong-Ahafo Regions. The reported trend in Volta and Brong-Ahafo Regions is worrying with significant worsening of IMR. Since 2003, Upper West Region has made an impressive effort to bring IMR down from 105 to 67. AR WR NR BAR CR VR UER UWR ER GAR Ghana DHS 2003 80 66 69 58 50 75 33 105 64 45 64 MICS 2006 72 45 83 88 69 57 68 114 61 60 71 DHS 2008 54 51 70 37 73 37 46 97 53 36 50 MICS 2012 43 50 66 66 55 68 58 67 38 37 53 Table 6: Infant mortality rate 2003 – 2012, source DHS (2003 and 2008) and MICS (2006 and 2012) The under-five mortality rate remained stagnant since 2008. Despite stagnation of national average of under-five mortality rate, significant regional variations occurred. Northern Region and Upper West Region 27
Page 1 and 2: Ministry of Health Ghana Holistic A
Page 3 and 4: List of abbreviations and acronyms
Page 5 and 6: Executive summary The year 2012 rep
Page 7 and 8: 3. Regions of excellence and region
Page 9 and 10: Food and Drugs Authority From the n
Page 11 and 12: Korle-Bu Teaching Hospital The hosp
Page 13 and 14: Introduction The year 2012 represen
Page 15 and 16: 2012 POW 2007 2008 2009 2010 2011 T
Page 17 and 18: Figure 1: Supervised deliveries by
Page 19 and 20: Figure 3: Doctor: population ratios
Page 21 and 22: Figure 5: OPD visits by gender and
Page 23 and 24: Total Gross Revenue, recorded by th
Page 25: 2.2.3 National Health Insurance Act
Page 29 and 30: eastfeeding. There will be the need
Page 31 and 32: 2.5 Health Objective 5: Strengthen
Page 33 and 34: 3.0 Regions of excellence and regio
Page 35 and 36: The development of the health care
Page 37 and 38: such as deep-freezers, chest freeze
Page 39 and 40: plan was finalized and submitted to
Page 41 and 42: • Organization of training progra
Page 43 and 44: ACHIEVEMENTS HO1: Bridging the Equi
Page 45 and 46: Under a programme to prevent, detec
Page 47 and 48: 2010 N=160 2011 N=197 2012 N=165 1
Page 49 and 50: 2012 Achieved 2011 Achieved Patient
Page 51 and 52: Ashanti 5 11 16 Eastern 4 11 15 Cen
Page 53 and 54: • Quality of care challenges •
Page 55 and 56: • The improvement in service outp
Page 57 and 58: 6.0 Follow-up on Aide Memoire recom
Page 59 and 60: OPD The number of outpatients per c
Page 61 and 62: Annex 1: Sector Wide Indicators and
Page 63 and 64: Annex 2: Sector wide indicator tren
Page 65 and 66: The indicator has experienced a rel
Page 67 and 68: Wealth Quintile 2003 2008 2012 Redu
Page 69 and 70: Figure 15: Supervised deliveries by
Page 71 and 72: parts of the region has not benefit
Page 73 and 74: Greater Accra continue to be the Re
Page 75 and 76: 2012 Performance: 38.5% 2012 Target
Page 77 and 78:
Total fertility rate 2012 Performan
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2009 - 59.7% 78.2% - 87.4% 46.9% 71
Page 81 and 82:
Discussion: The slow reduction in t
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Figure 21: Penta 3 coverage by regi
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Source: National TB Programme Outco
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Basket of critical equipment functi
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mortality ratio at all levels of th
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Annex 4: Indicator definitions and
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TB success rate Psychiatric patient
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vulnerable Update National Health A
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Some district assemblies organized
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and Volta 3.2 Reduce the major caus
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Implement national strategic plan t
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atio of 10. 4.2 Improve prevention,
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Bolgatanga Regional Hospital about
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Annex 6: Capital Investment Update
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21 1 Regional Hosp., Ridge Greater
Page 111 and 112:
Dua Yaw Nkwanta PATS Classroom Bloc
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4 Boosting Reproduction and Child H
Page 115 and 116:
Annex 7: Procurement plan Draft 201
Page 117:
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2012 Holistic Assessment of Health Sector POW - Ministry of Health

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