2012 Holistic Assessment of Health Sector POW - Ministry of Health

have since 2003 had relatively high U5MR. While Upper West Region was able to bring down under-five
mortality rate by 50%, Northern Region achieved only limited improvement (Figure 12).
Figure 12: Under 5 mortality by region 2003-2012, source DHS (2003 and 2008) and MICS (2006 and 2012)
With the scale-up of CHPS, increased utilisation of ITNs, high EPI coverage and improving coverage of skilled
deliveries since 2008, the ministry did expect to see an improvement of both IMR and U5MR. The ministry
plans to analyse the underlying data thoroughly to identify reasons for the observed stagnation in child
mortality indicators.
2.3.3 Nutrition
The proportion of children below the age of six months that are exclusively breastfed has significantly
dropped since 2008, and the current performance at 45.7% is below 2003 levels and far below the target of
70%. At district level, health activities to promote good nutrition, including exclusive breastfeeding, have
received decreasing attention over the past years. Because of limited financial and human resources and
since these activities are less integrated into the routine district level activities than for example EPI, the
tendency has reportedly been to give preference to other activities. Moreover, the Ghana Health Service
head quarter’s monitoring and support to regions and districts in the area of nutrition has reduced. Factors
external to the health sector are also likely to have influenced the trend, e.g. increased number of women
engaged in the workforce and behavioural changes as a consequence of economic growth and attainment
of middle-income country status.
The under-five prevalence of low weight for age has reduced slightly to 13.4%. The slow reduction in the
under-five prevalence of low weight for age is a reflection of the low performance of the sector in nutrition
in general. The target of 8.0% is far from being achieved. The coverage of nutrition interventions in the
country is not high. Most of the interventions like community management of acute malnutrition and
community growth promotion cover only few districts and regions. The ministry is concerned about these
trends and will work with its agencies to strengthen nutrition activities and promote exclusive
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