2012 Holistic Assessment of Health Sector POW - Ministry of Health

Health Objective 3: Improve access to quality maternal, neonatal, child and adolescent health and
nutrition services
The total fertility rate increased from 4.0 to 4.3. Meanwhile the contraceptive prevalence rate for the same
period has improved significantly, increasing to 23.4% from 16.6% in 2008. 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%. 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 MICS gave
the country a skilled attendant at delivery coverage of 68.4%. 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%The national Infant Mortality Rate (IMR)
increased by 6% over the DHS 2008 figure from 50 to 53. IMR is highest in Volta, Upper West, Northern and
Brong-Ahafo Regions. Northern Region and Upper West Region have since 2003 had relatively high U5MR.
Upper West Region has been able to bring down under-five mortality rate by 50%.
Health Objective 4: Intensify prevention and control of communicable and non-communicable diseases
and promote a healthy lifestyle
According to the MICS 2011, use of ITNs has improved by almost 50% since 2008 and the proportion of
children under five sleeping under ITN the previous night has also increased. The national prevalence of
malaria parasitaemia in children aged 6-59 months based on microscopy was 27.5% with the highest
prevalence in Upper West Region (51.2%) and Northern Region (48.3%). Lowest prevalence was recorded in
Greater Accra Region (4.1%). While the national number of expected malaria cases among children has not
dropped significantly, case-fatality of malaria for children under five years has improved, dropping from 1.2
in 2011 to 0.6 in 2012 deaths per 100 confirmed malaria cases.
In 2012 coverage of Penta 3 was 87.8%. The MICS gave the corresponding survey based coverage of 92.1%..
The country continues to maintain surveillance for guinea worm. While the proportion of the population
with access to improved sanitary facilities that are not shared increased, the access to all improved sanitary
facilities, shared and not shared, reduced. TB treatment success went up to 86.2% but the target of 89%
was not achieved. The adverse outcomes reduced from 16.7% to 13.8%.
Health Objective 5: Strengthen institutional care including mental health service delivery
The total number of mental health nurses in the three psychiatric institutions was 1,068. This comprises
both community psychiatric nurses and registered mental nurses. Total number of patients seen during the
year was 67,732. No formal training exists for training community psychiatric nurses. The current crop of
community psychiatric nurses amount to 400 who are registered nurses converted to practice as
community psychiatric nurses.
Institutional infant and under five mortality rates improved significantly in 2012 with more than 50%
reduction in both. Institutional Maternal Mortality (iMMR) dropped significantly from 211 maternal deaths
per 100,000 live births in 2011 to 193 in 2012. While iMMR at Komfo-Anokye Teaching Hospital continued
to be high with 1,252 deaths per 100,000 deliveries, Korle-Bu Teaching hospital reduced institutional
maternal mortality ratio significantly from 1,133 in 2011 to 841 in 2012. The continuous high maternal
mortality ratio at the teaching hospitals calls for stronger and more structured collaboration between the
teaching hospitals and the referring hospitals and clinics at all levels.
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