Kadjebi District Assembly Annual Progress Report for 2016

KADJEBI DISTRICT ASSEMBLY

IMPLEMENTATION OF DISTRICT MEDIUM-TERM DEVELOPMENT PLAN (2014-2017)

ANNUAL PROGRESS REPORT FOR 2016

PREPARED BY: DISTRICT PLANNING COORDINATING UNIT TABLE CONTENTS PAGE 1

CHAPTER ONE 1.0 VISION ……………………………………………………………………………..2 1.1 MISSION ……………………………………………………….. …………………2 1.2 PROFILE……………………………………………………………………………2 CHAPTER TWO………………………………………………… ………………....3 2.1 Introduction……………………………………………….…………………………..3 2.2 Status of Implementation ………………………………….…………………………4 2.2 Purpose of the Quarterly Report …………………...……………………………….3-4 2.3 Processes involved …………………………………...……………………………….4 2.4 Challenges Encountered ………………………………….…………………………..4 2.5Progress report activities (M&E)………………………….………………………..5-6 2.6 Sources and Disbursement of Funds ……………………………………………….7 2.7 Internally Generated Funds (IGF)………………………...... 8 2.8 Strategies Adopted To Increase IGF……………………………………………….8 CHAPTER THREE ………………………………………………………………...9 3.0 Updates on Key Developments……………………….………...... 9 3.1 Education …………………………………………….……………………………...9 3 .1.1 Educational Facilities ………………………………….……...... 9 3.1.2 Completed Educational Facilities ………………….……...... 9 3.1.3 First cycle schools …………………………………….…………………………..9 3.1.4 Enrolment by sex in primary schools …………… …….…...... 10 3.1.5Enrolment by sex in junior high schools ……………….…... ………………….10 3.1.6 Second cycle schools ………………………………….………………………...11 3.1.7 Availability of teaching professionals …………………………………………..11 3.2 Health ……………………………………………….……………………………..14 3.2.1 Health facilities ……………………………………………...... 14 3.2.2 Health facilities Kadjebi district …………………..……………………………..14 3.2.3 Under 5 OPD Attendance, Admission and Deaths, 2014-2016 ……………….15 3.2.4OPD Attendance by Facility Type, 2014-2016 (Mid-Year)…………………….16 3.2.5 Top Ten under Five OPD Morbidity 2013-2015 (Mid-Year)………………….17 3.2.6 Health service providers in the district …………………………………………..18 3.2.7 HIV/AIDS report for this quarter ………………………..………………………19 3.2.8 Child Health Services …………………………………………………………..20 3.3.1 District Health Insurance Scheme ………………………..……………………...21 3.4.1 Sanitation ………………………………………………..………………………22 3.4.2 Solid and liquid disposal facilities ……………………….……………………...23 3.4.3 Liquid Waste Management ………………………………………………………23 3.5.1Ghana Youth Entrepreneurial Development Agenda…….……………………….23 3.6.1 Information Service Department ………………………………………………...23 3.7.1Fire service department …………………………………………………………..23 3.8.1 Agriculture……………………………………………………………………….24 3.9.1Town and country planning ……………………………………………………...25 3.9.2National Disaster Management Organization ………………………………..26

CHAPTER ONE

VISION STATEMENT TO BECOME THE BEST MANAGED ASSEMBLY THAT CREATES OPPORTUNITIES FOR HUMAN AND NATURAL RESOURCES DEVELOPMENT IN GHANA

MISSION STATEMENT THE KADJEBI DISTRICT ASSEMBLY EXISTS TO IMPROVE ON THE SOCIO-ECONOMIC WELL –BEING OF HER PEOPLE THROUGH THE PROVISION OF BASIC SOCIAL SERVICES AND THE PROMOTION OF SUSTAINABLE RESOURCE DEVELOPMENT WITHIN THE CONTEXT OF GOVERNANCE

Profile

Kadjebi District Assembly was created as an Assembly by Legislative Instrument (L.I.) 1465 in 1989. After being carved out of the Jasikan district councils. Its capital Kadjebi is located about117 kilometers from Ho the regional capital and 272 kilometers from Accra the national capital. The district has a population of 59,303 with 29,951 males and 29,303 females representing 50.51% 49.49% respectively. Kadjebi District is one of the Twenty –five among the two hundred and thirty seven administrative districts of the Volta Region and Ghana respectively. It has a land area of 949 km2.and lies within longitudes 0.15E and 15.35W and latitudes 7.45N and 6.15S located in the south of the northern belt of the Volta Region of Ghana and forms part of the six (6) northern districts of the Region. It is bordered to the North by the Nkwanta District, to the South by the Jasikan District, to the West by Krachi East. Kadjebi district has Ghana’s International border with the Republic of Togo to the east. The strategic location of the district promotes cross border activities with the republic of Togo. The strategic location of the district promotes cross border

CHAPTER TWO Introduction The Local Government System has taken care of Development Planning System in the local Government Act 462, NDPC Acts 479 and 480 which mandates all Metropolitan, Municipal And District Assemblies to draw up Developmental Action and strategic revenue generation plans which should reflect on the needs as well as the aspirations of the people, within the prescribed framework and guidelines of the National Development Planning Commission

The 2014 – 2017 Medium Term Development plan has been prepared in response to the New Planning system which seeks to support and anchor the Government’s Decentralization Policy by encouraging a bottom – up approach for achieving grass root participation in planning and decision making.

In view of this the Kadjebi District Assembly’s 2014 – 2017 Medium Team Plan was prepared in the spirit of the GSGDA II and it main focus is to address the economic imbalances, re-stabilizing the economy and placing it on a path of sustained accelerated growth and poverty towards archiving the Millennium Development Goals and middle income status. The objective of the Assembly is to implement the policies and programmers outlined in the plan and at the same time monitor the implementation in order to get feed backs that can be factored into future programmers.

STATUS OF IMPLEMENTATION

The 2016 Annual Progress Report indicates an assessment of the implementation of projects policies and programmes detailed in the medium term development plan of 2014_2017. The MTDP was prepared using the six (6) out of seven (7) thematic areas of the Ghana shared Growth and Development Agenda 2014-2017. These are:

1. Ensuring and Sustaining Macroeconomic Stability. 2. Enhancing Competitiveness of Ghana Private Sector. 3. Accelerated Agricultural Modernization and Sustainable Natural Resource Management. 4. Infrastructure and Human Settlements Development. 5. Human Development, Productivity and Employment. 6. Transparent and Accountable Governance.

Purpose of End-Year Evaluation Report:

The main purpose is to track the process and access the impact of implemented programmes and projects in the District Development Plan (DDP) on specifications and targeted beneficiaries. It also help to access whether or not the developmental goals, objectives and bench marks have met in Annual Composite Action Plan performed from the MTDP of Kadjebi District Assembly. It is to mark out achievements, constraints and challenges to improve in service delivery and resource allocation. It’s also access stakeholder involvement including governmental agencies, development partners, the opinion leaders, traditional activities in the District development process and also helps in the creation of database to guide monitoring and evaluation process.

Processes involved

The preparation of the Progress Report was participatory, in that, stakeholders such as Assembly Members, Traditional Authority NGOs and Heads of Department took part. Series of meeting and working sessions were held with stakeholders and heads of the Decentralized Departments in the district on progress of plan implementation in their sectors. Data were collected and collated from the decentralized department for the report. A draft report was first prepared and a validation meeting was conducted with stakeholders such as the heads of department agencies and the central administration for validation. Comments that came up were incorporated into the report.

Challenges Encountered

There were challenges encountered in the preparation of the report; some of which were: 1. Generally data used to prepare this report were obtained mainly from sectors, departments and agencies, and their responses and collaboration with the DPCU have not been too good. Some departments even failed to submit progress reports required. 2. Inadequate funds to carry out monitoring and evaluation activities on planned projects and programmes 3. Lack of vehicle within the Assembly to serve the DPCU in its monitoring, evaluation and inspection activities 4. Lateness and absenteeism of some heads of decentralized departments, agencies and centralized departments in attending DPCU meetings. 5. Failure of some departmental heads to prepare and submit their quarterly reports. 6. Late submission of quarterly reports from the departments (both Decentralized, agencies and central administration).

Expenditur Expected Project Project Budget Date Contract Fundin e for the Expendi-ture Sector Project Location Contractor Completion Implementation Description/title allocation started Sum g source Reporting to date date Status Period 1 Construction of Health Kadjebi RICHVANTUS 0.00 19/01/12 19/08/14 310,211.29 DDF 0.00 195290.38 95% 1No. ward (phase I) VENTURES 2 Construction of Health Kadjebi SABU DAVE 0.00 10/12/12 10/07/15 251,915.75 DDF 0.00 196283.62 76% 1No. ward (phase CO. LTD II)

3 Construction of Health Dodi Akum CRAVETRS GH. 0.00 May 2013 Sept. 2014 115,262.49 DDF 0.00 109449.36 75% 1No. CHPS LTD compound

4 Construction of Health Kadjebi RICHVANTUS 0.00 10/12/12 12/07/15 245,313.30 DDF 0.00 70% 1No. Theater VENTURES 5 Construction of Health/Di Kadjebi KWAPEADU 451,077.40 08/04/16 08/04/17 451,077.40 DDF 51,950.14 119,611.75 30% Fire/Ambulance saster COMPANY LTD Bay 6 Construction of Education Sumnanten DOMKOF 0.00 May, 2013 Sept. 2013 114,044.6 DDF 0.00 111773.17 100% 1No. 3unit classroom block, 7 Construction of Education E.P Primary SHEF ‘T’ 42,647.50 March Aug. 2015 192,640.60 DDF 42,647.5 192,647.5 100% 1No. 6unit Kadjebi ENTERPRISE 2015 classroom block, office,store,library and staff common room 8 Construction of Health Dodo-Bethel KWAS CO. LTD 40,902.82 Nov.2014 18th July 175,87.199 DACF 16,011.00 150,980.77 100% CHPS Compound 2015 9 Construction of Health Kpompka CANDO 15,741.98 Nov.2014 18th July 2015 167,323.00 DACF 0.00 151,581.02 100% CHPS .Compound CONSTRUCTIO N WORKS LTD 10 Construction of 1 Education Ampeyo SAMAPCO GH 196,887.00 17th 18th July 2015 196,887.00 DACF 10,000.00 10,000.00 25% N0 3 Unit LTD March Classroom office 2015 and store 11 Construction of WASH District wide PRINCE 225,002.50 16th 225,002.50 DACF 0.00 160,000.00 70% 15No. Boreholes MALAIKA March GHANA LTD 2016 5

12 Construction of 1 Education Kosamba DOMKOF. CO 262,252.28 19th 19thFeb 2016 375,252.28 DACF 30,000.00 143000.00 60% N0 6 Unit LTD June.2015 Classroom office and store. 13 Construction of 2 Sanitation Ahamansu & MUTUAL ENDS 16,480 Jan.2015 March 2015 12,480.00 Donor/ 1000.00 16,500.00 70% No. public urinals Dodo-Amanfrom LTD DACF 14 Construction of 1 Education Gyamonome CHRISTLAND 120,992.00 26TH Oct. Jan.2016 190,992.00 DACF 21,055.00 91,055.00 88% No. 3Unit 2015 Classroom Block 15 Construction of 1 Education Poase Cement GUIDLINE ENT. 133,666.56 26TH Nov. June 2016 193,666.56 DACF 25,000.00 85,000.00 100% No. 3Unit 2015 Classroom Block office and store. 16 Construction of Health Goldsmith ABBYKENT. 141,862.05 26th 26th July 2016 177,963.30 DACF 8,898.75 45,000.00 55% CHPS Nov.2015 17 Construction of Health Dapaa KWAS CONST. 118,964.35 8th Dec. 8th Aug. 2016 178,963.60 DACF 23,988.75 83,988.75 100% CHPS 2015 18 Rehabilitation of Education Kadjebi CHRISTLAND 170,617.13 4th April 4th Oct. 2016 170,617.13 DACF 0.00 0.00 0% community library 2016 19 Construction of Health Asato DOMKOF. CO 100,000.00 31st March 31st Sept. 2016 124,515.18 DACF 47,450.00 66,127.28 88% Nurses quarters LTD 2016 Construction of Health Dodo Pepesu DOMKOF. CO 100,000.00 31st March 31st Sept. 2016 126,069.44 DACF 45,602.48 64,512.90 80% Nurses quarters LTD 2016 20 Construction of 1 Education Asuboe GET Fund 4th June GET 100% N0 6 Unit 2014 Fund Classroom office and store. 21 Construction of 1 Education Dodo Amanfrom GET Fund 15th GET No. 3Unit R/C Primary March Fund Classroom Block 2011 office and store. 22 Construction of 1 Education Dodi Papase R/C GET Fund 15th Feb. GET No. 3Unit Primary 2011 Fund Classroom Block office and store

SOURCES AND DISBURESMENT OF FUNDS

(1) District Assemblies Common Fund (DACF)

The DACF is not released quarterly as intended. As at now, some quarters are in arrears making it difficult for the development plans be followed as scheduled. The quarterly DACF releases are also getting smaller and smaller and cannot cater for major projects hence the need to plan bigger projects in phases.

Below is a graphic representation of DACF major expenditure.

Health Education Local Govt

(2) District Development Facility (DDF) District Development Facility (DDF) is assessed on passing the Functional Organization Assessment Tool (FOAT).This fund is supposed to be released annually. This facility has helped in the implementation of huge community projects.

Internally Generated Funds (IGF)

Internally Generated Funds (IGF) are internally made and the amount realized depends on the availability of the various taxes of businesses operations, properties markets and corporate As at September 2016, Two Hundred and Twelve Thousand, One Hundred and Eighty Eight Ghana Cedis Nineteen Pesewas(212,188.19) representing 72.1% of the total 2016 Internally Generated Funds (IGF) budgeted.

Strategies Adopted To Increase IGF . Creating an enabling environment for the growth of taxable businesses . Identifying more taxable businesses . Intensive Public education on the need to pay taxes . Identify and seal leakages of revenue collection . Unannounced verification and inspection by management in markets. . Provide logistics to revenue collectors . Create forum for tax payers to see and feel the benefits of taxes paid . Capacity building for revenue collectors

CHAPTER THREE UPDATES ON KEY DEVELOPMENTS EDUCATION EDUCATION STATISTICS -KADJEBI DISTRICT SCHOOL PUBLIC PRIVATE TOTAL Kindergarten 70 14 84

Primary1 14 83 69 Junior Secondary 37 10 47

Senior Secondary 3 0 3

Kadjebi District Assembly together with other development partners through the various programmes such as the GETFUND, SIF, VIP, GPEG, NGO’s such as World Vision, Action Aid, Plan Ghana among others have built and rehabilitated a significant number of school infrastructure. The Kindergarten schools, the Primary and the Junior Secondary Schools do not have adequate supply of furniture. The infrastructural status of the schools in the district has therefore improved. COMPLETED EDUCATIONAL FACILITIES FOR THE QUARTER The Kadjebi Education Office took delivery of keys to a newly constructed 3 unit classroom, office and store from the District Chief Executive and handed it to a team made up of the PTA Executives, the Moderator and Pastor, Head and teachers of Asato E P Primary school. This facility was constructed after a rainstorm caused total destruction of a 3 unite classroom. The stakeholders of Kadjebi EP Junior High School (PTA Executives Head and teachers, staff of the District Assembly) witnessed handing over the completion of an abandon HIPIC initiated 1 No 6 unit classroom staff common room and office by the District Chief Executive to GES Directorate and to the school management.

First Cycle Schools The first Cycle Educational Institutions in the district comprise of the Primary and Junior secondary Schools. They are also spatially distributed within the eight (8) educational circuits (see table).

Enrolment by sex in Primary Schools in Kadjebi District (2014-16)

C i r c u i t S e x Total % M a l e % Female % Kadjebi 866 14.0 904 16.0 1770 14.8 Poase-Cement 558 9.0 511 9.0 1069 8.9 Dodo-Amanfrom 798 12.9 713 12.3 1511 12.6 Pampawie 689 11.1 669 12.0 1358 11.3 Dodi-Papase 574 9.2 444 8.0 1018 8.5 Ahamansu 684 11.0 624 11.0 1308 10.9 Dzindziso 616 9.9 523 9.0 1139 9.5 Asato 626 10.1 559 10.0 1185 9.9 Private 796 13.0 838 14.4 1634 13.6 T o t a l 6207 100 5785 100 11992 100

Enrolment by sex in Junior High Schools in Kadjebi District (2016

S e x C i r c u i t Total % M a l e % Female %

Kadjebi 429 19.2 383 22. 812 20.5 0 Poase-Cement 206 9.2 132 7.6 338 8.5 Dodo-Amanfro 313 14.0 190 11. 503 12.7 m 0 Pampawie 244 10.9 192 11. 436 11.0 1 Dodi-Papase 197 8.8 168 9.7 365 9.2 Ahamansu 226 10.1 138 8.0 346 8.7 Dzindzso 193 8.7 146 8.4 339 8.6 Asato 216 9.7 145 8.4 361 9.1 Private 206 9.2 240 13. 446 11.3

T o t a l 2230 100 1734 100 3964 100

The District has a small enrolment figure for the Junior High School. In terms of sex composition of students while males form 51.8% of the total population, females constitute only 48.2% even though there has been significant improvement over the past three years.

Second Cycle Schools The whole district has only three (3) Senior High Schools located at Kadjebi/Asato, Dodi-Papase and Ahamansu. The total number of students enrolled in these three (3) schools was 2941 for the 2014/20145academic year.

(i) Low motivation for girls to advance in education

(ii) Early marriages of girls in the district

(iii) High-level poverty levels among parents

Availability of teaching professionals

There are 1235 teachers of varying qualifications teaching in Kindergarten and basic schools in the district. Out of this 276 teach in Kindergartens, 631in the Primary School and 330 in the Junior High School. 132 teachers are currently teaching in the three Senior High Schools. Some schools in the hinterland have staff inadequacy problems. Accommodation for teachers in the district is also a problem. Tables below present the distribution of teachers within the schools in the district.

No. of Teachers in Pre-Schools by Circuit – Kadjebi

District (2016)

C i r c u i t Trained Teachers Un-trained Teachers Total Male Female Male Female Kadjebi 1 14 8 19 42 Dodi-Papase 2 5 4 18 29 Ahamansu 3 4 5 19 31 Dodo-Amanfrom 4 1 6 17 28 Pampawie 1 2 2 24 29 Poase-Cement 2 1 4 14 21 Asato 1 1 4 25 31 Dzindziso 1 2 5 25 33 Private - - 6 24 30 District Total 15 30 46 185 276

Distribution of Teachers in Primary Schools – Kadjebi District (2016)

C i r c u i t Trained Un-trained T o t a l Teachers Teachers Male Female Male Female Kadjebi 19 38 11 7 53 Dodi-Papase 15 8 27 15 74 Ahamansu 16 5 39 13 71 Dodo-Amanfrom 20 5 68 6 94 Pampawie 12 3 35 15 63 Poase-Cement 15 6 37 16 72 Asato 12 4 43 17 70 Dzindziso 13 6 28 25 70 Private - - 42 22 64 District Total 122 75 330 136 641

No and distribution of JHS Teachers – Kadjebi District (2015)

C i r c u i t Trained Teachers Un-trained T o t a l Teachers M a l e Female Male Female Kadjebi 30 19 1 1 51 Dodi-Papase 18 2 6 0 26 Ahamansu 21 1 8 1 31

Dodo-Amanfrom 13 4 10 1 28 Pampawie 17 1 12 4 34 Poase-Cement 17 1 16 4 38 Asato 22 3 19 2 46 Dzindziso 25 3 11 0 39 Private - - 31 6 37 District Total 163 34 114 19 330

HEALTH

Health Facilities The health delivery system in the district is well planned and organized so that communities can access a health facility within the radius of 8 km which is recommended by the Ghana Health Service. Health Facilities in Kadjebi District

Type of Facility Public Private Location Hospital 1 - Dodi-Papase

Health Care 6 - Kadjebi, Pampawie, Dodo-Amanfrom, Dodi-Mempeasem, Poase-Cement, Ahamansu Health Clinic/ 6 - Dodo Pepesu, Wawaso CHPS Dzamlome, Ampeyo ,Asato Maternity Home - 1 Dzindziso

CLINICAL SERVICES

Table 1: OPD Attendance by Insurance and Sex, 2014-2016 (Mid-Year)

Total OPD Year Insured Non-Insured Male Female Attendance

2014 43,565 40182 (92.2%) 3383 (7.8%) 16459(37.8) 27106 (62.2) 2015 33,958 30399 (89.5) 3559(10.5%) 12917 (38.0) 21041 (62.0) 2016 37,210 32580 (87.6) 4630 (12.4) 14091(37.9) 23119 (62.1)

The utilization of mid-year OPD services has been decreased as shown by the total OPD attendance. Total OPD attendance dropped from 43,565 in 2014 to 33,958 in 2015 due to the delay payment of NHIS claims to service providers but in the year 2016, total OPD attendance increased from 33,958 in 2015 to 37,210 in 2016 which represented 8.7%.

Table 2: Under 5 OPD Attendance, Admission and Deaths, 2014-2016 (Mid-Year)

OPD ATTENDANCE ADMISSIONS DEATHS (AFR) AGE GROUPS 2014 2015 2016 2014 2015 2016 2014 2015 2016

0-28 days (Neonatal) 114 160 174 53 48 85 2 9 7

1-11 Months 1,833 1,825 2,071 105 102 123 1 3 3 (Postneonatal) 1-4 Years 8,044 6,976 7,118 551 304 349 2 3 7

Grand Total 9,991 8,961 9,363 709 454 557 5 15 17

Ghana launches a national newborn health strategy and action plan to speed up the reduction of newborn deaths. Launch of national newborn care strategy and action helps bring attention to high neonatal mortality rates in Ghana. In Ghana a newborn dies every fifteen minutes and about 30,000 die annually. Much more, the past ten years have witnessed stagnation in the reduction of newborn deaths. Neonatal death rate of Kadjebi district has increased from 2.45% in 2014 to 11.75% in 2015 and also witness slight declined by 9.27% in 2016 under mid-year review. The district health directorate with collaboration of stake holders is working around the clock to reduce neonatal death by 2% by the end of the year 2016.

Table 4: OPD Attendance by Facility Type, 2014-2016 (Mid-Year)

Facility 2014 % 2015 % 2016 % Hospital 21,166 48.6 14,936 44.0 17,377 46.7 Health Centre’s 18,094 41.5 15,240 44.9 15,527 41.7 Clinics 1,161 2.7 1,093 3.2 1,197 3.2 CHPS 3,144 7.2 2,689 7.9 3,109 8.4 43,565 33,958 37210 Total OPD Attendance

Table 6: OPD Attendance by Facility, 2014-2016 (Mid-Year)

% of % of Total INC/DEC Facility 2014 2015 2016 2015 2015

St. Mary Theresa Hospital 21,166 14,936 17,377 46.7 14.0 Ahamansu Health Centre 2,462 1,739 1,475 4.0 -17.9 Poase Cement Health Centre 1,008 972 869 2.3 -11.9 Dodo Amanfrom Health Centre 2,408 2,453 4,752 12.8 48.4 Pampawie Health Centre 1,383 1,392 605 1.6 -130.1 Kadjebi Health Centre 10,833 8,684 7,826 21.0 -11.0 Faith Maternity Clinic 1,161 1,093 1,197 3.2 8.7 Ampeyo CHPS 200 248 228 0.6 -8.8 Mempeasem CHPS 1,114 812 1,131 3.0 28.2 Pepesu CHPS 1,175 844 451 1.2 -87.1 Dzamlome CHPS 413 305 376 1.0 18.9 Asato CHPS N/A N/A 475 1.3 N/A Wawasu CHPS 242 480 448 1.2 -7.1 Total OPD Attendance 43,565 33,958 37,210 100.00 8.7

Analysis of facilities performance show wide variations as shown in Table 6. All health facilities recorded decrease in OPD attendance, with the exception of St. Mary Theresa Hospital, Dodo Amanfrom Health Centre, Faith Maternity clinic, Mempeasem CHPS, and Dzamlome CHPS.

Table 7: Top Ten Under Five OPD Morbidity 2013-2015 (Mid-Year)

2014 2015 2016 % % % NO. OF OVER NO. OF OVER NO. OF OVER DISEASE CLIENTS TOTAL DISEASE CLIENTS TOTAL DISEASE CLIENTS TOTAL Malaria 5396 36.8 Malaria 3680 27.8 Malaria 3909 24.2 URTI 2672 18.2 URTI 2962 22.4 URTI 2719 16.8 Diarrhoea Diarrhoea Skin Diseases 1406 9.6 Diseases 1709 12.9 Diseases 1849 11.4 Anaemia 1315 9.0 Anaemia 1000 7.6 Anaemia 1576 9.8 Skin Skin Diseases 815 5.6 Diseases 667 5.0 Skin Diseases 868 5.4 Intestinal Intestinal Pneumonia 420 2.9 Worms 626 4.7 Worms 749 4.6 Intestinal Worms 388 2.6 Septiceamia 129 1.0 Septiceamia 126 0.8 Acute Eye Acute Eye Acute Eye Infection 125 0.9 Infection 104 0.8 Infection 109 0.7 Rheumatism & Other Joint Pains 101 0.7 Pneumonia 85 0.6 Ulcer 81 0.5 Home Septiceamia 57 0.4 Injuries 61 0.5 Otitis Media 76 0.5 All Other All Other All Other Diseases 1960 Diseases 2214 Diseases 4097 Total 14655 Total 13237 Total 16159

In 2013, an estimated 62,000 children died in Ghana, with pneumonia and diarrhoea being two of the leading causes of deaths according to Philips African Innovation Hub Study by (Dr.Marten Van Herpen). The prevalence of the malaria cases or condition among the children under five populations in the district is pegged at 24.2% by the end of the year 2016 under half year review. Due to malaria intervention programs in the district, malaria cases had being decreasing consistently from 27.8 in 2015 to 24.2% in 2016 mid- year.

Table 9: Top Ten Causes of Admission, 2014-2016 (Mid-Year)

Disease/Cases Number of Cases Percentage (%) Malaria 440 18.77 Anaemia 152 6.48 Hypertension 76 3.24 Gastroenteritis 70 2.99 Urinary Tract Infection 65 2.77 Gastritis 45 1.92

Incomplete Abortion 44 1.88 Pneumonia 43 1.83 Septicaemia 40 1.71 Hernia 38 1.62 All Other Diseases 1,331 56.78 Total Cases 2,344 100.00

ANTENATAL SERVICES The total number of registrants was 1364(49.6%) and 3,962 attendances with 551(13.9%) making their 4th visits. The average number of visits per client stood at 2.9. In the period, 811(20.5%) pregnant women received TT2+ and out of the total number of registrants 847 (62%) had their Hb checked at various facilities with more than half, i.e. 449(53%) having anaemia. On the other hand 278 pregnant women had their Hb checked at 36 weeks of pregnancy and 62(22.3%) were anaemic. In this mid-year, 151 (7.7%) pregnant women registered in their third Trimester, while 211(5.5%) were teenagers. Pregnant women who received Sulphadoxine Pyrimethamine during the period were as follows; IPT1-839, IPT2-569, IPT3-372, IPT4- 153 and IPT5-35. There was shortage of SP at the district hospital from May and June. SKILLED DELIVERY 774(28.1%) mothers delivered at the various health facilities and out of this number, 82 (10.6%) had Caesarean Section. MORTALITY During the first half of the year there was one (1) maternal death with a ratio of125 PER 100,000 Live Births, 2 infant deaths Rate (7.8‰ LB) and 19(19.6‰ SD) stillbirths were recorded. POSTNATAL CARE A total of 711(25.8%) mothers received postnatal care services at the various health facilities during the period under review. FAMILY PLANNING SERVICES Family planning acceptors stood at 2381 (14.4% of WIFA) as at the end of June 2016 with 1454.3 as Couple Year of Protection. The preferred method accepted was Depo Provera, followed by Implants, Male Condon, then Norigynon with the least being IUD.

HIV/AIDS AND SYPHILIS PREVALENCE RATE MID YEAR 2013-2015

INTRODUCTION

Prevention continues to play a major role in the fight against HIV/AIDS in Kadjebi district as well as in the entire country.

One of the major strategies for prevention is testing and counselling that provides opportunity for individuals to know their HIV status. Many pregnant women during their antenatal service refuse to be tested for reasons best known to them.

The Unit in effort to increase the number of pregnant women tested for HIV will increase the number of testing and counselling units in all health facilities including CHPS zones. Develop a mechanism to ensure there are test kits at the various facilities throughout the year.

PREVENTION OF MOTHER-TO CHILD TRANSMISSION - HIV & SYPHILIS Table 17: Trend of PMTC 2013-2016 (Mid-Year)

INDICATORS Jan-June Jan-June Jan- June Jan- June 2013 2014 2015 2016 NO. OF ANC 736 1332 937 1421 REGISTRANTS NO. TESTED 540 930 925 1434 % TESTED 73.4% 69.8% 98.7% 100.9%

NO. POSITIVE 23 (4.3%) 25 (2.7%) 18 (1.9%) 25(1.7%)

NO. RETESTED 51 POSITIVE AT 34 WEEKS MOTHERS RECEIVING ARV 1 PROPHYLAXIS FROM 14 WEEKS

CHILD HEALTH SERVICES Service Providers within the Kadjebi District 1. Mary Theresa Hospital at Papase 2. Kadjebi Health Centre

Non- Governmental Organization (NGOS) 1. Pillar of Change for the Rights of women and Children 2. Better Life Organizations 3. Pro-Link Community Based Organizations (CBOs) 1. Yaadzomang 2. Hope for long life 3. Adiayepena Development Organization 4. Kadjebi Youth Confident Association of PLWHA 5. Hello The NGOs and CBOs Create awareness on the dangers of HIV AIDS in the form of community Sensitization and also provide limited services through 1. Care and support (Distributing good nutrition and drugs) 2. Distribution of Condoms 3. Training of peer-educators 4. Counseling and testing programmes The Services Providers also gives Anti-retroviral Treatment and Counseling and Testing.

NATIONAL HEALTH INSURANCE AUTHORITY

The Kadjebi District Office of the National Health Insurance has registered 5,087 members comprising, 1,473 new and 3,614 renewed members representing 65% of the third quarter target.

TOTAL HOSPITAL ATTENDANCE Claims submitted for payment by the facilities to the scheme amounted to GHc 514,045.04 for 14,962 members comprising of 4,901 male(33%) and 10,061 female(68%) who attended the various facilities as at the end of September 2016. FINANCE The District office mobilized total premium of GHc18,088.00 in the third quarter. The total IGF was GHc 19,461.00. Total amount of GHc 601,151.22 was paid to service providers in good standing with the scheme. Health institutions providing services under the scheme include: - (i) Dodi-Papase Mary Theresa Hospital

(ii) Kadjebi Health Centre

(iii) Dodo-Amanfrom Health Centre

(iv) Ahamansu Health Centre

(v) Poase-Cement Health Centre

(vi) Mempeasem Health Centre

(vii) Dodo Pepesu CHPS zone

(viii) Dzamlome CHPS

(ix) Pampawie Health Centre

(x) Wawasu CHPS zone

(xi) Ampeyor CHPS

(xii) Asato CHPS

(xiii) Twith Pharmacy

Challenges (1) Lack of office Accommodation (2) Lack of telecommunication network in some communities (3) Lack of District Hospital (4) Inadequate office staff

SANITATION Kadjebi is leading in the region in terms of Community Led Total Sanitation (CLTS) implementation. As at September 2016, 42 communities out of 102 communities triggered were declared ODF. 24 communities are ODF basic waiting for independent verification. Effort to meet 2017 deadline for District wide ODF is on course.

Waste Management covers the collection and proper disposal of both solid and liquid waste is now normal in the Kadjebi District. This is because most people consider the collection and disposal of waste as a social service which should not be paid for. But waste management is provided at a cost. The problem of managing waste in this district which revenue base is low and residents are poor becomes more complex. A survey carried out indicates that 60% of households dispose of Solid Waste at public dumps while 30.5% of households dump solid waste in-discriminately. The survey also reveals that 52.6% of households use the pit latrine, 17.6% of households use the public toilet while 16.1% of households have no disposal facility at all for liquid waste. This situation calls for concerted efforts in the area of waste management to improve sanitary conditions in the communities.

Liquid waste Management

The Public–Private Partnership agreement entered into with the some individuals and Zoomlion to Rehabilitate, Operate and maintain some public toilets has started yielding positive results though slow but sure GHANA YOUTH EMPLOYEMENT AGENCY (YEA)

Ghana Youth Employment Agency (YEA) is functioning under six (6) modules as at now. Result of the national restructuring exercise to make youth learn skills training for development is in course. The seven modules have created 203 jobs under its categories:  Youth in police (YIP) -13  Community Health -88  Youth In Fire -6  Youth in teaching -65  Youth in prison -6  Youth in Arabic Teaching -22  Youth in e-health -3 2. INFORMATION SERVICE DEPARTMENT

 Public sensitization on tax education in the entire district.  .Awareness creation on environmental cleanliness in the District.  Education on government programmes and policies

3. FIRE SERVICE DEPARTMENT

GENERAL

The fourth quarter of 2016 is a very significant phase on the calendar for the Ghana National Fire Service. We have an obligation to ensure that the district is protected from the ravages of fire at all times. In effect the organisation embarked on cogent activities to realize our aim as a security service.

FIRE OPERATIONS Operational duty performed by the service is our mandate as a service and we performed series of activities for the quarter and they are as follows; 1. the turnout time of less than a minute was maintained through the . 2. Response time time to fire scene improved over the period but were seriously challenged with human and vehicular traffic. 3. A total of one (1) fire outbreak was attended for the whole quarter and the estimated cost of damage was reported as GHc 27,267.00

Month Types of fire Number of Number of Cost of

fire(s) casualty damage October Electrical fire 1 - GHø27,267.0 0 November - - - - December - - - - Total - 1 - GHø27,267.0 0

FIRE APPLIANCES AND EQUIPMENT Pier Fire Appliance number DPT F.S. 528 was in commission for the whole quarter. HYDRANT INSPECTION AND MONITORING The available hydrant for the station is currently faulty and it has been in that state for the whole quarter. For the quarter under review,the station has relied on priming from the water bodies and also replenishing from a hydrant at Jasikan. This condition poses a challenge to fire fighting operations.

RESCURE OPERATION There was no rescue operation recorded for the quarter under review. TRAINING (a) Training is organize on regular basis to quip personnel with the requisite skills for fire fighting.

Maintenance of the fire appliance was not carried out during the quarter

FINANCE AND ADMINISTRATION STAFF ANALYST FOR THE QUARTER

The total strength of staff at the station for the quarter was fifteen (15). This comprises fourteen (14) males and one (1) female out of these, three (3) are senior officers and twelve (12) are junior officers.

RURAL FIRE

Whiles we are edging closer to the harmatten season, there was the need for education to be intensified to create awareness to farmers for them to protect their properties. In view of this, there is a complete plan for the department to work on, within the quarter but efforts are truncated because of funding for the department. There was no record of bushfire campaign within the quarter under review.

CHALLEGES FIRE OPERATIONS

 The hydrant for the service at Kadjebi was faulty.

THE ADMINISTRATION AND FINANCE  There was lack of adequate office equipment for its operations, for example A4 sheets, photocopy machine and stapler machine etc.  The sign board for the Fire Service Kadjebi is damaged.  There was inadequate funding for safety budgeted activities for the next quarter.

SAFETY DEPARTMENT  The recommendations stated in fire audit report for the various institutions were bt complied with.  There was unavailability of conveying vans to the deprived zones of the district to create awareness on fire safety tips.  There were no no funds to pay the fire inspectors who are engaged to educate the rural dwellers on standard safety practices  There were inadequate material resources for the department.

RURAL FIRE  There was o sponsor for any bushfire campaign for the quarter under review.  There was inadequate logistics for fire volunteers within the various communities.

RECOMMENDATIONS  Three (3) fire hydrants should be set up to improve our access to water when the need be.  District Assembly and other stakeholders should provide us with ready assistance in the fueling of the tender because of our area of coverage. 24

 The funding of the campaign programmes for safety and bushfire department should be made readily available to facilitate their activities.  The stakeholders and other agencies with the capacity to support this worthy course should help the service in motivating the personnel who are engaged to educate the rural folks on fire prevention.  There should be availability of vans from the district assembly to aid our transport to those remote areas in the district.  The District Assembly should speed up work for the ongoing project for the service and also financial assistance should be provided to ease up debt owed to Electricity Company of Ghana (ECG).

It is our hope that if these recommendations contained in this report are adhered to, the development of the service will be realized.

4. AGRICULTURE Agriculture production is the predominant sector of the District Economy in terms of employment opportunities and incomes. The residents of the district who are predominantly rural provide the maximum contribution to the district’s share of food security. Agriculture production is small-scale but high yields due to good soils and rain fall Food and Crops Production The cultivation of crops in the Kadjebi District includes Food and Cash crops. Food crops produced in the district are mainly: maize, plantain, cassava, rice, cocoyam and yam. “They constitute the staple food crops in the district. The major producing areas of these crops are as shown below: - Cassava : Dodo-Amanfrom, Papase, Pepesu, Gyamonome, Ahamansu, Kosamba, Kadjebi, Dapaa and Koru

Plantain : Asato Traditional Area, Papase, Ampeyo, Kadjebi and Dodo-Amanfrom Cocoyam : Ampeyo, Asato Traditional Area, Papase, Kadjebi, Dodo-Amanfrom, Pampawie and Poase- Cement Maize : Kadjebi, Ahamansu, Titiaka, Menusu Rice : Kadjebi

Yam : Cultivated in Dodo Tamale, Koru, Kadjebi The total Agricultural land area in the district is 496,573 acres of which only 2372 acres were cultivated under various food crops in 2014.

Agro Processing Oil palm, paddy rice and cassava remain the main agricultural produce which are processed in the district Oil Palm Volta Red is a major processing company located at Ahamansu Junction that processes its own over 71 tons of palm fruits a week from the company’s plantations at Dodi -Papase in the Kadjebi district and Abubruwa in the Nkwanta South district and over 16 tons from out growers all over the districts. Palm processing into red palm (dzomi) and palm kernel oil on small scale basis is widespread everywhere in the district by women on either individual or groups.

Rice Processing Mills Rice mills are located in the rice producing areas of Kadjebi and Ahamansu which remain the major rice producing areas. There exists rice farms in other parts of the district that send there produce for processing at Kadjebi. Cassava Processing Equipment Kadjebi District Assembly in partnership with the European Union provided cassava processing equipment, 8hp diesel engine, sealing machine for the Issorwazina farming & Processing Group. Cassava processing is a major domestic industry all over the district by women especially

5. CO-OPERATIVE DEPARTMENT

 Organization and formation of co-operative societies.  Support co-operative societies in registration  General education on the need to form co-operatives

7. TOWN AND COUNTRY PLANNING DEPARTMENT The Kadjebi District Town and Country Planning Department is generally responsible for planning our communities and formulating policies on human settlement and other related issues The department in Kadjebi district is overwhelmed with street naming and house numbering activities, educating prospective land lords on preparatory stages of putting up a building as well as sitting of buildings .The department is seriously

26 scrutinizing the inclusion of sanitation facilities and enforcing the implementation of plans submitted for approval on the ground. The department is into public sensitization on the importance of getting permits before building, drawing of district population distribution map education on and provision of assess roads in Communities and town

8. FORESTRY SERVICES DIVISION

 Education on protection of the forest resources.  Construction of fire belts.  Sensitization of wild fire.  The need of planting of trees to help combat climate change

9. NATIONAL DISASTER MANAGEMENT ORGANIZATION

The national disaster management organization experienced an eventful quarter as stormy rainfalls resulting in rainstorm disaster at Dzindzisu blew off the roofs of a few buildings. This reignited the education on disaster prevention .this followed with the distribution of teak tree seedlings from their nursery at Menusu.