ANNUAL PROGRESS REPORT

OF THE

NANUMBA SOUTH DISTRICT ASSEMBLY

FEBRUARY, 2017

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Table of Contents Table of Contents ...... 2 CHAPTER ONE ...... 4 1.1 INTRODUCTION ...... 4 1.2 PURPOSE OF THE ANNUAL PROGRESS REPORT ...... 4 1.3 MONITORING AND EVALUATION (M&E) ...... 4 1.4 PROCESSES INVOLVED IN PREPARING THE REPORT ...... 5 1.5. BRIEF PROFILE OF THE DISTRICT ...... 5 1.5.1 LOCATION AND SIZE ...... 5 1.5.2 Climate ...... 5 1.5.3 Vegetation and Drainage ...... 6 1.5.4 Population size and growth rate ...... 6 1.5.5 Spatial distribution and density of population ...... 6 1.5.6 Household Sizes/Characteristics ...... 6 1.5.7 Religious Composition ...... 6 1.5.8 Age and Sex Composition ...... 6 1.5.9 Occupation Distribution ...... 6 1.5.10 Ethnic diversity ...... 7 1.5.11 Agriculture...... 7 1.5.12 Governance ...... 7 1.5.13 Manufacturing ...... 7 1.5.14 Tourism ...... 8 CHAPTER TWO (2) ...... 9 2.1 STATUS OF IMPLEMENTATION OF DEVELOPMENT PROJECTS IN THE 2016 ANNUAL ACTION PLAN (AAP) ...... 9 2.2 HEALTH ...... 14 2.2.1: MAJOR CONCERNS AT THE BEGINNING OF THE YEAR ...... 14 2.2.2: KEY PRIORITIES ...... 14 2.2.3: SUMMARY OF ACTIVITIES PLANNED AND IMPLEMENTED ...... 15 2.2.4: EXPANDED PROGRAMME ON IMMUNIZATION (ROUTINE) ...... 15 2.2.5: TUBERCULOSIS CONTROL PROGRAMME (TBCP) ...... 16 2.2.6: POLIO ERADICATION (NIDS) ...... 16 2.2.7: MALARIA CONTROL PROGRAMME ...... 16 2.2.8: ANTENATAL CARE (ANC) ...... 16

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2.2.9: ANEMIA IN PREGNANCY ...... 17 2.2.10: MEASURES IN PLACE TO CURB ANAEMIA IN PREGNANCY ...... 17 2.2.11: NUTRITION ...... 17 2.2.12: OTHER NUTRITION INTERVENTIONS ...... 18 2.3 AGRICULTURE...... 18 2.4: OTHER DEVELOPMENT PROJECTS ...... 19 2.4.1 SCHOOL FEEDING PROGRAMME ...... 19 2.4.2 COMMUNITY DEVELOPMENT AND SOCIAL WELFARE ...... 20 2.4.3. DISABILITY FUND ...... 20 2.4.4 RESILIENCY IN NORTHERN GHANA (RING) ...... 20 2.4.5 NORTHERN REGIONAL ACCELERATED SANITATION PLAN ...... 21 2.5 GENDER ISSUES RAISED AND ANALYSED IN THE PROJECTS ...... 21 2.6 PROJECT SELECTION STAGE ...... 22 2.7 PROJECT IMPLEMENTATION STAGE ...... 22 2.8 CAPACITY BUILDING ...... 22 2.9 MONITORING AND EVALUATION ...... 30 2.10 IMPACT OF MONITORING AND LESSONS LEARNT ...... 30 2.11 ENVIRONMENTAL ISSUES ADDRESSED ...... 30 2.12 CONSTRAINTS AND CHALLENGES ...... 31 2.13 THE WAY FORWARD ...... 31

List of Tables

Table 2.1: Annual Progress Report under the District Development Facility (DDF) ...... 9

Table 2.2: Annual Progress Report under the District Assembly Common Fund (DACF) ..... 11

Table 2.3: Annual Progress Report of other Development Projects (NORST, GSOP and others) ...... 12

Table 2.4: Safe Motherhood Indicators 2014-2016 ...... 17

Table 2.5: List of Schools under the Ghana School Feeding Programme with their Corresponding Enrollments ...... 19

Table 2.7 Learning, Training and Development Plan ...... 23

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CHAPTER ONE

1.1 INTRODUCTION Significant resources are committed by Government and Development Partners in respect of various development interventions designed to improve the socio-economic conditions of the citizenry across the country. In the light of this, the Annual Progress Report (APR) is designed to showcase the status of implementation of the 2016 Annual Action Plan (AAP) of the 2014- 2017 Medium Term National Development Plan of the Assembly (NSDA) in line with the Ghana Shared Growth and Development Agenda II (GSGDA II) Policy Framework. The Overall focus of the GSGDA II is targeted at accelerating employment creation and income generation for poverty reduction and shared growth. Policy measures identified to achieve this overall goal are prioritized in seven (7) thematic areas namely:

1. Ensuring and sustaining macroeconomic stability 2. Enhancing competitiveness of Ghana’s private sector 3. Accelerated agricultural modernisation and sustainable natural resource management 4. Oil and gas development 5. Infrastructure and human settlements development 6. Human development, productivity and employment and 7. Transparent and Accountable Governance

The preparation of the 2016 APR is in line with the assessment of status of targets and indicators adopted for monitoring the progress of key policy and programme interventions undertaken by the NSDA as at 31st December, 2016. The report has been prepared based on the Guidelines issued by the NDPC.

In the light of this, the Assembly prepared the report in fulfilment of the requirements of the NDPC Guidelines as well as a tool for monitoring and evaluating its programmes, projects and activities outlined in its 2016 AAP.

1.2 PURPOSE OF THE ANNUAL PROGRESS REPORT The APR is to provide relevant information to government and development partners on the impact of the resources they commit in support of various development interventions designed to improve the socio-economic conditions of the people in the district. Again, it is to enable the District Assembly provide requisite information to stakeholders and other development partners on the status of implementation of the 2016 AAP of the District Assembly. These were made possible through effective Monitoring and Evaluation (M&E).

1.3 MONITORING AND EVALUATION (M&E) The District Assembly has a project monitoring team that conforms to the guidelines of the National Development Planning Commission (NDPC). They include the following:

 District Coordinating Director  District Planning Officer  District Budget Officer  District Works Engineer  District finance Officer

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 Gender Desk officer  Chairman of works Sub-Committee

In addition to the M&E team, the Sector Heads of beneficiary departments such as GES, GHS, and MoFA as well as Assembly person(s) of project(s) beneficiary community(ies) took part in monitoring visits embarked upon by the team.

Chiefs, Opinion leaders, representatives of women’s organizations as well as youth leaders within the various beneficiary communities were involved in projects monitoring.

1.4 PROCESSES INVOLVED IN PREPARING THE REPORT The preparation of the report was done in a participatory manner with the involvement of all key stakeholders especially Heads of Departments (HODs) of the Assembly, members of beneficiary communities among others.

In preparing the report, we captured inputs from, Assembly members, partner NGOs and other development partners. The DPCU relied on the M&E plan of the Assembly and collected data for the report.

1.5. BRIEF PROFILE OF THE DISTRICT

1.5.1 LOCATION AND SIZE Nanumba South District was carved out of the former Nanumba District as one of the twenty eight (28) newly created districts and was inaugurated on 27th August 2004 it is located between Latitude 8.5o N & 9.0o N and Longitude 0.5oE & 0.5oW of the Greenwich Meridian, which more or less divides the district into two parts. The district is found in the eastern corridor of the of Ghana and shares boundaries with District and the Republic of Togo to the east, East Gonja to the west, Nkwanta District of the Volta Region to the south- east, Nanumba North District to the North and District to the south west. The District covers a land mass of 1,789.2 Km Square.

1.5.2 Climate The Nanumba South District lies in the Tropical continental climatic zone with the mid-day sun always overhead. As a result day temperatures are fairly high ranging between 29oC and 41oC and occasionally 45oC.

Like any other part of the West African sub-region, the district is under the influence of the wet southwest monsoon and dry northeast trade winds. The district experiences single maximum rainfall regime throughout the year. The district records a mean annual rainfall of 1200mm most of which falls for six months (May – October) leaving the other half of the year dry i.e. when the region comes under the dry North East Trade winds. During this period evaporation and transpiration are very high, grasses dry out, bush fires become rampant creating acute water shortage. Maximum rainfall records in September with its accompanied windstorms. During this period streams and rivers over flow their banks and a lot of surface run-off.

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The result of this type of rainfall pattern is that there is a single cropping season, as most farmers in the district run rain-fed agriculture.

1.5.3 Vegetation and Drainage The vegetation type found in the district is the Guinea-Savannah with tall grass (particularly elephant grass) interspersed with draught and fire resistant trees. Some of the tree species are the shea, dawadawa, a few baobab, etc. Streams and rivers as well as man-made dams and dugouts drain the district. The two main rivers include the Daka, which spans 145km of the western border of the district with East Gonja and the Oti River, which meanders north south across the eastern part of the district with a total of 85 km within the district with their tributaries occasionally breaking into series of pools during the long dry season.

1.5.4 Population size and growth rate The current population of the district is 93,464 (Ghana Statistical Service; 2010 Population and Housing Census) with an annual growth rate of 2.8%. The district has 143 communities.

1.5.5 Spatial distribution and density of population The district has an urban population of 16,712 and 76,752 rural. This makes the district a predominantly rural. The district has a sex ratio of 100.2 and a population density of 52.2. (Ghana Statistical Service; 2010 Population and Housing Census)

1.5.6 Household Sizes/Characteristics The average Household size of the district is 7.9 (Ghana Statistical Service; 2010 Population and Housing Census) due to larger family ties resulting in lower quality of life in most part of the district.

1.5.7 Religious Composition The Religious composition of the district largely gives an indication of ethnicity especially with the dominant groups. Whilst Nanumbas are predominantly Moslems, Konkombas are largely Christians.

1.5.8 Age and Sex Composition The ratio of male to female 50 to 50 and the population is basically youthful with about 52.1% between 0-18 years. As a result there is a slight change in the rate of growth i.e. from 2.8% to 2.7% per annum.

1.5.9 Occupation Distribution Around 85% of the district population engage in agriculture, while 1% in fishery, 3% manufacture, and 11% to other small and informal enterprises. 76.4% of the working population is employed (including self-employment) while 3.6% is unemployed, 20.1% is inactive and 1.5% is in other conditions.

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1.5.10 Ethnic diversity Although the district has a variety of ethnic groups, the dominant ones are the Nanumbas, Konkombas and Basares. There is Bator settlers from the Volta Region found along the Oti River who engage in mainly fishing.

Among the dominant ethnic groups, namely Nanumba and Konkomba, the former is fairly larger in number compared with the latter.

1.5.11 Agriculture The major occupation of the people is agriculture. Conservative indications are that about 85% of the people are in this sector. Crops grown are roots and tubers, cereals, legumes and tree crops such as cashew and teak. The district is a net exporter of legumes and roots & tubers. According to data available, it is clear that Yam, Groundnuts, Maize and Cassava are produced in the district to feed other areas in the country.

1.5.12 Governance The Nanumba South District Assembly established by Legislative Instrument LI 1454 (1988) and later modified by LI 1640 (1998) currently has one (1) constituency, twenty-eight (28) electoral areas, (3) Area Councils and thirty-eight (28) Unit Committees. Staffs of the Area Councils and all Unit Committees are in place.

The lower structures of the Assembly however need more support to function properly in decision-making to give meaning to the decentralisation process.

1.5.13 Manufacturing The manufacturing sector of the district is made up of Agro-processing; black smiting, and casting of cooking pots. (a) The agro-processing sector is made up of: - Oil extraction i.e. groundnut, shea butter - Cassava processing into gari and chips - Rice processing - Akpeteshie distillers and pito brewing. - Food processing (bread baking, chop bar operating, etc).

Closely associated with food processing is grain banking which involves purchase, treatment and storage of cereals and legumes.

(b) Blacksmithing is done to produce tools such as hoe blades cutlasses/knives, sickles, bicycle racks as well as cooking pots.

(c) Smock weaving; dressmaking and tailoring also constitute an important segment of the manufacturing sector in this district.

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1.5.14 Tourism The tourism sector remains unexploited coupled with undeveloped infrastructure. However, the district has a few guesthouses operated by two (2) individuals and the District Assembly, which are woefully inadequate. Tourism potentials that exist in the district include among others: (a) Kukuo scarp and witches shrine, (b) Kpalga Ancient Mosque (Slave Mosque) (c) Fetish Groves - Nakpa-Gbeini Grove has a special water body from which the Nakpa-naa is prohibited from taking a drink or even fish from it. - Dakpam grove noted for wild crocodiles and is significant as far as the Bangyili gate of Nanumba State is concerned. - Dalaayili Grove, where the ‘Damli’, the staff of any enskinned -naa. (d) Juale Defence wall and Gorge on the Oti River. (e) Colonial bunker at . (f) Chieftaincy and traditional festivals.

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CHAPTER TWO (2)

2.1 STATUS OF IMPLEMENTATION OF DEVELOPMENT PROJECTS IN THE 2016 ANNUAL ACTION PLAN (AAP)

Table 2.1: Annual Progress Report under the District Development Facility (DDF) Stage Project Funding Contract Payment Commencement Completion Done No. Detail Location Source Contractor Sum to Date Date Date (%) Status Construction and furnishing of 1 no. 3 unit M/S Jowalsi classroom Kanjo Company 164,979.0 156,730.0 1 block Kura DDF Limited 0 5 08-Mar-16 100 Completed Construction and furnishing of 3 unit M/S classroom Sulmohaq 159,982.0 133,757.7 2 block Baduli DDF Enterprise 0 6 20-Feb-16 100 Completed Furnishing of district court M/S room and Dewubua 3 staff office Wulensi DDF Co. Ltd 82,000.00 77,900.00 20-Feb-16 100 Completed Procurement M/S of 200 no. Damsung 130,000.0 130,000.0 4 8m low Wulensi DDF Ent. Ltd 0 0 20-Feb-16 100 Completed

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tension poles 1,500m (50mm cables) Construction of 1 No. operation Theatre at M/S Wulensi Dewubua 193,456.7 149,414.6 5 Health Centre Wulensi DDF Co. Ltd 0 6 05-Sep-16 80 On-going Rehabilitatio n of Nakpayili - Garikpe - M/S Junior Gunguni Original 6 Feeder Road Garikpe DDF Ent. 80,116.62 76,110.78 14-Nov-16 100 Completed Rehabilitatio n of Bimbilla M/S Naa- - Kpatinga Soore 7 Feeder Roads Kpatinga DDF Enterprise 80,000.00 76,000.00 14-Nov-16 100 Completed Rehabilitatio n of Naabayili - Bandajua - M/S Junior Daalanyili Original 8 Feeder Road Bandajua DDF Ent. 55,000.00 52,250.00 14-Nov-16 100 Completed Rehabilitatio n of Nakpayili - M/S Naa- Monchani Nakpayil Soore 9 Feeder Road i DDF Enterprise 35,002.00 33,251.90 14-Nov-16 100 Completed

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Table 2.2: Annual Progress Report under the District Assembly Common Fund (DACF) No. Location Funding Contractor Contract Payment Commencement Completion Stage Done Project detail Source Sum to Date Date Date 1 Construction and Monchani DACF M/S Naa- 160,990.00 137,644.45 11-Mar-16 20-Mar-16 95 furnishing 1 no. 3 soore Ent unit classroom block

2 Construction of 1 Wulensi DACF M/S 290,201.13 0.00 27-Apr-16 42 No. Store House at Dewubua the District Co. Ltd Assembly

3 Construction of 1 Gunguni DACF M/S 214,302.38 85,424.90 27-Apr-16 85 No. CHPS Dewubua Compound with Co. Ltd ancillary facilities

4 Construction of 1 Gimam DACF M/S Junior 215,657.95 163,900.02 27-Apr-16 48 No. CHPS Original Compound with Ent. ancillary facilities

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Table 2.3: Annual Progress Report of other Development Projects (NORST, GSOP and others) No. Project Detail Location Funding Contractor Contract Payment Commencement Completion Stage Status Source Sum to Date Date Date Done 1 Rehabilitation Juali GSOP M/S 269,692.00 110,270.60 50 Completed of 1 No. dug- Lovemark out at Juali Ventures Ltd. 2 Rehabilitation Tampoaya GSOP M/S M. 268,835.85 181,478.03 04-Apr-15 24-Aug-15 75 Completed of 1 No. dug- Taasco out at Ventures Tampoaya 3 Afforestation Kanjo GSOP District 52,859.25 30,715.74 40 On-going project Assembly (Nurturing and management of 20 hectors of cashew tree plantation 4 Afforestation Juali GSOP District 52,859.25 14,038.53 30 On-going project Assembly (Nurturing and management of 20 hectors of cashew tree plantation 5 Afforestation Sakpe GSOP LIPW 55,789.48 97,676.77 12-Sep-15 On-going project (Nurturing and

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management of 8 hectors of mango tree plantation 6 Afforestation Gbungbaliga GSOP LIPW 55,789.48 41,673.99 12-Sep-15 On-going project (Nurturing and management of 8 hectors of mango tree plantation 7 Rehabilitation Koyaja GSOP M/S M. 93,543.95 69,038.39 25-Jan-16 55 On-going of 1 No. Dug- Taasco out at Koyaja Ventures 8 Spot Chichagi GSOP M/S Daa- 162,698.95 108,675.00 25-Jan-16 65 Completed improvement Dingbe Co. of Chichagi- Ltd Pudua feeder road 9 Drilling of 7 Different Locations MP's M/S Naa 74,680.00 41,090.05 15-Jun-16 On-going No. boreholes Common Sei Express in Kanjo Fund Ent. Kura, Likanbol, Kpalin, Kalakpi, Tinawando, Ngerigmado, Opidua

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2.2 HEALTH

2.2.1: MAJOR CONCERNS AT THE BEGINNING OF THE YEAR 1. High Defaulter rate (CMAM), 2. Low cure rate(CMAM) 3. Low detection rate(CMAM) 4. Lack of standard CMAM Register and CWC register for 0-24months 5. Low coverage of children 12-59months during growth monitoring and promotion. 6. Lack of standard tally books for GMP. 7. Low coverage of Vitamin A supplementation for children 12-59 months 8. To achieve 100% coverage in all antigen by the end of the year 9. To ensure daily records reviews in all facilities 10. To organize integrated monitoring and supervision to facilities and outreach points 11. To organize at least one mop up each quarter of the year 12. To improve surveillance system for all epidemic prone diseases 13. To achieve 100% reportage for CBS 14. To continually put guinea worm under active surveillance 15. To increase TB notification and case detection and ensure 100% cure rate 16. To ensure timeliness and completeness of all reports 17. Low family planning acceptor rate. 18. Inadequate midwives.

2.2.2: KEY PRIORITIES 1. To increase Family planning acceptor rate from 15.4% to 40% 2. To increase supervised deliveries from 24.2 to 30% 3. To conduct cooking food demonstration in 15 selected communities. 4. To increase case detection rate by Strengthening and improving community based Management of Severe Acute Malnutrition (CMAM). 5. To achieve the 75% cure rate, <15% defaulter rate and <10% death rate in CMAM 6. To Strengthen nutrition communication (IYCF counseling) targeting the first 1000 days of life and micronutrient malnutrition; – Vitamin A deficiency – Iodine Deficiency Disorders – Worm infestations 7. Intensify efforts in anemia control in Pregnant women, adolescents, Pre School children and Children of School Going Age 8. Engage some communities on the utilization of OFSP and locally available nutritious food through food demonstrations. 9. To improve selected low coverage indicators through quality improvement training 10. Intensify supportive supervision to all health facilities to improve upon service delivery and Data Management 11. Conduct routine quarterly integrated monitoring and supportive supervision in all the health facility and follow-up visit 12. To increase access to health services by rolling out more CHPS programme and strengthening clinical management and prevention of diseases at community level. 13. To train 25 health staff and Volunteers on C-IYCF 14. Formation of C-IYCF and ENAs in all sub districts and community engagement.

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15. Reduce malnutrition and micro nutrient deficiencies by promoting good nutrition, Exclusive Breastfeeding. 16. To maintain and improve upon routine EPI coverage at all levels. 17. To ensure 100% cure rate of all identified TB clients. 18. To investigate all epidemic prone diseases.

2.2.3: SUMMARY OF ACTIVITIES PLANNED AND IMPLEMENTED 1. 20 health staff trained on C-IYCF 2. 17 support group facilitators trained on C-IYCF 3. Food demonstration conducted in 15 communities with 361 active participants 4. 27 health staff trained on anaemia preventions and treatment 5. 97 CHV trained on anaemia preventions, Identification and referral 6. 27 health staff trained on CMAM 7. 98 CHV Trained on CMAM 8. 14 non-health staff trained on ENA 9. Video Advocacy on stunting in all the five sub-districts with 169 participants. 10. Mass Media campaigns (health durbars on ENA) in 15 communities with 2702 participants reached. 11. 51 health staff benefited on quality improvement training. 12. 45 health staff both benefited on Baby friendly hospital initiative training. 13. 30 health staff trained on Bottleneck Analysis training on Vitamin A supplementation. 14. Integrated quarterly supportive monitoring and coaching for both staff and CHV. 15. health staff trained on outreach planning and data utilization 16. Home visiting and defaulter tracing carried out 17. 65 Health staff trained on malaria case management 18. LLINs point mass distribution campaign – 2016 19. Reporting and investigation of suspected cases in the district. 20. Training and sensitization of CBS volunteers on integrated disease surveillance and response during MenA campaign 21. One (1) TB quarterly review meeting. 22. 3 Integrated monitoring and supervision carried out. 23. Celebrated National immunization day’s campaign 24. Celebrated Child health promotion week 25. Conducted one Mini mass vaccination exercise 26. Family planning sensitization meetings in 15 communities

2.2.4: EXPANDED PROGRAMME ON IMMUNIZATION (ROUTINE) Expanded programme on immunization (EPI) has proved as mainstay in the primary health care strategy. It is a cost-efficient intervention that prevents thirteen (13) common childhood diseases; poliomyelitis, measles, diphtheria, neonatal tetanus, whooping cough, tuberculosis, hepatitis B, haemophilus influenza type B, diarrhoea, yellow fever, rubella, meningitis and pneumonia.

EPI is not only important because it seeks to prevent child mortality and morbidity due to vaccine preventable infections but it is also an important entry point for many significant public

APR/NSDA/2016 15 | P a g e health interventions within the communities such as vitamin A supplementation, growth monitoring, birth registration, deworming and many others.

2.2.5: TUBERCULOSIS CONTROL PROGRAMME (TBCP) The district has no laboratory facilities to diagnose Tuberculosis, hence specimens of suspected TB patients are sent to either Kpandai or Bimbilla hospital for investigation where facilities are available for diagnosis.

Health education and promotion on TB at both outreach and static points were carried out, creating awareness on the signs and symptoms of the disease, its mode of transmission and prevention and also the need for early treatment. It is also emphasized that the disease is curable and at the same time preventable by vaccine during early childhood immunization. Quarterly review meetings were held. During the period under review, four TB cases were identified and kept on treatment from a total of 15 suspected cases.

2.2.6: POLIO ERADICATION (NIDS) For the year under review National Immunization Days (NIDs) campaign was not organized. NIDs are supplemental immunization activities which serve to complement the routine immunization that is not able to achieve 100% coverage. The NIDs are done vigorously in house- house and has the potentials to cover all the children between 0-59 months who are not reached due to geographical accessibility in a single campaign.

During the NIDs, Acute Flaccid Paralysis (AFP) surveillance are activated into full gear, systems are put in place to actively look for and investigate all AFP cases. Despite the fact that NIDs were not organized this year, the IDSR was able to pick up two (2) AFP cases from the Nakpayili sub-district and 60-days follow up has since been carried out on the cases.

2.2.7: MALARIA CONTROL PROGRAMME In Ghana, malaria kills more children than any other disease; most children who die of convulsions and anaemia (Haemoglobin content) have actually died of malaria. Malaria is an acute illness caused by malaria parasite. Human beings are affected through the bite of an infected female Anopheles mosquito. There are many types other types of mosquito; some that bite in the daytime and those in the early evening. These categories of mosquito do not transmit the malaria parasite.

To ensure that everybody is prevented from getting malaria, Ghana aim is to continuously make LLINs available at our Health post to households through the distribution to an individual ANC registrants and children due for measles 2 doses.

2.2.8: ANTENATAL CARE (ANC) Antenatal care refers to the care that a woman receives during pregnancy which helps to ensure healthy outcomes for women and new-borns. Antenatal care is a key entry point for pregnant women to receive a broad range of health promotion and preventive services. They include nutritional support, prevention and treatment of anaemia, early detection and treatment of

APR/NSDA/2016 16 | P a g e malaria, provision of ITNs, prevention of sexually transmitted infections, HIV/AIDs counselling and testing and tetanus toxoid immunization.

Table 2.4: Safe Motherhood Indicators 2014-2016 INDICATORS 2014 %COV 2015 %COV 2016 %COV ANC REGIST. 94.6 3,968 3,710 86.02 3446 78.0

4+ VISITS 2,024 48.3 1,926 44.7 2409 54.3 TT2+ 3,603 86.0 3,605 83.6 3074 69.3 AV. VISITS 3,576 3.1 3,710 3.0 3446 3.0 ATTENDANCE 10,621 11,287 10194

The district registered a total of 3,446 pregnant women for the period under review which gives a percentage coverage of 77.6% as against 94.6% and 86.02% in 2014 and 2015 which indicates a decrease in ANC registration.

2.2.9: ANEMIA IN PREGNANCY A total of 3,213 pregnant women out of 3,446 ANC registrants had their hemoglobin level checked at registration for the year under review. Out of that number,1526 had their Hb levels less than 11g/dl. Also, 961 had their hemoglobin (Hb) level rechecked at 36 weeks gestational age with 322 of that number having Hb levels less than 11g/dl. However, Hb checked at 28 weeks has not been captured because it was introduced during the fourth quarter of the year under review.

2.2.10: MEASURES IN PLACE TO CURB ANAEMIA IN PREGNANCY A total of twenty-five (25) health staff were trained on the usage of the Hemocue machine to detect hemoglobin levels. This better enables the health staff detect and counsel all anemic expectant mothers as well as mothers with children under five to prevent the Potential Health Complications of Anemia such premature births, low birth weight and Growth Retardation in Infants and young Children. Health Staff were also equipped with skills to enable them give adequate counseling to prevent all forms of malnutrition and ensure adequate growth in children and better outcomes of pregnancy.

Early registration of pregnant women at the Antenatal clinic is also a vital measure as it ensures early and close monitoring, diagnosis and treatment of anemia among pregnant women and hence lowers the risks associated with anemia in pregnancy. Daily iron supplements are usually given at the various antenatal service delivery points to correct mild and moderate anemia. Iron treatment is administered until delivery and continued during the post-partum period.

2.2.11: NUTRITION Despite recent improvement in nutritional status of children in the district, the district still faces nutritional problems, including under nutrition in children less than 5 years of age,

APR/NSDA/2016 17 | P a g e micronutrient deficiencies among women and children, sub-optimal infant and young child feeding (IYCF), and increasing rates of obesity and nutrition-related non-communicable diseases (NCDs). The malnutrition situation in the district is further compounded by problems of food security, food safety, poor hygiene and sanitation, and health care. The deleterious effects of malnutrition include increased risk of illness and death especially in children under five years, which include reduction in cognitive capacity, lowered economic productivity potential, and increased risk of diet-related non-communicable diseases in adulthood.

A wide range of nutrition-specific interventions are currently being implemented by the District Health Administration and partners such as focusing on promotion of women’s nutrition before, during and after pregnancy, optimal breast-feeding including the context of HIV and AIDS, optimal complementary feeding, control of Vitamin A , anaemia and iodine deficiency disorders; public health interventions such as deworming, promoting hygiene and sanitation, school health and nutrition; malaria control; and growth monitoring and counselling.

In addition, nutrition-sensitive interventions related to food security, poverty reduction, hygiene and sanitation, social protection, and health and nutrition education are also being implemented by all the health facilities in the district. Many of these interventions impacts largely to improve child nutrition and there is a strong collaboration and co-ordination with the District Agricultural development unit particularly to ensure nutritious food security for all.

2.2.12: OTHER NUTRITION INTERVENTIONS 1. Cooking Food demonstration conducted in 15 communities with 361 active participants and 869 Observance 2. Cooking demonstrations make good use of locally available food which help mothers learn how to incorporate highly nutritious foods into dishes during the first 1,000 days’ period. 3. The following local dishes were prepared 4. Soya beans “Gambili” 5. Soya fufu and soya light stew 6. Soy bean “Tuo-Zaafi” (TZ) 7. Pamparasa (YAMMA) 8. OFSP(Fried) and eaten with sesame seeds 9. OFSP(Boiled) and Yam slices and soya stew

2.3 AGRICULTURE 1. The District Department of Agricultural undertook a number of activities during the period. These are listed as follows: 2. Conducted a number of home and farm visits 3. Collected, collated and Submitted 12 weekly and one market report 4. Conducted open the bag field days on Purdue Improved Crop Storage bags (PICs) in four communities under the Cowpea Out scaling Project 5. Trained beneficiary households on small ruminant housing, feeding, watering and sanitation as well as the need to patronize veterinary services 6. Trained 9 paravets in small ruminant beneficiary communities 7. Conducted community orientation and group facilitation trainings on soya bean and orange flesh sweet potato (OFSP) production

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8. Trained 14 beneficiary holds in Nasamba on layer poultry management, feeding, watering and disease prevention 9. Supplied Assorted inputs under WAAPP for the production of tomatoes in a greenhouse 10. Ploughed and planted 3 acres of community seed production fields at Yadoya and Nyankpani under the ICRISAT groundnut out scaling programme to enhance community seed production 11. Identified and selected site in Kajeso to undertake a demonstration on soil fertility improvement. 12. Trained 100 farmers on best storage methods under the ADVANCE programme (Wulensi and Kpalsogu) 13. Under GSOP, lined and pegged, dugged and manured 10 hectare plots at Nassamba and chifulni for grafted mango production 14. Supervised the weeding of cashew and mango plantations at Kanjo and Juali and Gbungbaliga, and Sakpe respectively. 15. Trained 30 beneficiary FBO representatives clustered at Kukuo Zone under the Social Investment Fund. 16. Facilitated the establishment of Orange fleshed sweet potato planting materials multiplication site at Kambo

2.4: OTHER DEVELOPMENT PROJECTS

2.4.1 GHANA SCHOOL FEEDING PROGRAMME The programme covers Twenty-Eight (28) schools in the district. A total of Eleven Thousand Nine Hundred and Ninety-Four (11,994) pupils benefited from the programme in 2016. Below are the beneficiary Schools and their enrolment figures (gender disaggregated) as at December, 2016.

Table 2.5: List of Schools under the Ghana School Feeding Programme with their Corresponding Enrollments BOYS GIRLS NUMBER OF S/N NAME OF SCHOOL ENROLMENT 1. Gbungbaliga D/A Primary, 361 341 702 2. Kanjo R/C Primary 397 372 769 3. Nakpayili D/A Primary 242 233 475 4. Wulensi D/A Primary B 243 243 486 5. Lahito Primary 240 278 518 6. Tinageria E/A Primary 143 161 304 7. Saba Primary, Wulensi 245 254 499 8. Gimam No. 1 Primary D/A 250 242 492 9. Tampoaya D/A Primary 283 263 546 10. Tahiriya E/A Primary, Wulensi 223 227 450 11. Nasamba D/A Primary 240 249 489 12. Lungni D/A Primary 216 228 444 13. Pudua D/A Primary 213 141 354 14. Kukuo D/A Primary 198 198 396 15. Juali D/A Primary 146 156 302 16. Kanjo Kuraa Primary 415 302 717

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17. Irshadiya E/A Primary, Wulensi 146 229 375 18. Nabayili D/A Primary 186 194 380 19. Nakpayili E/P Primary 164 155 319 20. Kajesu D/A Primary 159 176 335 21. Moba E/P Primary 109 78 187 22. Chichagi D/A Primary 136 128 264 23. Kpanyansi D/A Primary 180 199 379 24. Lankani E/P Primary 110 138 248 25. Kpabuya D/A Primary 202 184 386 26. Wulensi D/A Primary “A” 155 218 373 27. Lungni D/A Primary “B” 207 200 407 28. Gimam No. 2 D/A Primary 206 192 398 TOTAL 6,015 5,969 11,994

Farmers have benefited from the programme since food stuffs like maize, rice, beans, gari and yam are purchased locally to feed the children. It will be appreciated if more schools in the district could be brought on board.

2.4.2 COMMUNITY DEVELOPMENT AND SOCIAL WELFARE The Community Development unit undertook a number of activities in the course of the year as follows:

1. Organized a training workshop for women and girls to become hygiene, sanitation and hand washing promoters in selected communities 2. Conducted house to house visits in 5 LEAP beneficiary communities 3. Undertook monitoring in collaboration with the Environmental Health Officers (EHOs) in selected CLTS communities 4. The department under social protection increased the number of beneficiaries on LEAP programme in 3o communities in the district through a public information campaign (LEAP Phase 2B)

2.4.3. DISABILITY FUND The district received and applied the disability funds in the following areas: 1. Educational support 2. Support for income generation activities - petty trading, credit retailing, smock weaving, tailoring etc 3. Agriculture – distribution of small ruminants among PWDs

2.4.4 RESILIENCY IN NORTHERN GHANA (RING) Under the programme, the following activities were implemented:

1. Procured and distributed 615 small ruminants to seven (7) beneficiary communities. 2. Installation of 25 hand washing stations in 12 basic schools and 1 public institution. 3. Undertook dry season leafy vegetables cultivation in 5 communities for 534 beneficiary households. 4. Procured and distributed 12 Yamaha motorbikes and crash helmets for decentralized departments.

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5. Assisted the cultivation of nutritious crops, improved grain storage and financial literacy training. 6. Supported C-IYCF training for health staff and community volunteers. 7. Supported the introduction of Village Savings and Loans Associations (VSLAs) in 12 communities and provided financial literacy, group dynamics and business skills trainings. 8. Purchased supplies for borehole repairs and established livestock watering areas in 5 communities (ie repaired broken down boreholes & constructed concrete pads and animal watering troughs). 9. Supported Community Led Total Sanitation (CLTS) activities in 16 communities. 10. Supported the cultivation of Orange Fleshed Sweet Potato (OFSP) in 6 communities 11. Established household water storage systems in 6 communities 12. Undertook food fortification (weanimix using soya beans) in 1 community (Gbungbaliga) 13. Organized training workshop for health workers and volunteers on CMAM 14. Organized training workshop for health workers and volunteers on anemia and support prevention activities in communities 15. Organized community based mass media campaign (health durbars) 16. Supported the roll out of advocacy video on stunting 17. Supported CHPS strengthening activities i.e technical support visits from the District to 10 health facilities 18. Conducted cooking demonstrations on locally available foods 19. Supported training of non-health workers in essential nutrition actions 20. Established 5 demonstration farms in each of the 3 Area Councils 21. Established a poultry farm in Nasamba community women group 22. Supported the cultivation of green leafy vegetables and financial literacy training in 6 communities 23. Supported the cultivation of Orange Fleshed Sweet Potato (OFSP) in 6 communities 24. Supported the strengthening of Area Councils

2.4.5 NORTHERN REGIONAL ACCELERATED SANITATION PLAN The project is an extension of the NORST project that was implanted in the region. It is implanted in seven communities across the district i.e. 2 small towns and 5 rural communities. The District Assembly implements the project in partnership Afram Plains Development Organization (APDO) as project consultant. The activities are mainly on Community Led Total Sanitation (CLTS).

2.5 GENDER ISSUES RAISED AND ANALYSED IN THE PROJECTS The main objective of this process is to ensure that women as well as men issues are integrated into the design, implementation, monitoring, and evaluation of all policies and programmes, so that women and men benefit equally to ensure that inequality is not perpetuated.

The process analyzes the needs, interest perception and opportunity for both men and women in other to reduce their full potentials under the project. The process also informs the key Actors of the project, outcomes and how it will benefit women and men.

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2.6 PROJECT SELECTION STAGE Gender issues were considered during the selection of the projects. One of the gender issues considered during the project selection stage was the need to identify a project that will enhance gender issues, hence the need to select the construction of the three-unit classroom blocks so that School children can be enrolled. This will go a long way to give their parents, especially mothers, ample time to concentrate on their economic activities to gain income, raise household income leading to the reduction of the poverty levels among women.

One of the major problems affecting women in most communities is how to get admission for their children in decent Schools, due to the inadequate School infrastructures in the District.

Another gender issues considered during the selection stage was the need to deal with issues relating to gender parity index, especially at the basic level in the district.

Another gender issues considered was the identification of projects that provide adequate security and protection especially to female pupils during menstrual periods. Hence a significant number of institutional latrines were constructed in selected communities in the district with female changing rooms attached.

2.7 PROJECT IMPLEMENTATION STAGE Community Implementation Committees were formed to assist in the implementation of the projects. Their supervisory and monitoring roles would be emphasized to make sure that they monitor the projects more efficiently.

This participatory monitoring and evaluation approach to project management would be employed to ensure value for money. The committees would be gender sensitive as it would comprise women’s groups and other opinion leaders.

2.8 CAPACITY BUILDING A number of capacity building activities were planned for the year under review. The status of the activities is presented in the table below.

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Table 2.7 Learning, Training and Development Plan NO DEPARTMENT TARGET OBJECTIVES DURATION, NAME OF SOURCE REMARKS GROUP DATE & SERVICE OF VENUE PROVIDER FUNDING Central Assistant To equip officers with 1 Year. GIMPA, DACF Successfully 1.0 Administration Directors Knowledge on Dec 14-Dec Tamale done Administration and 15. Management. Tamale To enhance the Two days Not carried capacities of officers training NSDA/ DDF Out in Local Gov’t programme ILGS, system, code of Tamale conduct & work March, 2016 ethics (service NSDA, protocols) Wulensi

To enable officers Three days NSDA DDF Successfully acquire requisite training Clinton & Carried out skills in the programme Gbangba following: 9-11th Feb Consult Procurement 2016 management, Contract administration and management, Asset management, Records keeping and computing

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Radio operators, To enable officers Successfully Secretaries and acquire requisite Three days implemented Records staff skills in the training NSDA DDF following: programme Clinton & Procurement 9-11th Feb Gbangba management, 2016 Consult Contract administration and administration, Asset management, Records keeping and computing Human Resource To enable officers One-day Local Gov’t DACF Successfully Officer, Heads of acquire knowledge on training Service & Implemented Dept. & Units performance workshop NRCC Management & Staff May,2016 Tamale appraisal. NRCC, Tamale

Sensitization One-day Successfully workshop on the training carried out establishment of a workshop. at Tamale comprehensive & 11th Jan,2016 common Human resource database for all public service employees in Ghana. Planning Officers, To equip officers in Two days DACF Successfully Engineers, Budget the area of proper training Implemented Officers & record keeping and programme Accountants Auditing

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To equip officers with Three days NSDA DDF Successfully the skills/knowledge 9-11th Feb Clinton & Implemented in: 2016 .NSDA- Gbangba Wulensi consult Procurement Management, Contract administration and management, Asset management, Records keeping and computing skills Senior Executive To equip officers with Three days NSDA DDF Successfully Officers the skills in the training Implemented following: programme Clinton & 9-11th Feb Gbangba procurement 2016 consult management, Contract management, Asset management. Records keeping and computing skills

Procurement To equip officer in Successfully Officer Procurement Three days NSDA/ DDF Implemented management, contract 9-11th Clinton & administration and Feb.2016 Gbangba management, NSDA- consult Asset management, Wulensi. Record keeping & computing.

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Department of Community To enhance the Three days UNICEF Successfully 2.0 Social Welfare & Development & capacities of officers training NSDA Implemented community Social Welfare in small towns CLTS Jan,2016 Officers training under the Clinton & accelerated sanitation Gbangba project. Jan –Dec 2016 consult DACF

To equip officers with DCDSW Successfully the requisite skills in Implemented Social protection/LEAP USAID & registration exercise. Three day RING refresher To conduct a training Successfully refresher training for programme. Implemented the staff of Community April- Development and May,2016 Social Welfare DPCU Asst. planning To equip officers with Three days NSDA DDF Successfully 3.0 Officers the requisite skills in training Implemented the following: programme. Clinton & Procurement Gbangba management, 9-11th consult Contract Feb,2016 management, Assets management, Records keeping and computing. USAID & Successfully To enhance the RING carried out capacities of the Area

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Council Staff on the preparation of community Action plans and Area action plans. Heads of To equip officers of Three days NSDA DDF Successfully Departments/Units, DA & Decentralized training Implemented Planning , depts. with the programme. Clinton & Accounts & requisite skills and Gbangba Budget Officers knowledge on the 9-11th consult following: Feb,2016 Procurement management, Contract management, Asset management, Records keeping and computing. Two days USAID & To conduct training training RING programme for the programme staff of Accounts April- Department in the May,2016 area of revenue mobilization.

To equip officers of Successfully Accounts Carried out Department/ Revenue Unit in the area of data gathering and reporting

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4.0 Internal Audit Assistant Internal To enhance the Successfully Unit Auditor capacities of internal Three days Clinton & Carried out auditors in training Gbangba DDF procurement programme. consult management, contract 9-11th Feb management, asset 2016 management, records keeping and computing.

To build capacities of Two days USAID & Successfully officers in the area of training RING Implemented proper record keeping programme and auditing May,2016 5.0 Department of Agricultural To enhance capacities Three days MOFA USAID & Not carried Agriculture Officers of officers with the RING out technical know- August,2016 how/knowledge on the Use of the APS for feed measurement. To equip officers with Seven days MOFA USAID & Not carried the requisite skills and October,2016 RING out knowledge in Monitoring & Evaluation of projects To equip officers with MOFA USAID & Not carried requisite skills on Feb ,2016 RING out ICT. 6.0 Environmental Sanitation To enhance the Two days SNV/RING& Successfully Health Unit /Health Education capacities of officers April ,2016 NORST done Officers in the requisite skills

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To enhance the NRCC DACF Successfully capacities of health Three days done educators in the area training of small towns CLTS workshop. training under the 26-28th accelerated sanitation Jan,2016 project.

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2.9 MONITORING AND EVALUATION The District Assembly has a project monitoring team that conforms to the guidelines of the National development Planning Commission (NDPC). These include the following:

 District Coordinating Director  District Planning Officer  District Budget Officer  District Works Engineer  District finance Officer  Gender Desk officer  Chairman of works Sub-Committee

Besides the above, the Sector Head for any beneficiary department such as the GES, GHS, and MOFA and also the Assembly person for the project community are called to be part of any monitoring visit embarked upon.

The DMT also involves Chiefs, Opinion leaders, and representatives of women’s organization as well as youth leaders within the various beneficiary communities.

2.10 IMPACT OF MONITORING AND LESSONS LEARNT The high level of community participation in the monitoring of the various projects has rekindled the spirit of community ownership and participation in the various communities.

In the case of projects monitoring, the GDO was instrumental in the exercise as he is a member of the District monitoring team. His role was to ensure that gender issues were mainstreamed during projects execution. He thus made sure both men and women were equally represented during site meetings; equal opportunities during recruitment of labour force for a particular project; and equal opportunities to share opinions during community durbars. All these were put in place to mitigate some of the gaps identified in the gender analysis captured in the District profile.

It is therefore hoped that these interventions will help address some of the issues that hinder integrated development as capture in the District profile.

2.11 ENVIRONMENTAL ISSUES ADDRESSED Environmental degradation concerns like flooding, erosion, waste spillage, indiscriminate bush burning and over exploitation of natural resources like forest has been analyzed and would not have any negative effects on the projects.

One main activity to be considered would be the need to plant trees around the Schools and the residential accommodations and their environs to serve as windbreaks during rain storms. This intervention would also create a natural shed for the School children during break hours. This exercise would be carried out by the School children themselves.

Environmental clubs would be established in these Schools to protect the environment through the planting of trees/flowers and the protection of natural resources.

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A number of environmental issues were taken into consideration during the selection stage of the project. Some of the concerns were the project impacts on the natural resources e.g. the forest.

2.12 CONSTRAINTS AND CHALLENGES 1. Inadequate & Late release of funds During projects implementation, the District assembly has been confronted with inadequate funding to meet the pressing demands from the general public, contractors and other decentralized departments. This is partly due to the low revenue generation base of the Assembly.

The late release of funds from Central Government too is yet another challenge and this slows down project implementation.

2. Difficult Access to project sites Most of the feeder roads linking communities to the District Capital are in deplorable state. This makes access to some project sites not only impossible especially in the raining season, but difficult. Unfortunately however, funds are usually released in the second and third quarters of the year when the rainy season is at its peak.

2.13 THE WAY FORWARD 1. Timely Release of Funds Donor and Central Government funds should be released early enough to ensure speedy and timely project implementation.

2. Projects Implementation Implementation of projects in areas/communities that are hard to reach during the rainy season should be deferred to the dry season to ensure smooth execution

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