Ministry of Local Government and Rural Development

MINISTRY OF LOCAL GOVERNMENT AND RURAL DEVELOPMENT

REPUBLIC OF GHANA

JAMAN SOUTH DISTRICT ASSEMBLY

ANNUAL PROGRESS REPORT-2014

FEBRUARY, 2015

LIST OF FIGURES AND TABLES………………………………………….....IV

TABLE OF CONTENT CHAPTER ONE ...... 1 1.1 Background /Introduction ...... 1 1.2 Key M & E Objectives...... 3 1.2.1 Method ...... 3 1.2.2 Monitoring & Evaluation Activities ...... 4 1.3 Processes Involved and Difficulties Encountered ...... 4 1.4 Status of Implementation of DMTDP ...... 5 1.4.1 Enhancing Competitiveness in Ghana’s Private Sector ...... 5 1.4.2 Accelerated Agricultural Modernization and Sustainable Natural Resource Management...... 6 1.4.3 Infrastructure, Energy and Human Settlements Development ...... 6 1.4.4 Human Development, Productivity and Employment ...... 6 Education ...... 6 1.4.5 Transparent and Accountable Governance ...... 7 CHAPTER TWO ...... 8 2.1 Detailed M&E Assessment of the DMTDP Implementation on Specific Thematic Policies, Programs and Projects ...... 8 2.2 Enhancing Competitiveness in Ghana’s Private Sector ...... 8 2.2.1 Accesses to Rural Financed (ARF) ...... 8 2.2.2 Business Development Initiatives –Through BAC/NBSSI &GRATIS ...... 9 2.3 Accelerated Agricultural Modernization and Sustainable Natural Resource Management...... 10 2.3.1 Agricultural Extension Services ...... 12 2.3.2 Veterinary Activities ...... 12 2.3.3 National Farmers’ Day Celebration ...... 13 2.4 Infrastructure, Energy and Human Settlements ...... 14 2.4.1 Spatial Development Management Initiative -Street Naming and Property Addressing System ...... 15 2.4.2 Water and Sanitation ...... 15 2.5 Human Resource Development Productivity and Employment ...... 16 2.5.1 EDUCATION ...... 16 2.5.2 Gender Parity Index (GPI) ...... 17 2.5.3 Improvement in the infrastructure of deprived basic schools ...... 18

2.5.4 Improved Quality of Education ...... 18 2.5.5 Pupil: Teacher Ratio (PTR) ...... 19 2.5.6 Educational Sector Major Challenges...... 20 2.6 HEALTH ...... 20 2.7 Transparency and Accountable Governance ...... 38 2.7.1: Financial Decentralization through Composite Budgeting...... 39 CHAPTER THREE ...... 40 3.1: Report on Critical GOG Social Interventions and Poverty Issues ...... 40 3.1.1: Capitation Grant...... 40 3.1.2: Free Rid Mass Transit for School Children ...... 40 3.1.3: Ghana School Feeding Program ...... 40 3.2: Evaluation and Participatory M & E and the Results ...... 40 3.3: Status of the District Mutual Health Insurance Scheme ...... 41 CHAPTER FOUR...... 41 4.1 Update on Funding by Source and Disbursement ...... 41 4.2: Resource Challenges ...... 43 CHAPTER FIVE ...... 44 5.1: Key Issues Addressed ...... 44 5.2: Key Dev’t Issues to be addressed in 2014 ...... 44 5.3 Recommendation ...... 44 5.4 Conclusion ...... 45 Appendix 1: Health Sector performance ...... 46 Appendix 2: Status of development projects as at the end of 2014………………………50

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FIGURES

Figure 1.1: District map of Jaman South……………………………………………………2 Figure 2.1 Comparing Disease Trends for 2012, 2013, 2014……………………………..24 Figure 2.2: NID Coverage …………………………………………………………………..27 Figure 2.3: Total Malaria Cases 2012-2014………………………………………………..29

Figure 2.4: Cases of Malaria Compared With Total LLINs 2014………………………....29

Figure 2.5: HIV/AIDS trends ………………………………………………………...... 31 Figure 2.6: JSDA PPD attendance…………………………………………………………..37

TABLES

Table.2.1 Business development in the district: NBSSI, BAC&GRATIS…………………9 Table 2.2: Summary of activities initiated –MOFA……………………..…………………..11 Table: 2.3 Diseases/ Conditions and Treatments……………………………………………12 Table 2.4: Estimated Productions……………………………………………………………14 Table 2.5: Summary of Indicator achievement in water provision…………………………15 Table 2.6: Summary of Indicator Achievement in Sanitation Management………………. 16 Table 2.7: Trends in gross Enrolment Ratio in Basic Schools-2013/2014………………….17 Table 2.8: Trends in District GPI in Basic Education Sector: 2013-2014…………………..18 Table 2.9: Trends in Improved Basic Education Facilities (Classroom Block): 2014……..18 Table 2.10: Trends in % of trained teachers in Basic Schools 2012/2013 to 2013/ 2014….19 Table 2.11: pupil-teacher Ratio in Basic Schools 2012/2013 to 2013/ 2014……………...19 Table 2.12: Basic Health Indicators, 2013/2014……………………………………………20 Table 2.13: Distribution and location of Health Facilities by Sub-districts…………………21 Table 2.14: Key Areas of interventions – 2014…………………………………..………….21 Table 2.15: Staffing………………………………………………………………………….22 Table 2.16: General Staff Situation…………………………………………………………22 Table 2.17: EPI Achievement by Districts 2012, 2013, 2014 Compared…………………28 Table 2.18: Performance of CBAS 2012-2014………………………………………………30 Table 2.19: HIV/AIDS Trend Compared HTC/PMTCT 2012-2014………………………..31 Table 2.20: HIV/AIDs Testing and Counseling………………………………………….….32 Table 2.21: Analysis of NHIS claims in 2014………………………………………………34 TABLE 2.22: Pledges and Status of Implementation………………………………………………..35 Table 2.23: Mental Health Output …………………………………………………………..37 Table 4.1 Update on funding sources/expenditure………………………………………..43 Table 4.2 Comparative Financial Performance……………………………………………44

CHAPTER ONE

1.1 Background /Introduction The district has a total land area of about 798 square kilometers (km2), which is located between latitudes 7o 35’ N and 7o58’N and longitudes 2o 47’ W and 2o 78’W. It was established by the LI 1777 in 2004, following the split of the then Jaman District into Jaman North and South Districts.

As indicated in figure 1.1, the district shares borders with the Jaman North District in the North, Berekum Municipal in the South-East, Dormaa Municipal in the South -West and La Cote D’Ivoire in the West. The vast land mass of the district couple with its strategic location offer economic opportunities in the area large scale agriculture and a reliable market opportunity for farm produce.

The District Assembly is subdivided into (190) Unit Committees in thirty-nine (39) Electoral Areas grouped into Six (6) Area Councils and two (2) Town Councils. These include:  Drobo Urban Council  Japekrom Town Council  Adamsu Area Council  Zezera Area Council  Kwamesiekrom Area Council  Jenjemireja (JJMJ) Area Council  AtunaArea Council  Dwenem Area Council

Figure 1.1: District map of Jaman South

As required by act 480, the Jaman South District is expected to annually implement and report on key development projects and programs to enhance the wellbeing of the people. Therefore, this document comprises an Annual Progress Report (APR) of Jaman South District. It indicates the status of implementation of development Programs and Projects as captured by District Medium Term Development Plan (DMTDP) for the period of 1st January to December 31st, 2014. Specifically, it is a review of the extent of actions taken on the implementation of projects and programmes as outlined in the district’s 2014 Annual Action Plan.

To a very large extent, this report is a result of data and information compiled from stakeholder monitoring and evaluation of the status of development projects and programmes undertaken by the District in 2014.

1.2 Key M & E Objectives As indicated above, this report is prepared with the sole purpose of providing information on the progress made through the implementation of the 2014 Annual Action Plan. It is to enhance tracking of achievement or the impact of the entire District Medium Term Development Plan 2014– 2017.

Specifically, the following objectives were being sought:  To monitor and evaluate the progress towards the achievement of key targets for the district under the review period.  To evaluate the impact of key programs, projects and policies in the DMTDP.

 Identify challenges or bottlenecks for redress.  To form the basis for decision making

1.2.1 Method Participatory Rural Appraisal (PRA) tools such as check list, FGDs, critical observation, and review of existing departmental reports, etc., were adopted in the process of compiling the report.

1.2.2 Monitoring & Evaluation Activities The performance assessment was based on the thematic areas of the policy framework GSGAD namely: Enhancing Competitiveness in Ghana’s Private Sector, Accelerated Agricultural Modernization and Sustainable Natural Resource Management, Infrastructure and Human Settlements Development, Human Development, Productivity and Employment and Transparent and Accountable Governance.

1.3 Processes Involved and Difficulties Encountered

The document has been prepared by the District Planning Co-ordinating Unit (DPCU) with inputs from very relevant stakeholders and other development NGOS/Civil Society Organizations operating in the District. Monitoring and evaluation data were collected from both primary and secondary sources to assess the development impact of policies, projects and programmes on the target groups.

Quarterly and Annual Reports from Decentralised Departments, Subverted Agencies, Development Partners, Non-Governmental Organisations among others were compiled to serve as secondary data for the preparation of the report. Primary data were obtained through designed questionnaires and interviews with key stakeholders and opinion leaders in the District.

The Monitoring and Evaluation reporting format issued by the NDPC in collaboration with MMDA’s and other stakeholders were sent to all Sector Departments to facilitate data collection and uniformity. Data gathered focused on the core twenty NDPC and District specific indicators and targets identified in the District Monitoring and Evaluation Plan. The District Planning Coordinating Unit collated, analysed and interpreted all data collected from key stakeholders after various review meetings, workshops were held at the District Assembly Hall.

A meeting was held to validate the draft APR, 2014. Comments from the meeting were used to finalise the report. Some challenges were encountered in the preparation of this report. They include;  Inadequate logistical and financial support for effective M & E activities at the District level.

 Inadequate capacity in M & E at MMDA’s and sub-structures.

 Unavailability of established baselines and targets at MMDA’s and national levels, to progress monitoring in all sectors.

 Lack of standardized reporting formats for MMDA’s

 Lack of feedback and incentives to motivate staff in MMDA’s

 Poor road condition and network.

Even though the M & E report format was adopted and sent to Sector Department for reporting, there is the need to synchronised the reporting periods, establish M & E units within MMDA’s and building the capacities of M & E focal persons for effective delivery.

1.4 Status of Implementation of DMTDP In order to have information on the performance of outcomes of policies, programmes and projects as outlined in the DMTDP 2014 – 2017, an M & E system was also developed to facilitate the monitoring of key development indicators of the DMTDP 2014 – 2017. Data gathered through this approach enables a detailed impact assessment of the thematic issues/policies in the following chapter. The approach adopted revealed following data on development initiatives under the various thematic areas;

1.4.1 Enhancing Competitiveness in Ghana’s Private Sector  Const. of Pavement of Lorry Park at Drobo

 Financial Support to the Physically challenge  Supply of Equipment for Street Naming

 Train and enhancing financial and technical capabilities of SME’s  Training of SME’s on Business Management

1.4.2 Accelerated Agricultural Modernization and Sustainable Natural Resource Management  Increase rural farmers’ access to agric extension services and mainstreaming gender in agric.  Disseminate extension information through FBOs  Post-harvest handling training for farmers  Educate farmers on modern methods of agriculture  Yearly Farmers Day Celebration

1.4.3 Infrastructure, Energy and Human Settlements Development  Completion. 10 No. boreholes in 10 communities  Acquisition of 1 No. final disposal site.  Organized Clean Up Exercises on National Sanitation Days  Public Education on environmental health  Expanding Rural Electrification and Street lighting system in the district.  Reshaping of major roads

 Dislodgment of solid waste.

1.4.4 Human Development, Productivity and Employment Education

 Construction of 1 no. 3- Unit classroom Block with ancillary facilities at Ahmadiya Islamic Primary School -Japekrom

 Const. of 1no. 2-unit K.G block with ancillary facilities at Gonasua.

 Const. of ICT Centre at Drobo

 District Assembly support for My First Day in School.

 District Assembly support to district wide mock exams.

Health

 Const. of 1no. 2-unit demonstration Nursing & Midwifery Classroom at Drobo

 Const. 1no. 10-unit Rural Clinic and ancillary facilities at Merimano.

 Expanded program on immunization.

 Monitoring and reporting of AEFI.

 Providing sub district with feedback on their performance.

 Active case search on epidemic prone disease.

 Holding meetings with emergency preparedness committee and stakeholders.

 HIV/AIDS and TB control activities.

 Surveillance activities on guinea worm.

 Safe motherhood including infant / neonatal health.

1.4.5 Transparent and Accountable Governance  Update District Revenue Data and socioeconomic data base.  Cede revenue items to sub-district to enhance their financial needs  Organize training for revenue staff

 Review annual work-plan and budget  Institute effective Project Monitoring and Evaluation system on all on-going projects.  Prudent management of DA resources through budget hearings meetings  Training of Area Council members  Promulgation of by-laws to protect the vulnerable groups  Organize Town hall meetings to disseminate information on government policy framework.  Organize DISEC Meetings to help manage district security issues

CHAPTER TWO

2.1 Detailed M&E Assessment of the DMTDP Implementation on Specific Thematic Policies, Programs and Projects

To enable accurate reporting on the impact of implemented Programmes/Project Status as at December, 2014, the DPCU undertook a critical assessment on all development initiatives over the period. This was done in relation to the goal of the national development policy framework (2014-2017) goal, which seeks to achieve and sustain macroeconomic stability. As at the time of preparing this report a stakeholder performance review was conducted. The outcome of the review served as an input for the assessment. The district’s broad strategic direction focuses on the following themes:

2.2 Enhancing Competitiveness in Ghana’s Private Sector The objective under this thematic area for the year (2014) was to make the private sector the engine of growth of the district’s economy. Special attention was then geared towards building the capacities of the local entrepreneurs in the form of providing the needed support to enhance local businesses growth.

In order to stimulate growth of the sector the district has supported the implementation of the Rural Enterprises Programme (REP) in the district. The programme through the Business Advisory Centre (BAC), Rural Technology Service Centre (RTSC) seeks to develop MSEs in the district in order to;  generate profit,  growth and  Employment opportunities

2.2.1 Accesses to Rural Financed (ARF) Under this component, the Business Advisory Centre (BAC) in collaboration with Drobo Community Bank Limited followed up on clients who have enjoyed the REDF facility from REP to see how they are using the facility to improve their businesses.

2.2.2 Business Development Initiatives –Through BAC/NBSSI &GRATIS Through the EDAIF sensitization on export promotion and business plan preparation for EDAIF selected clients, the Kabile Cooperative Cashew Farmers and Processing Society and Glory Soap and Pomade Learning Centre are now aware of the need to improve the quality and the packaging of their products for export marketing.

Through the collaboration between NBSSI and the Ministry of Gender and Children Protection, the Drobo BAC Head attended a one day workshop on women development which will enable the BAC Office to train and develop women within Jaman South district to improve and expand their businesses which will go a long way to improve their lives and that of their families.

As already indicated earlier, NBSSI supports various small and medium scale businesses in the District. Below is a table indicating the activities of business advisory centre towards business development in the district. Table.2.1 Business development in the district: NBSSI, BAC&GRATIS

Activity Number of beneficiaries Male Female Total Preparatory Technical training: 1. Fasion Design 7 33 40

Management training 9 10 19 Leadership and partnership building Micro credit support 29 36 65 Technical apprentice 8 - 8 NVTI Certification 15 - 15 Source: District Rural Enterprises –BAC, NBSSI& GRATIS FOUDATION -Office. 2014

2.3 Accelerated Agricultural Modernization and Sustainable Natural Resource Management

A number of indicators were adopted for tracking the progress of this theme. It covers the period of January – December 2014. It seeks to outline agricultural situation in the district for the period under review. It provides information on commodity movement, food supply, crop and livestock performance.

It was revealed that there has been an improvement in both food and cash crops production in the District as compared with last year. This been realised as a result of core activities under taken by the District Agricultural Development Unit. These include; Mmonthly Review meetings, constant Field Supervision and Technical meetings to share experiences and discuss technical issues

Table 2.2: Summary of activities initiated -MOFA

Implementation Lessons Time Frame Performance Learnt/ Programme Baseline Expected Actual Output Actual Expected Expected Actual finish status challenges activities Previous Output/ Outcome Start start date finish date year Outcome date Agric. Ext. Agric. Ext. To ensure information flow on 2,592 home/farm visits Insufficient Agent farm / Agent technology practice and to get were made. and late Home visits Farm/Home feed back from farmers Farmers received more release of visit information on improved January January December December 82% funds methods of farming 2014 2014 2014 2014 2. AEA’s AEA’s To equip AEAs with method of AEAs were trained on the Insufficiernt Training Training farming following and late - Proper handling of agro- release of chemicals funds - Post harvest and pepper, maize and cowpea - Pest and disease January January December December 86% identification and control 2014 2014 2014 2014 in cocoa 3. Monitoring Monitoring of To suppervise on-going Insufficient of Youth in Youth in Programmes of youth in and late agriculture agriculture agriculture and activities of the 998 Visits were made. release of fund Programme Programme AEAs January January December December 87% by DDOs 2014 2014 2014 2014

4. Animal Animal Health To ensure that there would be no Livestock farmers were Insufficient Health Extension and disease outbreaks in the district educated on the need to and late Extension Livestock vaccinate their animals release of and disease regularly and to report on funds Livestock surveillance any new disease outbres January January December December 84% disease 2014 2014 2014 2014 surveillance 5. Veterinary Veterinary To ensure that poultry and NCD – 132,889 Insufficient Clinics and Clinics and livestocks in the district would BBPP – 361 funding treatment treatment be vaccinated and treated PPR (goat) – 754 against various diseases PPT (sheep) – 446 January January December December 89% Rabies (dog) – 733 2014 2014 2014 2014 Rabies (cat) – 57

2.3.1 Agricultural Extension Services Agricultural Extension Agents carried out their normal home and farm visits to advise farmers on good agricultural practices alongside with the implementation of Block Farm Programme, Root and Tuber Improvement and Marketing Programme ensuring proper Land and Environmental management. The extension activities carried out in the district during the period under review were on the following;  The use of improved planting materials (maize, cassava, cashew, cocoa, vegetables, etc.) that  The appropriate use of manure and chemical fertilizer application.  Proper handling and correct use of Agro-chemicals.  Carrying out On-Farm Demonstration strategically in five (5) operational areas within the District under the sponsorship of Peace Corp Ghana.  Carrying out of field days  Carrying out farmer fora.  Pruning and thinning of existing cashew farms.  Planting of mucuna to improve fertility of soil on selected farmers’ fields.  Row planting and correct spacing of various crops.  Listing of Agricultural Holders, Measurement and Plot Cutting as well as weighing of produce analysis of yield study plots.  Carry out the 29th National Farmers Day in the District.

2.3.2 Veterinary Activities The veterinary unit of the MoFA has undertaken the following activities in order to sustain production of poultry and the animals in the district:

Table: 2.3 Diseases/ Conditions and Treatments No Disease/ Condition Species 1 Abortion 1 goat 2 Anorexia 18 pigs , 4 goats 3 Aneamia 1 goat 4 Arthritis 2 pigs 5 Balanitis 1 piglet 6 Conjunctivitis 1goat

7 Diarrhoea 12 pigs, 10 goats, 5 sheep. 8 Dystokia (Manual) 3 sheep , 1 goat 9 Ectparasitism 5 pigs 10 Eczema 2 goats 11 Enteritis 18 goats, 1 sheep, 19 pigs 12 Foot rot 1 goat 13 Fracture 1 goat 14 General Debility 15 Helminthiasis 24 pigs, 2 caives 16 Mange 14 goats 17 Mastitis 6 goats, 1 pig 18 Paralysis 1 pig, 1 dog 19 Pneumonia 6 goats , 3 sheep 20 Prophylaxis 101 pigs. Source; MOFA-JSD2014

2.3.3 National Farmers’ Day Celebration The 30th National Farmers’ Day Celebration was organized in the District on Friday, 5th of December 2014 at Mempeasem a community in the district. The celebration was a necessity in view of the fact that, farmers have really made an invaluable contribution to the growth and development of our economy. It was therefore appropriate that our prime stakeholders (farmers) who have worked ceaselessly to feed our nation and also ensure food security be applauded officially and rewarded for their hard work done. The District Assembly, MOFA staff as well as the host community did very well in contributing in diverse ways towards the august programme to its success.

Over two thousand (2000) people from the District attended the occasion, and in attendance were dignitaries such as the Hon D C E, MP’s representative, Heads of Department, the Press, Past Award Winners, Ex-Assembly members, Security personnel, Awards Winners and The clergy Farmers as well as the Paramount Chiefs and their elders.

Speeches were delivered by the District Director of Agric, The Hon. District Chief Executive, Hon. Member of Parliament (Jaman South) and The District Fire Officer all aimed at ensuring food security through reducing Post Harvest losses, ensuring better nutrition and avoiding indiscriminate bush fires.

In all a total of twenty two (22) farmers were selected for the various categories of awards. They were made up of 13 males and 9 females.

The overall effort of activities undertaken by the District Agricultural Development Unit on food production is indicated in the following table. Table 2.4: Estimated Productions. Crop Estimated Estimated Yield (T/ha) Yield Production(M Production(M % +/- Area (ha) Area (ha) 2013 (T/ha) T) T) 2014 2013 2014 2014 2013 Yam 8607 8550 14.9 15 128244.3 128250 -.004 Maize 6,025 6138.5 2.3 2 13857.5 12277 -11.41 Cassava 4847 4915 14.1 14 68723.4 68810 +0.13 Cocoya 2627 2787 7.1 6.7 18651.7 18672.9 +0.11 m Plantain 1126 1345 8.6 8.5 9683.6 11432.5 +18 Pepper 2846 3852 0.9 0.9 2561.4 3466.8 +35.3 Tomato 35 39 4.62 4,7 161 183.3 +13.85 Cashew 48954 49100 0.8 0.8 39163 39280 +0.3 Cocoa 9097 9099 1.3 1.3 11826 11828.7 +0.022 Citrus 1,024 1043 8.2 8.2 8397 8552.6 +1-85 Okra 51 0.5 26 +23.8 Source; MOFA Field Survey 2014

2.4 Infrastructure, Energy and Human Settlements Under this theme, the district has undertaken a number of initiatives aimed at promoting the socioeconomic development of the area. Specifically among them are;  Accelerate the provision of safe water and adequate provision of sanitation facilities as indicated in the table below,  Management of natural disasters i.e. fire, which has been made possible through the acquisition of district fire van and the institutionalization of community fire guards.  Surfacing and reshaping of feeder roads district wide.  Construct of 1no. ICT centre at the district capital.

Efforts at improving the percentage of the district population with access to safe and clean drinking water continued to yield results. Access has slightly improved in both urban and rural communities through new construction of boreholes and expansion of small town water project in the District. The table below shows more information of the district’s position:

2.4.1 Spatial Development Management Initiative -Street Naming and Property Addressing System The Street Naming Team met on 14th August, 2014 to identify the tracked streets within Drobo, Japekrom and Dwenem for names to be solicited for the streets. Layouts covering some settlements in the district was scanned and geo – referenced within the quarter.

The district also acquired a 25 square kilometers of areal imagery covering the capital and other neighboring settlements within the districts from AM – Surveys in Accra and the quality checks has been performed by the Town and Country Planning Head Office within the year. This was backed by selection of streets in collaboration with the traditional authority.

Therefore as at December, 31st 2014, ten streets in Dwenem were named and signage installed representing 71.4 percent of the fourteen roads picked at Dwenem for the implementation of the first phase of the of the Street Naming and Property Addressing project in the year under review.

2.4.2 Water and Sanitation As indicated earlier, the district undertook a number of interventions towards increasing access to quality water and sanitation within the year. The efforts lead to the achievement as captured bellow. Table 2.5: Summary of Indicator achievement in water provision

INDICATORS TARGET FOR 2013 2014 STATUS AS PROGRESS MADE THE YEAR 2014 STATUS AT DECEMBER Percentage of rural 82% 67% 71% Minimal progress population with access to safe water sources Percentage of urban 83% 80% 82% No significant population with access to progress water sources Source: DWST Annual Report, 2014

The table below shows data on solid waste disposal in rural and urban communities’ district wide. The data suggests that the district assembly performed creditably in solid waste management. Table 2.6: Summary of Indicator Achievement in Sanitation Management

INDICATORS TARGET FOR 2013 2014 STATUS AS PROGRESS THE YEAR STATUS AT DECEMBER TOWARDS 2014 TARGET Percentage of rural 27% 22% 25% Significant progress population with access to adequate sanitation Percentage of urban 32% 28% 30% Significant progress population with adequate sanitation Source: DEHMU Annual Report, 2014

The above initiatives have led a betterment of lives for the community in the district. They have impacted positively on the environment and the health status of the people; it is evidence in the low number of cases of diseases related to improper solid waste disposal. The intervention ensures access to household’s energy, local markets and safe water and sanitation facilities.

However, to maintain this achievement, the Assembly needs to provide adequate refuse containers and regularly pick up refuse containers at the designated areas to prevent pile up of refuse.

2.5 Human Resource Development Productivity and Employment 2.5.1 EDUCATION The sector saw an improvement in terms of physical infrastructural in the year under review. 2 no.2-unit classroom blocks were initiated or executed and four other projects have since been successfully completed and handed over for usage. They were all funded from GETFUND and DDF allocation. The district assembly further assisted the district education directorate to organized mock exams, My First Day in school, among others. Performance in

16 the BECE results saw a slide drop in the year under review (85% in 2012 to 76.91% in 2014). This was due to inadequate teaching and learning materials, poor supervision and inadequate furniture. In order to ensure quality human resource for accelerated economic growth and poverty reduction, more is needed to be done on areas of: o Increasing access to and participation in education and skill training o Improve the quality of Basic education o Improved Education Delivery.

Indicators on Gross Enrolment Ratio (GER) and net Enrolment Rate (NER) were used to assess progress on this program objective. The Gross Enrolment Ratio is an indicator of participation in the educational system and measure the number of pupils/students at a given level of schooling regardless of age as a proportion of the number of children in the relevant age group. Table 3 provides a summary of the trends in enrolment growth for 2012-2013 to 2013-2014.

Table 2.7: Trends in gross Enrolment Ratio in Basic Schools-2013/2014 GROSS ENROLMENT 2012-2013 TARGET FOR 2014 STATUS AS PROGRESS TOWARDS RATIO BASELINE THE YEAR AT DECEMBER TARGET (Status) 2013-14

Kindergarten 6700 6770 6784 Significant achievement Primary School 11,200 11300 11,359 Target met Junior High 5200 5312 5305 Target not met Senior High 2010 2040 2103 Target Exceeded Source: Ghana Education Service District Office, 2014

2.5.2 Gender Parity Index (GPI) The objective of ensuring favourable Gender Parity of 1 for all levels of basic education by year 2014 as a national target is of serious importance to the stakeholders of the district. The Gender Parity Index which measures the ratio between boys and girls enrolment, the balance of parity being 1, has been adopted for educational assessment in the district.

Table 4 indicates that GPI improved at all levels of basic education between 2012/2013- 2013/2014 academic years. This progress was realized as a result of the introduction of various enrolment drives including the school feeding programme and the capitation grant. Table 2.8: Trends in District GPI in Basic Education Sector: 2013-2014

GENDER PARITY INDEX TARGET FOR 2013 2014 STATUS AS PROGRESS THE YEAR STATUS AT DECEMBER TOWARDS 2014 TARGET Kindergarten 1 1 1.05 Target missed Primary School 1 1.1 1.26 Target missed Junior High School 1 0.8 0.87 Significant achievement Source: Ghana Education Service District Office, 2014

2.5.3 Improvement in the infrastructure of deprived basic schools To meet the National target of Universal Basic Education by 2015, the implementation of projects for expanding and increasing physical facilities in basic schools continued in 2014. Table 5 indicates the trends in Improving Basic Educational Facilities in the District in 2014.

Table 2.9: Trends in Improved Basic Education Facilities (Classroom Block): 2014

PROJECT TARGET FOR 2013 2014 STATUS AS PROGRESS THE YEAR STATUS AT DECEMBER TOWARDS TARGET 2014 Kindergarten 70 69 71 Target met Primary School 73 70 72 Target not met Junior High School 55 54 54 Target not met

Senior High School 3 2 2 Target miss

Source: DPCU, JSDA – Drobo, 2014

2.5.4 Improved Quality of Education and Enhanced Delivery of Education Services  Status of Selected Indicators Progress towards achieving the objectives of improving the quality of education and enhanced delivery of education services are measured by the following indicators i. Percentage of trained teachers in basic schools

ii. Pupil Teacher Ratio iii. Percentage of Trained Teachers The quality of teaching and learning depends largely on the proportion of trained teachers among the teaching staff. Table 6 indicates that there is inadequate supply of trained teachers in basic schools in the district.

Table 2.10: Trends in Percentage of trained teachers in Basic Schools 2012/2013 to 2013/ 2014

LEVEL TARGET FOR 2013 2014 STATUS AS PROGRESS THE YEAR STATUS AT DECEMBER TOWARDS 2014 TARGET

Kindergarten 47% 46% 48% Significant progress Primary School 52% 51% 52% Significant progress Junior High School 45% 39% 40% Target not met

Source: Ghana Education Services, District Office, 2014

2.5.5 Pupil: Teacher Ratio (PTR) The pupil Teacher Ratio (PTR) is a key input indicator used as proxy for assessing the quality of education. The policy objective is to achieve a national PTR of 45:1 at primary level and 40:1 at the Junior High level. Table 7 indicates trends in pupil Teacher Ratio in basic education in the District.

Table 2.11: Trends in Percentage of pupil-teacher Ratio in Basic Schools 2012/2013 to 2013/ 2014

LEVEL TARGET FOR THE 2013 2014 STATUS AS PROGRESS TOWARDS YEAR 2014 STATUS AT DECEMBER TARGET Kindergarten 45:1 36:1 37:1 Average output Primary 40:1 30:1 38:1 Average output School Junior High 35:1 26:1 30:1 Target met School Source: Ghana Education Services, District Office, 2014

2.5.6 Educational Sector Major Challenges  Lack of motivation for hard working and deserving staff.  Inadequate residential accommodation for key offices such the front liners and desk officers.  Poor road network in the District also makes supervision very difficult.  Lack of computers to teach ICT in some schools.  Inadequate furniture for basic schools

2.6 HEALTH The overall objective of the District Health Administration is to ensure that populate have access to good quality health and nutrition services. The status of selected indicators within the sector is as follows:- Table 2.12: Basic Health Indicators, 2013/2014

INDICATORS TARGET FOR 2013 STATUS PROGRESS 2014 STATUS AS AT 31 TOWARDS DEC. 2014 TARGET Infant mortality rate per 1000 live births 0 11 9 Target not met Under five mortality rate per 1000 live 4 9 11 Target not met births Under five who are malnourished (under 0 2% 1% Significant weight) progress 0 3.01% 5% Target not met HIV/AIDS prevalence rate 0 4 2 Significant Malaria fatality-Under five per 10,000 progress Doctor-patient Ratio 1:15,000 1: 24,446 1:25,622 Target not met Nurse-patient ratio 1:1500 1:1,178 1: 1,235 Exceeded target Source: Ghana Health Directorate District Office, 2014  Infrastructure and organization

The district has been divided into six sub-districts with each sub-district with institutions as shown in table below.

Table 2.13: Distribution and location of Health Facilities by Sub-districts

SUB-DIST TYPE OF DROBO JENJEMIREJ ABIRIKASU GONASUA ZEZERA ADAMSU OWNERSHIP A FACILITY Hospital CHAG 1 - - - - - Policlinic GoG 1 - - - - - Health GoG/ Dwenem JJMJ Presby Abirikasu Gonasua and Zezera and Adamsu, Centre Baano Adiokor Mission and Drobo H/C Bodaa and RCH/FP/PS Asare YCH CHPS/clinic GoG - Abuokrom Atuna CHPS - Asempanaye Taiano II ,Tekese and cente Yaamansa miremano Mat. Home Private Elizabeth - Angels Mat. Vida’s Mat. Saviours St. Micheals Mat. Home Atuna Home Mat. Mat. Dwenem Kwameseikrom Kofitiakrom Adamsu Source: DHD, JSDA 2014

To reduce inequities in access to care and increase coverage, quality and use of health services so as to achieve a healthier national population.

Table 2.14: Key Areas of interventions - 2014. S# Health Sector Objective Priorities Activities

1 Bridge the equity gaps in Scale-up CHPS and Deploy staff and logistic to geographical access to health improve referral 2 new compounds services 2 Ensure sustainable financing for Improve source of funding Train I/C on claims health care delivery and financial and claims management management & strategies protection for the poor. to improve IGF 3 Improve efficiency in governance Embark on quality Hold quarterly DHMT and management of the health assurance and quality Meetings and carry out system. improvement staff satisfaction survey

4 Improve quality of health service Improve quality of care and Train staff on dhis2 delivery including mental health. Data management (dhis2) 5 Enhance the national capacity for Promote maternal and child Train Health staff on ANC the attainment of the health related health services MDGs and sustain the gains.

6 Intensify prevention and control of Improve IDSR functions to Carry out daily records non-communicable disease and detect and interrupt review & community other communicable diseases. possible outbreaks based surveillance Source: DHD, JSDA 2014

 Human Resource The core function of this unit is to analyze the service provision, advice on the numbers and appropriate trained health workers to be requested for. It also looks at the equitable distribution, efficient utilization and high motivation of these staff to deliver quality health services in areas most needed.

Table 2.15: Staffing Cadre 2012 2013 2014 Specialist 0 0 0

Medical Officers 0 0 0 RMN 0 1 5

Community Health Nurses 4 3 4 Enrolled Nurses 4 2 5

RGN 0 1 3 Administrative Manager 1 1 0

Accountant 1 1 1 Technical Officer (HI) 1 1 1 (Posted In)

Technical Officer (Lab) 1 0 0 Source: DHD, JSDA 2014

Table 2.16: General Staff Situation Category 2012 2013 2014

Medical Officer 2 2 1 Medical Assistant 2 2 3 General Nurses 13 3 8 Technical Officer 7 7 9 Field Technician 5 5 7 Community Health Nurses 49 49 48

Medicalrecords/ 3 3 3 Biostatistics Assistant Typist/Stenographer 2 2 2 Storekeeper/Electrician 1 1 2

Watchman 6 6 6

Accountants 2 1 1

Pharmacist/Pharmacist Technician 2 2 2

Dispensing Assistant 0 0 0

Biomedical Scientist 0 0 1

Health Assistant/Ward Assistant 14 14 12

Drivers 2 2 1

Hospital Orderly 2 2 2

Executive Officer 1 1 0 Labourer 1 1 1

Casuals 18 22 25

Totals 267 109 131

Source: DHD, JSDA 2014

Major activities under taken

 Disease surveillance and control services

The year 2014 has been the most challenging for the health care providers of the district. Funds flow has been very poor. However, logistics supply for EPI and surveillance to the district greatly helped in achieving most of our set target for EPI and disease surveillance. The department lacks transport logistics especially motor bikes to facilitate staff tracking.

The increasing numbers of cholera cases and the threat of Ebola Viral Disease call for constant refresher training of staff and enhancement of our surveillance and response system.

Despite these problems the district was able to carry out some activities rather with lots of difficulties. It took dedication and commitment for the few hard working staff to be able to achieve the year set targets. Specific focus:  Surveillance on communicable diseases  Co-ordination of EPI/CC activities  Supply of logistics for EPI and NID activities  Preparation and response/management of epidemics (cholera, Ebola viral diseases etc.)  Cold chain maintenance  TB control activities  Malaria control activities  Guinea worm eradication  Neglected tropical disease control

Figure 2.1 Comparing Disease Trends for 2012, 2013, 2014

Suspected Cases 16

0 meningitis cholera yellow fever measles AFP Ebola 2012 1 0 9 12 2 0 2013 0 0 3 14 4 0 2014 1 2 12 12 2 2

Source: DHD, JSDA 2014

 Training The DHD organized several in-service training for staff and volunteers on disease surveillance activities, TB control activities, malaria control activities, Ebola etc.

 Specific Control Activities Sporadic cases of elephantiasis have been reported in the district, a total of 4 cases have been reported, they were all investigated and they were all confirmed to be true cases. Drugs were requested from the region and all the cases have been treated. In the case of the elephantiasis drugs have been given to the cases and case management instructions have been given to the cases for proper management.

 Ebola Viral Disease/ Cholera On the 49th week of 2013, the index case of deadly Ebola disease was recorded in a West African. The disease has spread to several West African countries; the spread is mainly due to:  Highly mobile farming and hunting communities which come into contact with wild game  Cultural rites and rituals on care for the sick and dealing with the dead normally involves close physical contact with the sick or dead  Trade and other commercial activities attract traders from the sub-region and possibly from some of the affected countries. Ect.

Activities carried out on Ebola Viral Disease:  Formation of District Ebola epidemic management committee which is chaired by Hon. DCE  Preparation of District Ebola epidemic preparedness plan.  Sensitization of key health staff including clinicians.  RHD has organized training for all our port health officers, but there is the need to organize constant refresher training for them.

 Distribution of posters and fliers across the district.  Plans are far advanced to put up an isolation ward in the District hospital.  Distribution of personal protective equipment to all border personnel.  Formation of district contact tracing team.  Frequent visits to our border posts.

Suspected cases of Ebola The district has suspected two Ebola cases in 2014, blood specimen were taken and sent to the regional health directorate for onward submission to Noguchi for confirmation. Provisional results indicated that, the entire two specimens were negative; however, the DHMT has strengthened surveillance on the deadly disease.

Cholera Several cases of cholera were recorded along the country with many deaths. In Jaman South district, the trend of diarrheal diseases started escalating, this triggered the DHMT to strengthen the surveillance system. Clinicians and all field workers were sensitized; posters and fliers were distributed to all health facilities, schools, FM stations etc. in the district. DHMT carried out massive health educational campaign on cholera at the OPDs, churches, mosques etc. jingles were also played along the three FM stations in the District to sensitize the public on the need to keep the environment clean, eat food while it is hot and early report of all suspected cases for prompt management.

Suspected cases of cholera Two suspected cholera cases were reported in the year under review. Stool specimen were taken and sent to the regional hospital for investigation and confirmation. Provisional results indicated that, the two specimen were negative, however, the DHMT has strengthen surveillance on the disease.  National Immunization Activities EPI activities in the area of measles, polio, BCG etc, were carried out in all the six sub- districts with specific aim of enhance the wellbeing of the people. As indicated in the diagram below, annual targets were met with limited resources.

Specifically, the district was able to hold two successful rounds of NID’s, in September and October. Package  Polio vaccine for children 0-59 months  Vitamin A for children 6-59 months

Figure 2.2: NID Coverage

coverage of first round NID "14 25000 20000 15000

10000 coverage 5000 0 0-11 12-59 No. of No. of % % months months children children Coverag Coverag (20% of (80% of Total Total 0-11 12-59 e of chn e of chn Total children children Children children Months Months 0-11 12-59 coverag vaccinat vaccinat Vaccinat targeted vaccinat vaccinat vaccinat vaccinat e ed in ed in ed ed with ed with ed with ed with October October OPV OPV OPV OPV 2013… 2013… TARGET NO. VACCINATED COVERAGE Jaman south 4201 16805 21006 4317 17960 22277 102.8 106.9 106.1

Source: DHD, JSDA 2014

Table 2.17: EPI Achievement by Districts 2012, 2013, 2014 Compared

2012 2013 2014 Antigen Annual No.Mm %Imm Annual No.Imm %Imm Annual No.Imm %Imm Tgt Tgt Tgt 2014 2012 2013

BCG 5118 132.0 4444 111.8 3849 94.8 Measles 4692 121.0 3967 99.8 3546 87.4

3878 3976 4059

Dphepih 5056 130.4 4073 102.4 3732 91.9 Opv3 5056 130.4 4073 102.4 3731 91.9

YF 4692 121.0 3967 99.8 3630 89.4

Tt2 2949 76.0 2942 74.0 2530 62.3 Rota 2 2811 72.5 2548 64.1 3694 91.0 Pcv3 4038 104.1 4073 102.4 3734 92.0 Msls 2 4099 105.7 3182 80.0 3279 80.8 Source: DHD, JSDA 2014

Malaria Control Key Activities  OPD Malaria trend  Inpatient Malaria trend  Malaria related death  Home based Care program  IPT (SP) coverage Malaria has remained on top of OPD morbidity and inpatient admissions in the district. A number of control interventions have been put in place to curb the increasing number of malaria cases in the district. Some of which are:  LLIN hang up campaign where nets were distributed to households all with the aim of preventing people from mosquito bites.  The use of intermittent preventive therapy (IPT) for preventing malaria among pregnant women has also boosted the fight against malaria for some time now.  The implementation of home base care programme since 2011 is another strategic intervention which has now been scale up in all 68 communities with the aim of controlling malaria among children under five.

Figure 2.3: Total Malaria Cases 2012-2014

Total Malaria Cases 2012-2014 90000 80000 70000 60000 50000

40000 CASES 30000 20000 10000 0 sub- Jenjemire Abirikasu Adamsu Drobo Gonasua Zezera TOTAL district ja CASES 2012 7534 9353 39441 8754 6110 8473 79665 CASES 2013 4786 5824 38309 9165 7140 8266 73490 CASES 2014 7948 9739 34910 11421 7187 12158 83363

Figure 2.4: Cases of Malaria Compared With Total LLINs 2014

Total malaria cases/ LLINs distributed '14

total cases

79665 83363 73490

5002 2012 2013 LLINs 2014

Source: DHD, JSDA 2014

Inpatient Malaria Cases

Under 5 cases of malaria recorded under the year review was 1643 while Above 5 (years) was 1074. Total death was 1 and 1 for fewer than 5 and above respectively.

Long Lasting Insecticide Nets Distribution

A total of 5002 bed nets were received from regional health directorate. Out of this, 4,994 of the nets have been distributed to all the facilities for onward distribution to all pregnant women and children under two years free of charge. Home Base Care Volunteers have trained to carry out health education on malaria and treat minor ailment (malaria) with malaria treatment kits that have been given to them. They are supervised by CHOs and other field officers Table 2.18: Performance of CBAS 2012-2014

YEAR

sign

with illness

No Referred

No with fever

No with diarrhea

Treated with A.A

No with fast breath

No with danger

No of and C IE given

No chn brought to cbas

2012 1641 86 15 1548 63 1452 210 3769 2013 1592 4 10 1451 83 1376 73 2305 2014 1440 18 17 1363 146 7 164 2141

Source: DHD, JSDA 2014

Initiative towards combating HIV/AIDS Addressing HIV/AIDS issues continues to be one of the top priorities of the health sector and the Government of Ghana. Though HIV has spread more slowly in Ghana than in other African countries, the disease is firmly established within the general population as well as within certain high-risk groups.The HIV situation in Jaman South is not different from what is happening in most districts in Ghana.

HIV/AIDs testing and counseling (HTC) and Prevention of Mother to Child transmission (PMTCT) interventions were carried out to promote better health. All pregnant women presented at the ANC received information on HIV testing. Pre and posttest counseling for pregnant women, diagnostic testing, walk-in, Couples etc, were carried out during the year.

Table 2.19: HIV/AIDS Trend Compared HTC/PMTCT 2012-2014

2012 2013 2014

Clients 2546 3268 3375 No. Positive 48 66 194

% positive 2% 2% 5.74% Source: DHD, JSDA 2014

Figure 2.5: HIV/AIDS trends Figure 2.8 HIV/AIDS Trend Compared HTC/PMTCT 2012-2014

4000 3500 3000 2500 2000

CASES 1500 1000 500 0 Clients No. Positive % positive 2012 2546 48 2% 2013 3268 66 2% 2014 3375 194 5.74%

Source: DHD, JSDA 2014

Table 2.20: HIV/AIDs Testing and Counseling Age Groups (Years) 0-9 10- 15-19 20- 25-29 30-34 35-39 40- 45- 50+ Total 14. 24 44 49 Receiving Male 1 46 14 26 33 26 27 30 24 42 269 Pretest Female 2 25 17 42 60 47 42 46 28 62 371 Information Tested Male 2 51 14 26 32 26 27 30 24 43 265 Female 1 20 12 39 58 45 40 44 28 62 349

Positive Male 1 7 1 3 2 5 6 10 8 6 49 Female 2 1 10 16 20 16 13 12 19 109 Receiving Male 1 8 1 5 4 7 7 12 9 6 60 Positive Test Female 3 1 8 17 21 17 15 11 20 113 Results

Receiving Male 1 46 9 23 31 24 25 26 24 42 251 Posttest Female 1 20 12 39 58 45 39 44 28 62 348 counselling Screened for Male 1 6 1 3 3 5 6 10 8 6 49 TB Female 2 1 10 16 18 16 13 12 18 106 Referred Male 1 6 1 3 2 5 6 8 7 5 44 into Care Female 2 2 9 16 21 14 13 10 17 104 Source: DHD, JSDA 2014

TB Control Programme 2012-2014

The district health directorate in collaboration with district health facilities embarked on numerous TB screening exercise in order to enhance the wellbeing of the populace. A stakeholder effort was directed at finding out how HIV/AIDS could triggers TB.

Enhancing Maternal Health

Reproductive and Child Health (RCH) care is combined activities of preventive curative, promotional and rehabilitation services for improving the health and well-being of the population especially women and children under five (5) years. Consequently, it reduces the maternal and infant morbidity and mortality in the district. RCH service in the district is integrated to other services to make it accessible to all individuals, within the context of primary health care.

Priorities/Focus areas • Safe motherhood including infant health

• Family Planning (including prevention of unwanted pregnancies)

• STI / HIV/ AIDS prevention and management including PMTCT

• Post Abortion Care

• Prevention and management of cancers of the reproductive system.

• Adolescent health

The priorities of Child Health Care are:

• Neonatal Health

• Growth Monitoring

• Prevention and Management of nutritional problems

• Prevention and control of infectious diseases and injuries

• Clinical care of the sick and injured child

• School health

Objectives Set For 2014 Maternal Health

• To Increase ANC Registrants from 82.3% to 91.7%

• To increase average ANC visit from 4.1 to 4.8

• To increase skilled attendance delivery from 77.7% to 90%

• To increase PNC registrants from 69.2% to 90%

• To increase Family Planning Acceptors from 59.4% to 60.7 %

• To increase TT2+ coverage 61.1%to 89%

Child Health

• To increase 0 – 11 months registrants at CWC from 91.2- 100%

• To increase 12 – 23 months registrants at CWC from 14.6% to 16%

• To increase 24 – 59 months registrants at CWC from 12.2% to 16%

• To examine 90% to school children

Health Financing

To improve financing quality health care, the district was able to carry out

a. Frequent engagement with National Health Insurance Scheme to ensure adequate payments for the services b. Scaling up CHPS in the district; operationalizing all electoral areas into functional CHPs c. Improving technical staffing of health facilities d. Pursuance of completion of stalled Infrastructural projects e. Claims validation and submission to NHIA

Table 2.21: Analysis of NHIS claims in 2014 Month Submission Refunds Disputed Outstanding % % Deputed Refund Jan 78542.67 78194.07 348.60 0.00 99.56 0.44 Feb 81585.24 80278.87 1306.37 0.00 98.40 1.60 Mar 83781.38 82545.42 1235.96 0.00 98.52 1.48 Apr 90943.49 89828.57 1114.92 0.00 98.77 1.23 May 112156.43 111612.60 543.83 0.00 99.52 0.48 Jun 117363.63 109951.52 7412.11 0.00 93.68 6.32 Jul 114677.07 114677.07 0.00 0.00 Aug 105955.99 105955.99 0.00 0.00 Sep 72984.16 72984.16 0.00 0.00 Oct 87357.56 87357.56 0.00 0.00 Nov #Div/0! #Div/0! Dec #Div/0! #Div/0! Total 945347.62 552411.05 11961.79 380974.78 58.43 1.27

Source: DHD, JSDA 2014

Special Initiatives to Increase Access to Health Care Jaman South district is privileged to have many health facilities, which have been evenly distributed throughout the district. Access to health been improved through the implementation of nine (9) functional CHPS compounds.

Implementation of CARMMA Project

During the inauguration of CARMMA in Brong Ahafo Region, the administration of Jaman South District Assembly pledged to undertake the following activities as captured in the table below:

TABLE 2.22: Pledges and Status of Implementation

S/ PLEDGE STATUS OF IMPLEMENTATION REMARKS N 1. Training of Midwives and Construction of 1 No. 4-unit Steadily in progress-sub Nurses Demonstration block for the training of structure Nurses at Nurses Training School Berekum (Drobo Campus) Construction of 1 No. 4-unit Medical Completed and in used Doctors Bungalow at St. Mary’s Hospital at Drobo. 2. Construction of CHPS Construction of 1 No. CHPS at Completed and in used Compound in remote Asempaneye communities to improve access Construction of 1 No. 10-unit Rural Clinic In progress - roofing level to maternal care at Miremano Reshaping of feeder roads to and from On-going Rural Communities to enhance health care access. Source:DPCU-JSD 2014

 Community Based Health Planning And Services (CHPS) The District have lineated 35 Community based Health Programme zones with 9 functional CHPS which four has CHPS compounds constructed at Abuokrom,Tekese,Atuna, Asempanaye, Yaamansa and Meremuano.

All the CHPS centers have been accredited by NHIS in order to enhance universal access to health care. All the operating CHPS compounds have one motorbike each to enhance their movement to other communities and outreach points. With the support of needy communities and the District Assembly, plans are underway to expand CHPS facility to Baatea, Anukunano and Kofiko

Clinical/institutional care Improving quality of health met drastic improvement in the year under review. All facilities were sensitized on mental health, prompt management and appropriate referral to higher level. This saw huge number of mental illnesses referred from prayer camps to Drobo Sub- district mental health corner and Saint Marys’ Hospital for management.

Priorities • Ensure the use of case management protocols and standard treatment uidelines.

• Use of Laboratory to improve the quality of diagnoses.

• Ensure that HR and logistics are available for effective and efficient services.

• To promote Quality Improvement (QI) In our health facilities.

• Institute a reponsive referral system on mental health care

• Promote mental health care services at all facilities

Per-capita OPD attendance improved from 2.3% to 2.7%. The district also recorded 99.2% insured attendance. Malaria accounted for the causes of OPD morbidity and admissions 22.2% and 18.4% respectively. The main cause of death was also septicaemia, 23.5%. Recorded and managed 2274 mental health disorders. Leading causes were epilepsy (37%)

Figure 2.6: JSDA PPD attendance Jaman South, OPD Att. Per Capita 2010-2014 Compared

3.00 2.70 2.50

2.00 2.30 2.30 2.30 2.10 1.50

1.00

0.50

0.00 2010 2011 2012 2013 2014

OPD ATT. /CAPITA

Source: DHD, JSDA 2014

Table 2.23: Mental Health Output Condition New Cases Old Cases Total 2013 2014 2013 2014 2013 2014

Epilepsy 33 33 741 799 774 832 Mental Disoredrs Due Psychoactive Drug Use 8 17 52 158 60 175

Schizophrenia,Schizotypical And Delusional 56 27 575 522 631 549 Disorders Mood Disorders 28 14 132 178 160 188

Neurotic,Stress Related And Somatoform 56 66 402 401 458 467 Disorders Residual And Disorders Of Adult Personality And 2 3 16 19 18 22 Behaviour Organic Mental Disorders And Mental Retardation 2 2 2 8 4 10

Total 185 162 1920 2085 2105 2247

Source: DHD, JSDA 2014

Constraints of the sector

1. Erratic flow of funds (NHIA)

2. Insufficient office & residential Accommodation

3. Inadequate requisite & critical staff

4. Weak protocols Adherence

5. Inadequate office & basic clinical Equipment

6. Weak inadequate and inappropriate Transport

7. Periodic Shortage of Some commodities at RMS

8. Poor filing system in BMCs

9. Poor Network connectivity hindering data management

Way forward

 Advocate for regular re-imbursement from NHIA

 Liaise with DA for office & residential Accommodation

 Liaise with DA & other organizations for basic equipment

 Organize training for all staff

2.6 Transparency and Accountable Governance

 Protection of the Vulnerable

During the period under study, the number of reported cases of abuse (women and children) assumed a lower ascendancy, moving from as high as 6% in 2013 to 2% in 2014

 Citizens Security The police citizen ratio as at December, 2014 was 1:1,423 as against 1:1542 in 2012. This indicated a significant progress in police citizen ratio of the district. This situation is largely attributable to the beefed up in the police personnel over the years.

 Resource Generation and DA Expenditure Patterns Improving financial resource mobilization alongside improved expenditure management is core to assembly administration. The district therefore undertook effective IGF improvement planning and constructing and expanding of weekly markets infrastructure in the district. Although targets not met because internal revenue generated reduced from GHȼ227, 767.16 in 2013 to GHȼ 193,301.22 in 2014, there has been significant achievement.

This performance can be attributed to the effective revenue planning system initiated with revenue collectors, the identification of revenue potentials including realistic property rates setting /collection District wide.

The amount of Donors and NGO’s funds uses to support the implementation of programmes and projects in the District Medium Term Development Plan has not been encouraging in

2012 ie Japan Embassy. Most of the development projects and programs implemented by the DA were resourced from DACF as a result of the situation.

The multiple revision of the policy framework of the DMTDP affected both financial inflows and the development process of the DA. The table below gives a better understanding of the programs and projects under the theme.

2.7.1: Financial Decentralization through Composite Budgeting The composite budget concept which was established to facilitate effective financial management of decentralized departments of Metropolitan, Municipal, and District Assemblies MMDAs is keenly adopted in the district. The introduction of the concept became necessary after the transfer of some 30,000 civil servants to the Local Government Service through the Legislative Instrument LI) 1961. Its implementation, despite some teething challenges has promoted financial sanity as it minimises misapplication and unbudgeted for activities in the expenditure of the departments and the Central Administration.

CHAPTER THREE

3.1: Report on Critical GOG Social Interventions and Poverty Issues

3.1.1: Capitation Grant The introduction of the capitation grant as a way of accelerating the free and compulsory universal basic education FCUBE programme has substantially impacted positively in the enrolment and retention levels in basic schools in the district. The program has also harmonized the relationship between teachers and parents, since students are not being sent home to collect unauthorized fees from parents as it used to be. At same it enhanced the free flow of TLMs which are taken care of by SPIP.

Data available from the District Directorate of Education indicates an upwards growth in enrolment at the basic school level in 2013– 2014 academic year.

3.1.2: Free Rid Mass Transit for School Children This facility is also applicable in the District. Therefore school pupils usually time the moving of the busses that ply in and out of the district daily for easy commuting.

3.1.3: Ghana School Feeding Program Ghana School Feeding programme, since its inception has led to some increase in enrolments and improved attendance at both primary and KGs levels within the beneficiary schools. The District Assembly continues to collaborate with the program caterers to provide decent cooking facilities in the form of local kitchen infrastructures. During the year under review, the District Implementation Committee (DIC) executed its planned activities to ensure the successes of the programme.

3.2: Evaluation and Participatory M & E and the Results

The DPCU mobilized and involved all necessary stakeholders such as projects beneficiary communities, opinion leaders/chiefs, Area Council executives e.t.c. during M&E exercised. This approached ensures transparent and accountability in project management During the period under review, the following activities have been undertaken:

 Quarterly monitoring of on-going Development Projects in the district and this was followed by one stakeholders meeting on the outcomes of the monitoring

 One dissemination forum for key stakeholders within the district to discuss the content of M& E plan and their expected roles

 Undertake 8 days training workshop for 25 people selected from the four Area Councils

 Series of stakeholders meetings were held to validate findings in the district’s draft water and sanitation plan.

3.3: Status of the District Mutual Health Insurance Scheme

The National Health Insurance programme is a social protection programme that seeks to ensure that all residents of Ghana access quality health care without paying money at the point of service. The enrolment figure for the year under review was at 69,988. This represents 69.4% of the total projected population of the district (100,895).

In going further, the district led by the scheme officials would intensify efforts towards increasing coverage of the program within the district.

CHAPTER FOUR 4.1 Update on Funding by Source and Disbursement

The Jaman South District during the year under review was financed from various sources. The following shows updates on funding by sources of the Assembly from 2010 to 2014.

Table 4.1 Update on funding sources/expenditure

REVENUE ITEM 2011 RECEIPTS 2012 RECEIPTS 2013 RECEIPTS 2014 RECEIPTS GOG 661,760.35 1,237,268.62 1,432,735.12 1,496,983.00 HIPC 25,000.00 25000.00 90.00 - IGF 189,796.96 207,767.16 186,681.31 183,468.48 DACF 1,305,536.21 784,950.81 715,063.75 714,144.06 MP FUND 111,744.15 12,524.66 29,542.00 52,571.71 DONOR FUNDS 535,192.90 597,978.52- -

MSHAP 4,000.00 - - IDA - - - CBRDP 50,000.00 - - INFRASTRUCTURE AREA COUNCIL & OTHERS SCHOOL FEEDING 261,688.80 217,428.80 295,548.91 CODAPEC 110,191.26 134,579.13 77,752.01 - NYEP - - - WATSAN 451,493.11 - - GETFUND - - - RSTWSSP 94,888.12 - STWSSP 4,330.00 - TOTAL 3,706,403.74 3,325,438.26 3,434,609.74 2,447,167.25 Source: D A Finance Office 2014

As captured in the table above, the total financial inflow into the District decreased to GHȼ

2,447,167.25 in 2014, as compared with GHȼ 3,434,609.74 in the previous year 2013. Out of this 29.18% was DACF, 61.17% as GOG Grants. IGF formed 7.50% and MP’s common fund was 2.15% Even though GoG formed greatest portion of the inflow, the expected revenue for the year was GHȼ 925,167.39 but an amount of GHȼ 1,432,735.12 was received. This indicated an increment over of the budgeted figure of about GHȼ 507,567.73 This represents a percentage of 35.4%. Below also shows a corresponding update on disbursement of inflows into under the various expenditure item Table 4.2 Comparative Financial Performance

SOURCE 2013 2014 Approved Actual Actual Percent Approved Actual Actual Percentag budget receipts expenditure age budget GH₵ receipts expenditure e GH₵ GH₵ GH₵ % of GH₵ GH₵ % of budget budget receive received d ( (actual) actual) GOG 925,167.39 1,432,735.12 1,432,735.12 57.59 1,933,191.62 1496983 1449552.1 38.09 IGF 302,713.00 186,681.31 193,301.22 61.66 295,813.24 183,468.48 212,114.56 5.83 DACF 1,636,598.61 672,191.09 715,063.75 41 2,386,036.82 714,144.06 754,942.42 47.01 M.Ps Comm. Fund 100,000.00 189,677.94 29,542.00 52.72 52,571.71 173,531.70

HIPC 20,000.00 9 0.04 CWSP\ RSTWSSP 100,000.00 87,867.16 99,218.12 1.13 65,937.72

CBRDP

Poverty Alleviation

MSHAP (AIDS) 10,000.00 2,400.00 3,946.00 24

Youth Employment

School 9.08 Feeding 460,688.00 371,804.73 218,559.38 80.7 460,688.00 Programme

TOTALS 3,555,167.00 2,943,357.35 2,692,374.59 318.84 5,075,729.68 2447167.3

Source: D A Finance Office 2014 COMMENTS: Release of funds Effort to generate funds-IGF Any other challenge with regards to generating funds

4.2: Resource Challenges  Inadequate and late release of funds affects projects implementation. As a result, most projects are tackled half way  Low IGF leads to low allocation of common fund  Due to inadequacy of funds inaccessible areas are often neglected  Political interference especially, at source deductions without pre informing the district throws the district budget out of order.  Protocol extending official also put pressure on the budget  Absence of a substantive budget officer always makes it difficult to budget

CHAPTER FIVE

The Way Forward

5.1: Key Issues Addressed  Quarterly and Annual Reports submission to DPCU improved and

 Initiation of physical and non-physical projects and programs in the district as indicated in attached reports..

5.2: Key Dev’t Issues to be addressed in 2014  Offer Care and Support to HIV/AIDS Victims in the District  Provide infrastructure/logistics support for all health facilities  Provide potable water sources and sanitation facilities in the district  Maintain Peace and Security in the District duals to undertake small and medium scale enterprises.  Resource DPCU for effective supervision and M&E in the district

 Update of a District Database System.

 Resource officials to ensure effective Revenue Mobilisation.

 Improvement on agricultural technology and extension services  Provision of School infrastructure / facilities and teaching and learning materials  Reduce dropout rate among boys and girls

5.3 Recommendation  Timely and continuous in-service training and capacity building for staff.

 Timely capacity building workshop for revenue collectors to ensure effective revenue collection.

 Train stakeholders on M & E processes.

 Train staff on Project Management.

 Gov.t should ensure timely release of funds.

5.4 Conclusion From the above analysis, it is clear that the district has made some developmental progress in the major sectors within the period under review. Noticeable among is the educational sector where the district has achieved a good position on both regional and national rankings. Stakeholders should be encouraged to intensify their efforts so as to further enhance the districts desire for better standard of living for its people.

However, timely provision of financial support for planning and implementation of development programmes from the central government would be necessary as it will go a long way to facilitate effective services delivery.

Appendix 1: Health Sector performance EPI Coverage’s by Sub-District Jan.-Dec. 2014

BCG/OPV0 Cov. Compared '14 4500 4000 3500 3000 2500

COV 2000 1500 1000 500 0 Jenjemirej Abirikasu Adamsu Drobo Gonasua Zezera Total a tgt 499 539 1447 698 356 520 4059 OPV/Polio 0 82 235 2151 589 146 160 3363

Source: DHD, JSDA 2014

Measles 1&2 /Yellow Coverage Compared, Jan. To Nov. 2014

Bcg/Msls1/2/Yf Compared '14 4500 4000 3500 3000 2500 2000

coverage 1500 1000 500 0 Jenjemirej Abirikasu Adamsu Drobo Gonasua Zezera Total a tgt 499 539 1447 698 356 520 4059 BCG 258 383 2102 625 146 335 3849 Measles Rubella 392 461 1436 707 173 377 3546 Measles 2 349 418 1345 595 252 320 3279 Yellow Fever 395 461 1522 707 173 372 3630

Source: DHD, JSDA 2014

Measles Coverage/ Cases Compared 2012-2014

MSLS COV./ Cases Compared '12 /'13/'14

TGT COV CASES

4092 4059 3878 3976 3967 3546

12 14 12

2012 2013 2014

Source: DHD, JSDA 2014

Appendix 2: STATUS OF DEVELOPMENT PROJECTS AS AT THE END OF 2014 Contract Expected % of Date Sources of Payment Remarks sum Date of work Balance Awarded Funding to Date /Status (GH¢) Completion done S/N. Project Title/ Location Contract A EDUCATION SECTOR 1 Const. of ICT Centre @ Drobo 301,754.54 08-02-12 11-02-12 DDF 85% 150,877.27 Ongoing M/S Acquah Const. of 1 No. 2-Unit classroom K. 92,404.82 May 12 July, 2013 DDF 95% 64,039.71 28,365.11 On-going Kindergarten Block@ Adiokor Construction 2 Ltd Terminated Const. of 3-Unit Classroom Block M/S Mykye HIPIC 28,904.66 Nov. 04 Mar-05 85% 26,611.46 2,293.19 & at Dodosuo Methodist Ent. 3 /DACF Reparkaged

M/S Offei Terminated Const. of 6-Unit Classroom Block Brothers 73,357.13 Dec.05 Jul-06 DACF 75% 47,871.70 25,592.43 & at Zezera const. Reparkaged 4

Const. of 1 no. 2-unit K.G block 03 Sep. 03 AB Ziko 127,447.30 DDF 48% 87,597.04 39,850.26 on-going with anciliary facilities@ Gonasua 2014 March,2015 5 Const. of 1 no. 3-unit classroom block with office & store @ M/S Maa 03 Sep. 03 136,546.19 DDF 40% 80,220.88 56,325.31 on-going Ahmadiya Islamic prim. Sch. @ Adwoa Ent. 2014 March,2015 6 Japekrom B HEALTH SECTOR Phase One is Const. Of 1 No Story NHIS Adm M-S Garf 78,935.63 NOV. 06 Dec. 2007 DACF 100% 72,435.63 Nil Completed & Block At Drobo Const. Ltd In used 7 Const. of 1 no. 2-unit demostration M/S Oasis 03 Sep. 03 Nursing & Midwifery classroom 291,090.10 DDF 40% Nil 291,090.10 on-going Ltd. 2014 April,2015 8 block @ Drobo Const. 1 no. 10-unit Rural Clinic & M/S Oasis 03 Sep. 03 152,929.36 DDF 40% 104,374.29 48,555.07 on-going 9 anciliary facilities @ Meramano Ltd. 2014 April,2015 C WATER & SANITATION SECTOR

Construction of 10 no. boreholes M/S Comero with hand pumps@10 selected 132,000.00 02-09-11 02-09-12 DACF N/A 95,000 52,000.00 On-going Drilling Ltd. 10 communities Drilling Of 12 No Borehole At 12 AFD- M/S TBL Ltd. 118,604.64 Feb-11 Feb-12 100% - - Completed 11 Communities Donner D SANITATION Construction of 3 No, KVIP @ Atuna Islamic M/S Biyira Adiokor Health Centre Construction 46,000.00 Aug, 10 Aug. 11 DACF 70% 23,000.00 23,000.00 On-going Works 12 Boadjo Terminated Const. of 1 No Butcher Shop At M/S Myoho 21,054.96 Dec. 05 06-Jun DACF 65% 10,618.57 10,436.39 & Japekrom Company Ltd 13 Reparkaged E ROADS SECTOR Reshaping of all major roads @ - N/A N/A N/A GoG 90% N/A N/A On-going 14 Drobo/Japekrom F SECURITY Const. of 1 No. District Police Crownhouse Headquarters with ancillary Logistics& 171,350.70 Feb, 2013 July, 2013 DDF 100% 132,269.84 39,080.86 Furnishing 15 facility@ Drobo- Japekrom Const. G CENTRAL ADMINISTRATION Ofori and Const. 1 No. semi-detached March, Sons 92,695.59 Sept. 2011 DACF 90% 86,680 6,015.06 On-going Bungalow-Drobo 2010 16 Ltd M/S Emmaunel Terminated Const. of 1 no. 3 storey Dist. Otoo 420,620.90 Dec. 06 Dec. 2007 DACF 40% 163,540.85 257,080.05 & Assem. Adm Block at Drobo Furniture & Reparkaged 17 const. Const. of Fence Wall at DCE'S M/S Chaplain 57,400.00 Mar-10 Sept. 2011 DACF 100% 57,400.00 N/A Bungallow Ent Ltd. 18 Completed

Const. of Area Council at M/S Duutor 23,817.32 Nov. 04 Mar-05 DACF 70% 16,640.23 7,177.09 Terminated Kwameseikrom Heritage 19 H MICROECONOMIC

M/S M Bonsu Const. of 5 No. 20 Units Open Const. Works 95,926.50 Feb-13 July, 2013 DDF 80% 88,856.19 9,675.31 On-going Market Stalls@ Drobo 20 Ltd. Const. of Pavement of Mkt@ M/S Oasis 11 June, 11 Jan., 472,210.84 DACF 45% 190,831.63 281,379.21 On-going 21 Drobo Com. Ltd. 2014 2015 M/S Street Supply of Equipment for Street Naming GH 27,184.00 N/A N/A DDF 100% N/A N/A Completion Naming 22 Ltd Terminated M/S C. K. G. Const. of ware house @ Drobo 34,180.67 Sept. 06 April, 07 DACF 50% 13,628.94 20,551.73 & Adasama 23 Reparkaged PROJECTS UNDER THE RURAL ELECTRIFICATION PROJECT Rural Electrification Project (Shep - Jan-10 Jan-11 Gog 65% - - On-Going 24 Four)