On October 27th 2022 the Health Directorate commenced the DISTRICT FUNCTIONALITY ASSESSMENT, the team comprises the District Health Director, Medical Superintendent, Pharmacy Technician, Planning Officer, Health Information Officer and the PHN.
The Number of sub-district facilities was 4, Population in the 75101
The network of practice is one of Ghana’s strategies to achieve universal health coverage at the
primary level, focusing on improving quality health services, partnership and innovation.
It involves creating a network of health facilities within a defined geographical area providing
comprehensive health services. It allows a fruited system of managing and sharing resources
without significant adjustment to the existing organizational structures. It is created around
health centres with all other health providers within the sub-district.
The goal is to increase access to quality essential health care and population-based service for
all by 2023.
the Main Objective is to provide Universal access to better and efficiently managed quality healthcare services, Increase access to responsive clinical and public health emergency services, and Reduce avoidable maternal, adolescent and child deaths and disabilities.
Findings of assessments the availability of essential services score are 90.7%, whilst the coverage is 882% and financial
risk protection stands at 87.2%. These scores indicate that there is a need for sustained efforts and
sharing of lessons learnt.
The overall average availability of essential services score is 90.70% out of 100%. This score
means that there is a need for sustained efforts and sharing of lessons learnt.
The availability of essential services for pregnancy and newborn is 93.1%, for childhood 86.6%,
adolescent 96.5%, adults 88.2% and elderly 93.1%.
The availability of Essential services for pregnancy and newborns recorded at the Primary Health
Service was 87% while the Hospital recorded 100%,
the coverage of essential services for infectious disease is 100%, and coverage for
non-communicable disease is also 100%, whilst for reproductive, maternal and newborn is
93.1%. These scores mean that there is a need for sustaining efforts and sharing of lessons learnt.
The overall coverage of essential services for infectious disease for Primary health care is 98.8%
out of 100%, while coverage for the hospital is 80%. Coverage for Non-communicable diseases
for primary health care stands at 90.8% while the hospital recorded 100%. These scores mean
that there is a need for sustained efforts and sharing of lessons learnt.
The overall financial risk protection score of 87.8% out of 100%. This score
means that there is a need for sustained efforts and sharing of lessons learnt at the hospital but
there is a need for the introduction of new interventions at the primary health care facilities.
The inpatient admission services in primary health care facilities are 0.0% compared to hospital
90.9%
Inpatient operative services are 0.0% in Primary Health care facilities and 75.0% in hospital
The general outpatient services score is 100% in primary health care facilities, compared to 93.1% in
hospital, whilst specialist outpatient services score is 92.1% in primary healthcare facilities and
96.0% in hospital.
Financial risk protection for the score of the rehabilitative service is 0.0% in primary health care
facilities and the hospital as well due to the lack of specialists in the district.
The palliative care score is 75.0% in primary health care score is 75% in primary care facilities and
75.0% in hospital.
The overall average PHC score is 78.4% out of 100%. This score means that
there is a need for sustained efforts and sharing of lessons learnt, but there is a need for up –
scaling interventions for Capacity for knowledge production and use and community
empowerment.
The PHC approach for human resources is 75.0% with community empowerment at 67.8%.
Capacity for knowledge production and use is 67.8%, alignment of stakeholders with national
priorities 100%, financing 82.5% and technology transfer standing at 84.1%.
The overall determinants of health score is 75.3% out of 100%. The social determinants of health
stand at 86.6%, environmental determinants at 73.3%, economic determinants at 72.8% and
political determinants at 65.5%. This score means that there is a need for up–scaling
interventions apart from social determinants.
The overall average security for the district is 79.0% out of 100%. These are composed of multiple
factors which are grouped under prevention with a score of 77.2%, Detection 80.0%, Response
0%, and organization and leadership 86.6%.
The overall average health system functionality score is 85.2% out of 100%. The oversight
capacity is 90.9%, management capacity 83.6%and health systems capacity has a score of
83.8%.
the overall system capacity score is 83.8% out of 100%. Access is 91.8%
whereas the quality of care has a score of 96.6%. Demand is 79.0% and resilience has a score of
82.5%. These scores mean that there is a need for sustained efforts and sharing of lessons learnt.
the results for health system capacity breakdown across the four capacities
namely; Access, Physical access, socio-economic and financial. Within access is 91.8%, Physical
access has 95.6%, the financial score of 95.5%, and socio-cultural with the lowest score of 75%.
The demand, health-seeking behaviour is 77.2%, compared to individual health
actions 80.9%.
Technical accountability scored 86.6% compared to social accountability of 86.6%. The public health confidence is 86.6%, whereas stakeholders
engagement is 93.1%. The legal and authority score is 95.3%, whilst the regulatory mechanism
has a score of 86.6%.
The overall score for the district’s management capacity is 83.6. % out of 100%. Per the chart,
Share value has the highest score of 84.9% while style recorded the least value of 75%.
CHALLENGES
1. Inadequately trained staff on emergency and infection prevention
2. Inadequate supply of essential medicines
3. No adolescent immunization at all levels
4. Inadequate administrative staff at primary care facilities
5. All facilities in the District do not have adequate means of transport
6. Inadequate operational space at all levels
7. Primary healthcare facilities do not have an alternative power supply
8. Inadequate specialists at all levels eg, Occupational and speech therapists.
WAYFORWARD
1. Train staff on emergency and infection prevention
2. Liaise with Medical Stores for an adequate supply of essential medicines
3. Establishment of adolescent immunization centres at all levels
4. Liaise with Regional Health Directorate for adequate administrative staff at primary care
facilities
5. Liaise with Regional Health Directorate for adequate means of adequate
6. Liaise with District Assembly for adequate operational space at all levels
7. Lobby with District Assembly and other stakeholders for other alternative sources of
power.
8. Liaise with Regional Health Directorate for an adequate specialist to be posted at all levels
eg, Occupational and speech therapist.
CONCLUSION
The assessment was very educative and the district will conduct it each quarter. We will sustain
the gains and improve on our performance in the next quarter