2014 Half Year Performance review

1. 2014 HalfYear Performance review
Mrs. Beatrice Kunfah (MDHS)

2. OUTLINE OF PRESENTATION
 Background
 Priorities
 Key challenges
 Key achievements
 Performance in Key Service Indicators
 Innovations & Best Practices worth Sharing
 Key Recommendations andWay forward for Second half of

3. BACKGROUND INFORMATION/PROFILE
Pop: 115,597
6 Sub-Municipals
33 reporting Health
Facilities

4. PRIORITIES & CHALLENGES
 Scale Up Community –based Health
Planning and Services
 Improve quality of Reproductive and
Child Health
 Regenerative Health and Nutrition
including medical screening
 Disease Control and surveillance
 Regular community dialogue and
sensitization through nightVideos and
C4D activities
 Improve data collection and reporting
from private health facilities
 Data Management
 Intersectoral Collaboration
 Inadequate Critical Health Staff ( Medical
assistants, pharmacist and record and Lab
Assistants etc )
 Inadequate official and residential
accommodation
 Medicines and records management(folders)
 Delayed Reimbursement for NHIS claims
 Staff Indiscipline
 Weak Continuum of care(Regional hospital and
Health facilities)
 High communicable disease burden of Malaria,
TB, HIV/AIDS
 High infant, maternal and neonatal mortality
 Collaboration with Private Service Providers

5. KEY ACHIEVEMENTS (1)
 More than half of the Staff have beenAppraised for the year 2013
 Newly appointed staff were also oriented before posting to their various facilities
 In- service trainings were organized for staff to improve their performances on the
job.
 No major accident under the period of review.
 Active case search for CMAM Cases
 Successful sensitization on guinea worm identification and cash reward, &
preparation for visit of certification team
 Conducted 2 rounds Facilitative supervision to all Sub municipals
 Conducted first round of OTSS to all the facilities including private facilities.

6. KEY ACHIEVEMENTS (2)
 Conducted Mass Drug Administration (MDA) against filariasis and Onchocerciasis
 Organized refresher training for Community Based Surveillance volunteers
 Trained 24 CHNs/CHOs on Implanon and Jadelle insertion
 Organized fora for men on family planning and other RCH activities in all sub-municipals
 Organized community durbars on maternal/child health activities and importance of family planning
 Carried out maternal death audits in two communities on causes and prevention of maternal deaths
 Trained fifty five staffs on costumer care
 Organized midwives forum on MNH/family planning
 Screening of Fire service women for breast cancer
 Renovation of MHA Offices

7. CommitmentsTO RMS & NHIS Outstanding claims
FACILITY
RMS COMMITMENTS OUTSTADING
CLAIMS FROM
NHIS
NET BALANCE
NON DRUGS DRUGS
WA SUB. 1,765.61 35,331.02 145,710.42 108,613.79
KAMBALI 1,076.95 15,764.16 87,708.33 70,867.22
CHARIA 49.5 4,108.23 24,100.32 19,942.59
CHARINGU 1,248.49 2,593.94 12,054.60 8,212.17
KONTA NORTH 826.21 6,899.25 30,726.65 23,001.19
MARKET CLINIC -16.77 31,826.01 78,512.82 46,703.58
DOBILE CHPS 215.88 9,692.06 27,674.25 17,766.31
BUSA 754.73 6,034.29 28,730.06 21,941.04
BAMAHU 503.36 11,263.03 36,750.83 24,984.44
WA SHS 360.99 7,828.07 33,212.39 25,023.33
KPERISI 340.14 3,797.93 14,511.02 10,372.95
ADOLESCENT 277.92 10,313.33 23,565.90 12,974.65
TOTAL 7,403.02 145,451.32 543,257.59 390,403.26

8. HUMAN RESOURCE - SUMMARY
INDICATOR NUMBER
Total number of staff 260
Total number of staff on course 57
Total number of Staff at Post 203
Postings In 63
Promotions 11
Appointments 9

9. HIGHLIGHTS OF
PERFORMANCE

10. Sensitization on guinea worm Identification & Cash reward

11. VISIT OF GUINEA WORM INT. CERTIFICATIONTEAM

12. HIV & AIDS - PMTCT
INDICATORS 2012 2013 2014
ANC registrants 1,854 1,998 2,249
Number Counseled 1,692 1,915 2,187
percentage counseled 91.3% 95.8 97.2
No. Tested 1,662 1,909 2,195
Percentage Tested 89.6% 95.5 97.5
Number positive 17 19 20
percentage positive 0.05% 1.0 0.9
Number tested for syphilis 1,909 1,446
Number positive for syphilis 3 9
Number treated for syphilis 3 9

13. TUBERCULOSIS –NEW CASES @ HalfYear
INDICATOR 2012 2013 2014
New Smear Positive
PTB
26 5 5
New Smear Negative
PTB 10 0 0
Extra Pulmonary ETB
11 0 0
Smear Not Done 5 0 0
Total 52 0 5

14. MATERNAL & NEW BORN CARE – ANC, DELIVERY & PNC
2012 2013 2014
ANC 66.4 66.6 71.4
SKILLED DEL. 51.7 57.7 66.6
PNC 56.1 56.7 67.5
TARGET 45 45 45
0
10
20
30
40
50
60
70
80
%Clients

15. MATERNAL HEALTH – FIRSTTRIMESTER REGISTRATION
Median
Goal
0
10
20
30
40
50
60
70
80
Jan'10
Feb'10
Mar'10
Apr'10
May'10
Jun'10
Jul'10
Aug'10
Sept'10
Oct'10
Nov'10
Dec'10
Jan'11
Feb'11
Mar'11
Apr'11
May'11
Jun'11
Jul'11
Aug'11
Sept'11
Oct'11
Nov'11
Dec'11
Jan'12
Feb'12
Mar'12
Apr'12
May'12
Jun'12
Jul'12
Aug'12
Sept'12
Oct'12
Nov'12
Dec'12
Jan'13
Feb'13
Mar'13
Apr'13
May'13
Jun'13
Jul'13
Aug'13
Sept'13
Oct'13
Nov'13
Dec'13
Months
Percentage(%)

16. MATERNAL HEALTH – AVERAGEVISIT PER CLIENT
Sub Municipal 2012 2013 2014
Bamahu 2.9 4 4
Busa 3.1 3.4 4
Charia 3.3 5 5.3
Charingu 3.3 4.3 4.3
Kambali 5.1 3.3 4
Upper West
Regional Hospital
2.7 3.1 3.7
Wa Central 3.2 3.9 3.6
Wa Municipal 3.2 3.7 3.9

17. MIDWIVES FORUM

18. CUSTOMER CARETRAINING

19. TEENAGE PREGNANCIES – INCREASINGTRENDS
Bamahu Busa Charia Charingu Kambali
Reg.
Hospital
Wa Central Wa
2012 6.4 11 10.7 13.5 6.7 5.6 8.3 7.8
2013 7.4 19.1 17 20.2 10.1 7.4 9.4 10.3
2014 12.7 14 16.8 16.4 11.9 4.7 9.3 9.8
0
5
10
15
20
25
Percentage(%)0fAdolescents
% of Adolescent 10-19yrs attending ANC

20. MATERNAL & NEW BORN CARE – MATERNAL MORTALITY
– Half yearTrend (2008-2014)
2008 2009 2010 2011 2012 2013 2014
Maternal Deaths 4 7 3 4 3 6 3
MMR 278 429 190 218 132 224 98
Target 185 185 185 185 185 185 185
278
429
190
218
132
224
98
0
50
100
150
200
250
300
350
400
450
500
MMR/100,000Livebirths
MDGTarget (185/100,00 live births

21. CAUSES OF MATERNAL DEATHS
CAUSES OF MATERNAL DEATHS -2012-2014 1/2 YEAR
CAUSE OF DEATH 2012 2013 2014
HAEMORRHAGE 0 1 0
ECLAMPSIA 1 0 0
CEREBRAL MALARIA 1 0 0
HEPATITIS 1 0 0
DRUG REACTION ( community death) 1 0 0
MYOCARDIAL INFARCTION 0 1 0
MENIGITIS 0 1 0
SICKLE CELL DISEASE 0 1 0
UNSAFE ABORTION 0 1 2
SEPSIS 0 1 1
TOTAL 3 6 3

22. SCREENING FOR BREAST CANCER

23. MATERNAL & NEW BORN CARE – STILL BIRTH RATE
2008 2009 2010 2011 2012 2013 2014
Still Births 83 97 76 87 95 103 104
still Birth Rate 58 59 48 47 42 38 34
83
97
76
87
95
103 104
58 59
48 47
42 38 34
0
20
40
60
80
100
120
No.ofStillBirths&StillBirth
Rate/1,000livebirths

24. Neonatal Deaths, 2008-2014: HalfYear
15
6
11
4 4
9 8
7
7
20
28 31
34
30
0
5
10
15
20
25
30
35
40
45
50
2008 2009 2010 2011 2012 2013 2014
NO.OFNEONATALDEATHS
Post neonatal deaths Neonatal deaths (<1 m)

25. CHILD HEALTH – EXPANDED PROGRAM ON IMMUNIZATION
BCG PENTA3 MEASLES RUBELLA YF
2012 61 49 49 46
2013 102 48 40 40
2014 70 54 52 52
Target 45 45 45 45
0
20
40
60
80
100
120
%ofChn.Vaccinated

26. EPI COVERAGE & DROP OUT RATES - 2014
SUB
MUNICIPAL
BCG MEASLES PENTA 3 BCG/MEASLES
DROP OUT
PENTA 1 & 3
DROP OUT
BAMAHU 10% 49% 38% -378.0 -0.7
BUSA 27% 59% 63% -116.5 -18.5
CHARIA 11% 61% 61% -462.5 -17.6
CHARINGU 19% 29% 39% -53.1 1.7
KAMBALI 1% 67% 70% -6733.3 -24.6
WA CENTRAL 14% 44% 41% -208.0 -62.1
REG.
HOSPITAL
108% 7% 11% 93.9 65.9
MUNICIPAL 70% 52% 54% 26.1 0.2

27. FAMILY PLANNING ACCEPTORS
Bamahu Busa Charia Charingu Kambali Wa Central
Reg.
Hospital
Municipal
2012 32 30.6 34.6 15.1 36.5 9.8 4.7 32.4
2013 41.4 29.7 42.8 8.4 25.9 31.2 3.3 31.8
2014 34.7 28.6 52.4 17.9 50.6 40.9 5.4 42.3
Target 40 40 40 40 40 40 40 40
0
10
20
30
40
50
60
%FPAcceptors

28. NUTRITION – HOUSEHOLD SALT SURVEY
Neutral <15ppm >15ppm
May, 2011 27.3 34 38.3
May, 2012 30 37 33
June, 2013 26 25 49
June, 2014 10.3 31.8 57.9
0
10
20
30
40
50
60
70
PERCENTAGES

29. Proportion of suspected Malaria OPD Cases tested
TOTAL TESTED (MICROSCOPY OR RDT)%
TOTAL POSITIVE (CONFIRMED MALARIA
CASES ONLY) %
2013 39.60% 49.80%
2014 84.30% 63.40%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
2013
2014

30. INTERMITENT PREVENTIVETREATMENT
Sub Municipal
2012 2013 2014
IPT1 IPT3 IPT1 IPT3 IPT1 IPT3
Bamahu 203 117 194 164 62 2
Busa 58 61 76 40 30 2
Charia 119 91 141 127 83 0
Charingu 149 71 92 35 18 5
Kambali 229 89 224 88 45 27
Reg. Hospital 566 298 620 359 294 151
Wa Central 836 349 1047 694 284 116
Wa Municipal 2160 1076 2394 1507 816 303

31. Home based care by CBAs – Jan-Jun, 2014
Sub
Municipal
Children
Checked
Children
with
danger
sign
Conditions
Treatments with Recommended
Medicines
Referrals
Fast
breathing
Diarrhoea Fever AA Amoxicillin ORS Zinc
Bamahu 79 9 0 27 43 43 0 27 0 0
Busa 57 0 14 18 25 25 14 18 2 8
Charia 0 0 0 0 0 0 0 0 0 0
Charingu 53 0 22 12 19 19 22 10 2 25
Kambali 0 0 0 0 0 0 0 0 0 0
Wa
Central
475 6 81 173 215 145 81 173 0 120

32. Community Based Services – CHPS Implementation
24 24
2 2 3
7
10 10
12 12 13 13
2 2
4
8
11
13
15
20
22 22
0
5
10
15
20
25
30
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
No.ofZones
Demarcated Zones Zones with compounds Functional Zones
Target
CHPS ZONE
HOUSEHOLD
VISITS
DURBARS
SOCIAL GROUP
MEETINGS
CHC MEETINGS
TOTAL 15667 44 45 71

33. DISTRIBUTION OF CHPS ZONES

34. Intersectoral Collaboration
Partner/Collaborator Contribution
Municipal
Assembly
• Health Infrastructure
• Child Health
AGAMAL Ltd. • Indoor Residual Spraying for malaria control
PLAN GHANA • Disease control and child Health
World FOOD
PROGRAMME
• Child Health
GES • School Health Services
• Deworming and Immunization of school children
NCCE • Social Mobilization
National Ambulance • Referrals

35. Media collaboration

36. radio discussion on male involvement at w fm.

37. HMIS, RESEARCH & ICT
Networking of the Municipal Health Directorate
Creation of a Data bank and installing a server
Using file sharing system (e.g, dropbox) to make key
information available to desktop computers in the
network
Preparation for an Integrated EPI Cluster survey are
complete and will be conducted in the third quarter to
assess immunization coverage for all sub municipal.

38. Innovations & Best Practices worth Sharing
 Development and hosting a website for theWa Municipal Health
Service (www.wamunicipalhealthservice.com )
 Internal study tour among CHPS Zones in the municipal
 Formation of CHOs Association
 Using occasions in communities such as naming ceremonies to pass
Health messages to community members
 Compilation of social groups and their meeting dates withinCHPS
catchment areas in the Municipality
 Printing of Identity Cards for CommunityVolunteers

39. RENOVATION - MDHS OFFICE

40. Conference Room

41. Way forward for Second part of the year
 Intensify community education and dialogue on reproductive health services.
 Quarterly orientation on data management
 Organize a staff durbar in the 3rd qtr
 Functionalize demarcated CHPS Zones
• Conduct EPI Cluster Survey
• Conduct quarterly data validation at health facilities
• Posting/redistribution of midwives, CHNs and CHOs
 Organize health screening for health staff in the third Qtr.
 Begin to audit all neonatal deaths from the municipality
 Conduct Stakeholders forum in all sub municipals
 Meeting with all private health providers
 Staff Awards

42. ACKNOWLEDGEMENT
 RHD
 MUNICIPALASSEMBLY
 DECENTRALISED DEPARTMENTS
 PATH MALARIA CARE
 COMMUNITY BASEDVOLUNTEERS
 COMMUNITY MEMBERS &TRADITIONAL LEADERS
 NCCE
 WFP
 UNICEF
 WHO
 JICA
 Local NGOs

43. THANKYOU
visit www.wamunicipalhealthservice.com for more details
“Some is not a number,
soon is not a time, hope is
not a plan”
- Anonymous