UNIVERSITY FOR DEVELOPMENT STUDIES

SCHOOL OF MEDICINE

COMMUNITY BASED EDUCATION AND SERVICES

PROBLEMS AND POTENTIALS OF VITTING-DAGBOSHIE

COMMUNITY IN THE TAMALE METROPOLIS, NORTHERN
REGION

OCTOBER 2021

BY
GROUP 12
Presentation

This is a comprehensive report on the profile of the Vitting community and introduction to

Vitting Health Center compiled and presented by group 12 of the 2021 COBES of the University

for Development Studies, School of Medicine, and Tamale. Below is a list of the students of

Group 12 who contributed to the development of this comprehensive report.

NAME INDEX NUMBER

OKOBOH JOYCE SMS/0127/19

ATTAKUMAH AKU SIKA GIFTY SMS/0102/19

APPENAHIER JAMES ADDY SMS/0099/19

EUGENE OSEI AKOTO SMS/0122/19

CHIALIN YOBAAT SMS/0144/19

BUKARI ISSAHAKU SMS/0159/19

1
Acknowledgement
We are grateful to Almighty God for his endless guidance and protection throughout this period.
Our next thanks go to the leadership of Vitting community including the chief and his elders and
the assembly man who contributed to the success of this project. We also thank the entire
COBES board and our coordinators for their love and guidance. We express our profound
gratitude to the head of Vitting Health Center in the person of Mr. Paul Wanti and the entire
staffs of the facility.

2
Declaration
We hereby declare that this training report is our original work and has not been submitted
before for any academic award either in this or other institutions of higher learning for academic
publication or any other purpose. All the personnel from whom secondary data that were used in
this report were acquired from have been accordingly acknowledged.

Name: Okoboh Joyce, Attakumah Aku Sika Gifty, Appenahier James Addy, Eugene Osei Akoto,

Chialin Yobaat and Bukari Issahaku.

Signature………………………. Date 9th October, 2021.

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Table of Contents
Acknowledgement.....................................................................................................................................2
Declaration.................................................................................................................................................3
List of Tables..............................................................................................................................................5
Introduction...............................................................................................................................................8
Objectives of COBES for SoM.............................................................................................................8
Objectives for COBES II.....................................................................................................................10
Activities...............................................................................................................................................10
Research methodology............................................................................................................................11
Research limitations............................................................................................................................12
Chapter one..............................................................................................................................................13
Social-demographic characteristics....................................................................................................13
Location................................................................................................................................................13
Population distribution and dynamics...............................................................................................13
Sex distribution....................................................................................................................................13
Climate.................................................................................................................................................14
Religion.................................................................................................................................................14
Inhabitants/Ethnic groups..................................................................................................................14
Chapter two.............................................................................................................................................15
Education.............................................................................................................................................15
Educational status of the community.................................................................................................15
Challenges of the schools.....................................................................................................................19
Chapter three...........................................................................................................................................20
Social-economic activities....................................................................................................................20
Source of income and labour..............................................................................................................20
Transport and communications.............................................................................................................20
Transport.............................................................................................................................................20
Communication...................................................................................................................................20
Housing.................................................................................................................................................20
Chapter four............................................................................................................................................21
Water and sanitation...........................................................................................................................21
Water....................................................................................................................................................21
Challenges of water.............................................................................................................................21

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 Sanitation.............................................................................................................................................21
Chapter Five............................................................................................................................................24
Health and nutrition............................................................................................................................24
Health...................................................................................................................................................24
Availability of Health Facility.............................................................................................................24
Out-patient department (OPD)..........................................................................................................24
Services rendered.................................................................................................................................24
Labour Ward.......................................................................................................................................26
Antenatal care (ANC)/ Family planning............................................................................................26
Child welfare clinic (CWC).................................................................................................................27
Accessibility of Health Facility...........................................................................................................32
Affordability of the Health Facility....................................................................................................33
Utilization of Health Facility...............................................................................................................33
Skills acquired at the facility...............................................................................................................33
Health System and Health seeking behaviors....................................................................................34
Health...................................................................................................................................................34
Health seeking behaviors....................................................................................................................34
Vital events of the community............................................................................................................34
Death.....................................................................................................................................................35
Challenges at the Health Facility........................................................................................................37
Nutrition...............................................................................................................................................38
Food ethnography (dietary patterns and food habits)......................................................................38
Nutritional status of children under five (Anthropometric assessment).........................................38
Chapter six...............................................................................................................................................40
Community health needs assessment.................................................................................................40
Pairwise ranking..................................................................................................................................41
SWOT analysis....................................................................................................................................42
Conclusion................................................................................................................................................45
Recommendation.....................................................................................................................................45
Reference..................................................................................................................................................46
Appendices...............................................................................................................................................46

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List of Tables
Table 1.0 1Sex distribution in Vitting...........................................................................................14

Tabel 1.1 1Hanara primary and JHS enrolment............................................................................16

Tabel 1.2 1Wunzuuya Academy Complex enrolment...................................................................17

Tabel 1.3 1Vitting-Dagboshie primary enrolment.........................................................................18

Tabel 1.4 1Top ten OPD cases......................................................................................................25

Tabel 1.5 1CWC attendance for 2020...........................................................................................27

Tabel 1.6 1national immunization schedule for children..............................................................29

Tabel 1.7 1Vitamin A supplementation for 2019-2020, vitting health centre...............................30

Tabel 1.8 1EPI Coverage, half-year, 2021....................................................................................31

Table 1.9 1Vital events for past one year, Vitting health centre...................................................35

Table 2.0 1Top 10 morbidity cases................................................................................................36

Table 2.1 1Total children measured for stunting from 2019-2021................................................39

Table 2.2 1Pairwise ranking..........................................................................................................42

Table 2.3 1SWOT analysis............................................................................................................44

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Executive summary

This report gives a detailed account of a study carried out in the Vitting-Dagboshie community
in the Tamale Metropolis in the northern region by Group twelve (12) of PBL 2B during the
2021 COBES program. Vitting-Dagboshie community is located in the Tamale Metropolis of the
Northern Region of Ghana. Vitting shares boundaries with Tamale Central Sub-metro on the
south, north east by Mion district, North West by Salaga district, east by Sangnarigu and
Savelugu district and on the west by the Bilpeilia sub-metro. The community is predominated by
Dagombas who are Muslims, followed by Christians (predominantly the Roman Catholic) and
the African Traditional Religion. The secondary data from the district assembly indicate that out
of a population of 84,065 people, 44,593 are females and 39,472 are males.
Majority of the houses are built with block and cement, and roofed with aluminum sheets. Few
houses are also built with mud. The Community depends on mechanized boreholes, pipes with
taps, rainwater as well as wells, for their water supply.

There are few refuse and majority of the people burn refuse around their houses.
The community health center, the Vitting Health Centre, provides health service to five (5) sub-
districts under Vitting. A good percentage of the people are insured under the National Health
Insurance scheme (NHIS). Child Welfare Clinic (CWC), Antenatal Clinic (ANC) / Family
planning, Out Patient Department (OPD), Nutrition and Psychiatry, Disease control, Dispensary,
store and detention constitutes the various units of the Vitting health center.

There are Pharmacy and Over the Counter Chemical shops available in the community. The
predominant disease in the community is malaria.

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Introduction
“Community-Based Education is a means of implementing a community-oriented educational
program. It consists of learning activities that take place within the community where not only
students, but also teachers, members of the community and representatives of other sectors, are
actively engaged through the educational experience. Community-Based Education can be
conducted wherever people live, be it in a rural, suburban or urban area, and wherever it can be
organized.” (WHO, 1987) It has been long realized that Community-Based Education is more
meaningful when those been educated also offer some services to the community. By so doing
students contribute to filling service gaps in the community through direct service provision. It
also helps to demonstrate that it is possible to link the University and society to promote social
accountability.

Community-Based Education and Service (COBES) is universal to all the academic programs in

the University for Development Studies (UDS). The law establishing the University mandated it

to be community-based. The COBES component (Third Trimester Field Practical Training,

TTFPP) of UDS has been its claim to fame since its establishment in 1992.

When the School of Medicine and Health Sciences (SMHS), now School of Medicine, was

established in 1996, it had an additional mandate of using Problem-Based Learning (PBL) as its

method of instruction. An abortive attempt was made at introducing PBL in SMHS earlier.

Recently (2007/2008 academic year), PBL was successfully reintroduced but not without

bottlenecks/challenges. One of such challenges is the integration of TTFPP/COBES and PBL.

Objectives of COBES for SoM

 Help students develop favorable attitudes towards working in rural disadvantaged
communities

 Enable students to extend the skills of problem-based learning to gain insights into

community health problems

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 Enable students to appreciate the importance of health promotion and disease prevention

 Expose students to the reality of community and public health systems in rural settings

 Identify and explain factors that affect the health of the community

 Increase students’ knowledge related to Epidemiology and Biostatistics

 Increase students’ awareness about behaviors and practices that may affect health

 Expose students to methods of intervention that are applied as close as possible to

communities served by health centers and clinics, thus gaining an understanding of the

main goals of primary health care

 Help students acquire leadership and managerial skills

 Demonstrate an understanding of the concept of primary health care and play a role in its

implementation

 Understand the health policies and organization of the delivery of health care in Ghana

 Identify, plan, implement and evaluate measures for health promotion in rural

communities

 Understand the relationship between health and socio-cultural factors.

 Prepare students to be able to work in teams with other health professionals

 Collaborate with the community and other sectors in the promotion and maintenance of

health

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Objectives for COBES II
 Assist students to apply the methods and experiences acquired previously to collect
relevant data

 The main aim of COBES II is to improve students’ ability to conduct community health

diagnosis.

Activities
 Sociodemographic details of the community.

 Water and sanitation/Environmental conditions

 Health and Nutrition

 Identify the health problems and potentials of your community (both traditional and

orthodox)

o Identify ten health needs of the Community and describe them

o For each health need try and identify potentials that exist in the community which

could contribute towards satisfying that health need.

 Prioritize the health needs with the community members and come out with the topmost

health need.

o The top most need becomes your intervention for COBES III.

o Also explain how you did the prioritization/ranking using ranking tools, problem

tree and SWOT analysis

 Rotational observation at the health facility

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Research methodology
The basis of every research depends mainly on the methodologies and techniques in order to
enhance proper gathering of information for effective research. The following techniques were
employed to obtain suitable estimations and results for the project:

 Personal observation: Direct observation and participatory observations were employed

to obtain the required information. This method was used to observe the people’s culture,

rainfall, etc.

 Personal interview: This is where questionnaires were administered to some of the

community members. Vital information such as age distribution, health problems,

educational background, occupation, etc. were taken using the technique above.

 Key informant interviews: We held a discussion with Mr. Paul Wanti, the in-charge and

some of the unit heads of the Vitting Health Center and Kpala-naa of the community.

 Secondary data: Information on some topics such population dynamics, health and

educational data were obtained from the assembly man, health center and schools

respectively.

 Focus group discussions: The group met a section of the community members to discuss

and prioritize the health needs of the community.

 Preference/Pairwise ranking: Pairwise ranking is a ranking tool used to assign priorities

to multiple options. This was used to determine the top most health need of the

community.

 SWOT analysis: SWOT analysis is a technique for assessing the strength, weaknesses,

opportunities and threats of the community under study.

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  Transect walks: The group undertook a transect walk to take note of the geographic

features of the community, resources and important landmarks in the Vitting community.

Research limitations
The group faced some challenges and they are illustrated as follows:

 Language was a barrier.

 Poor record keeping was a problem in this research. Hence, there was barely any

substantial previous documents to augment our report.

 Some of the members of the community misunderstood our purpose in the community

and hence were reluctant in giving us vital information.

 The large nature of the community made our work very tedious.

 Since we self-financed our work, we had challenges in transportation and printing of our

work.

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Chapter one
Social-demographic characteristics
Location
Vitting-Dagboshie is located in the vitting sub-district in the Tamale Metropolis. Vitting is
located in the Southern Corridor of the Northern Region of the Republic of Ghana with
coordinates (9.390313, -0.793009). It shares boundaries with Tamale Central Sub-metro on the
south, north east by Mion district, North West by Salaga district, east by Sangnarigu and
Savelugu district and on the west by the Bilpeilia sub-metro. It is located on the Tamale-Yendi,
Salaga road.

Population distribution and dynamics

Secondary data from the district directorate indicated a total population of 84,065 (projected at
2.9% regional growth rate from 2010 census) and estimated children under five at 16,163 in five
sub districts. The community has a surface area of 359 sq.km which forms 35.5% of the total
land area of the Tamale Metropolis. Its population density stands at 125 persons per sq.km.

Sex distribution
The secondary data from the district assembly indicate that out of a population of 84,065 people,
44593 are females and 39472 are males. Table 1.0 shows the sex distribution of Vitting.

Table 1.0 1Sex distribution in Vitting

SEX NUMBER PERCENTAGE (%)

MALES 39472 46.954

FEMALES 44593 53.0459

TOTAL 84065 100

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Climate
The community experiences one rainy season from April/May to October, with peak in
July/August, which is influenced by the south-west, monsoon winds and a long dry season
(November to March) influenced by the north-east trade winds from the Savanna desert. It
records a mean annual rainfall of 1100mm with only three (3) months of intense rainfall.
Average maximum and minimum temperatures range between 20℃ to 39℃ respectively.

Religion
Most of the inhabitants are Muslims. Roman Catholic population remarkably dominates over the
other Christian population. African traditional religion is still practiced by a handful of people.

Inhabitants/Ethnic groups
Most of the inhabitants are mainly Dagombas from the Mole Dagbani ethnic group. They
migrated from Zapkalsi to Bayanwaya some years back and they are all Muslims and minority
from other two Northern Region (Upper East and Upper West), Vitting Sub-Metro is also noted
for good number of settlers from Burkina Faso, Mali and Niger.

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Chapter two
Education
Educational status of the community
From our research conducted, it shows that, most of the people have had basic education.
However, most of the people due to financial problems, teenage pregnancy and early marriages
dropped out of school. Nonetheless, a number of them have been able to make it to the
Secondary and Tertiary levels.

According to research there are about 20 and more educational facilities at Vitting and its sub

villages. Some of these educational facilities are;

1. Vitting Senior High Technical School

2. Dabgokpa Technical Institution

3. Vittin- Dabogshie Primary school

4. St. Peter’s J.H.S

5. St Joseph J.H.S

6. St. Charles S.H.S

7. Dabgokpa JHS

8. Luchis Basic School

9. B-Y primary School

10. Hanara primary and JHS

11. Abi academy School

12. Wunzuuya Academy Complex

15
The group visited 3 of these Schools during our transect walk and scheduled arrangement with

the heads of the schools. The table below shows the various enrollment of some of the

educational facilities of the schools visited.

 Hanara primary and JHS (An Annex)

Tabel 1.1 1Hanara primary and JHS enrolment

LEVEL Number of Number of Number of Total Percentage

males
females dropouts

Primary 5 07 35 0 42 31.82%

Primary 6 18 28 0 46 34.85%

JHS 1 15 28 1 44 33.33%

TOTAL 40 91 1 132 100%

PERCENTAGE 30.30% 69.00% 0.76% 100.0%

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  Wunzuuya Academy Complex

Tabel 1.2 1Wunzuuya Academy Complex enrolment

Level Number of Number of Number of Total Percentage

males females dropouts

Nursery 1 2 8 5 15 20%

Nursery 2 5 10 2 17 22.67

KG 1 4 11 0 15 20%

KG 2 6 9 0 15 20%

Primary 1 4 5 4 13 17.33%

Total 21 43 11 75 100%

Percentage 28% 57.33% 14.67% 100%

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  Vitting- Dabogshie Primary school

Tabel 1.3 1Vitting-Dagboshie primary enrolment

Levels Males Females Drop out Total Percentage

KG1 46 60 0 106 24.941%

KG2 26 39 0 65 15.294%

BS1 35 29 0 64 15.059%

BS2 22 28 0 50 11.765

BS3 28 24 0 52 12.235%

BS4 10 14 1 25 5.882%

BS5 14 25 0 39 9.176%

BS6 12 12 0 24 5.647%

TOTAL 193 231 1 425 100%

According to the headteachers and some teachers of the school, the reasons for the drop out of

students includes;

 Poor parental care

 Teenage Pregnancy

 Poor attitude of parents towards their wards in school.

18
  Some of the pupils do not understand the relevance of the education.

Total number of dropouts

School dropout rate in the three schools= ×100 % =
Total number of pupils

13
×100 %=2.057 %
632

Challenges of the schools

 Inadequate dustbins to dispose of waste
 Unavailability of Library
 Lack of Science and ICT laboratory
 Lack of first aid
 Inadequate classrooms
 No capitation
 High rate of needy learners
 Inadequate furniture (most pressing need)

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Chapter three
Social-economic activities
The most predominant occupation in the community is farming. They are into yam, maize,
sorghum, cowpea and millet cultivation. There are several small-scale economic activities that go
on in the community including trading, hair dressing, dress making, carpentry, masonry. Some
are also engaged in businesses like food vending while others are employed either in the public
or private sector in various disciplines. Fowls, sheep, goats, guinea fowls and cattle are the
animals reared in the Vitting-Dagboshie community.

Source of income and labour

The major source of labor is family labor. Sometimes people are hired to work on farms.

The major source of income in the community is the selling of the proceeds from their respective
farms.

Transport and communications

Transport
Motorcycles, bicycle, cars and ‘pragya’ / ‘yellow yellow’ serve as their means of transportation
in the community. Almost every household in the Vitting-Dagboshie community has a
motorcycle if not more. Only a few people in the community have cars. There are no bus stations
in the community. There are untarred roads in the community that link them to other
communities.

Communication
All the telecommunication networks in Ghana work in Vitting (i.e., MTN, Tigo/Airtel, and
Vodafone). From our interaction with some members of the community, most of them use smart
phones and also uses social media platforms such as WhatsApp and Facebook. Most of the
households in the community also uses television and radio sets.

20
Housing
Most of the houses at Vitting-Dagboshie are block houses roofed with Aluminum sheets. There
however are mud houses. Majority of the houses are not fenced but a few are.

Chapter four
Water and sanitation
Water
The major source of water for the Vitting-Dagboshie community is from the Northern-Ghana
Water Company Limited GWCL, but this source is intermittent hence most indigenes and
residents rely on wells and a dam located at the outskirts of the community. During the rainy
season, rain water serves as a supplementary source of water. The wells in the town usually
generates underground water but some households have connected pipes that channel rain water
from their roofs during rain fall into these well, thus serving as reservoirs. At homes where they
use pipe borne water, some have big poly tanks for storing water for use if taps are not flowing.

Challenges of water
1. Water supply is inconsistent

2. Inadequate number of boreholes

3. Long distance of borehole from settlement areas make access to water difficult.

Sanitation
The community is generally not clean. There are no common refuse dump sites in the community
for rubbish disposal. Few households have large rubbish bins into which they collect their solid
waste. These bins are emptied usually 3-4 weeks by Zoomlion. Members who cannot afford the
services of Zoomlion accumulate their rubbish and burn them behind their houses or nearby
bushes.

On the transect walk, we found out that the generally the community is quiet bushy which serves

a site of dumping grounds for most people. Liquid waste from the households is allowed to drain

21
along the ground into the surrounding. Few households have toilet facility hence most indulge

open defecation.

PROBLEMS OF SANITATION

The community is generally not clean and hence its problems of sanitation;

22
 Their method of waste disposal; almost all families always accumulate their rubbish at a

point not far from their compound where they later burn it.

 Their surroundings; most households have bushes surrounding their homes. The bushes

then serve as breeding grounds for mosquitoes. This may account for the level of malaria

infection in the community.

 Liquid waste from the households is allowed to drain along the ground into the

surrounding.

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Chapter Five
Health and nutrition
Health
Availability of Health Facility
Vitting-Dagboshie sub district of the Tamale Metropolitan has one health center (Vitting health
clinic). The sub-district holds 24% of the district population. It serves 69 communities and with a
population of 20,012 as of 2020. It has 117 community-based surveillance volunteers, one health
center, 5 private facilities, 9 functional CHPS zones, 4 with compounds (Zuo, Lahagu, Duyin,
Kotigli) and 5 without compounds. The Vitting health center provides various health services.
Below are the sections of the health center and the services they provide:

Out-patient department (OPD)

Records of patients are taken before they see either the nursing officer or one of the nurses in the
consulting room. The outpatient department unit at the facility comprises of consulting room,
place for vital signs taking, the detention room and the dispensary room. A first-time client goes
first to the OPD and then based on the presenting complain, appropriate direction is given as to
which unit to go. The in charge of the unit Mr. Amartey said the main challenge is the
unavailability of record folders for patients.

Services rendered
 Vital signs are measurement of the body’s most basic functions. These include body
temperature, pulse rate, blood pressure. RDT (Rapid Diagnostic Test for Malaria)
 Consultation: This is where patients’ history is taken by the nursing officer or other

nurses in the facility. There is one bed in the room for physical examination of patients.

Form here, patients are sent to dispensary, ANC, detention or are referred. Below are the

top ten cause of OPD attendants.

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Tabel 1.4 1Top ten OPD cases

Disease 2019 2020 2021

Upper Respiratory 3359 - 1289

Tract Infection

Hypertension 1970 5032 3

Malaria 1338 6605 2330

Diarrhoea 1118 944 -

Ulcers 1906 342

Rheumatism other 180 - -

joint pain

Anaemia 150 1183 -

Acute Urinary tract 119 1003 -

infection

Acute eye infection 120 178 857

Typhoid 110 1794 1810

Septicemia - 1015 1123

Pneumonia - 922 -

Skin disease - - 566

Gynecological - - 1135

condition

Internal worm - - 962

25
  Dispensary: The administration of drugs to patients takes place here. There is no

dispensary technician in the facility so the nurses also act as dispensary technicians. It is

the place where medications are prepared, kept, stored and given out for patient/clients.

The facility has a dispensary room but not conducive enough to store drug. Some of the

drugs available includes antibiotics (ex. Metronidazole), antipyretics (ex. Diclofenac

tablets), etc. The other infusions and injections are kept in the store room.

 Detention ward: Place of keeping/detaining patient with severe or complicated clinical

conditions for some time. The health center does not admit, it can only detain patients for

at most 24 hours. If the condition does not improve within 24 hours, the patient is

referred to the Tamale Teaching Hospital, Tamale Central Hospital, which are all under

the Vitting sub district and other nearby hospitals. In the detention room, we found out

that there are no beds and the place has been given out as an office since they don’t really

get serious medical cases to detain.

Labour Ward
The labor ward of the Vitting health center does not receive cases very often. The ward is run by
nurses and midwives of the Antenatal unit. Most mothers delivered at the ward usually have
their fetal presentation being cephalic, sometimes multiparous women whose fetal presentations
are breached, are aided to deliver through the use of maneuvers by the midwives or nurses
however nulliparous women, they are always referred as soon as they have a breached
presentation. The total deliveries in the ward for the 2021 year thus from January to October has
been 26 and hence the average deliveries for a month are 2.6. The average maternal age is
28years.

Antenatal care (ANC)/ Family planning

This is where care is given to the pregnant woman before birth. The health centre provides
antenatal care for pregnant women during which they examine the pregnant woman and also
monitor the development of the foetus. The women are also educated on how to keep their

26
unborn babies healthy as well as themselves. These include educating them on proper ways of
sitting, eating healthy foods, regular exercising and reducing stress. Usually on visits to the
health centre, pregnant women are given folic acid supplements, antimalarial drugs like
sulfadoxine-pyrimethamine. In giving, the antimalarial, the G6PD status of the mother would
have to be known.

The antenatal unit also provides education and counselling concerning family planning. During

these sessions, the nurses educate couples on the available methods of family planning and the

benefits of it as well. The common methods of family planning used in the health centre are the

oral contraceptive pills, injectables (Depo, Norigynon, etc.), implant, natural family planning and

the Lactational Amenorrhea Method (LAM).

Child welfare clinic (CWC)

The child welfare clinic creates awareness about child growth and care practices which is done
predominantly by the community health nurses. The child welfare clinic run as facility based,
community based and outreaches. At this unit, the weight and height of the children are regularly
checked and monitored. The children are then monitored by plotting weights on a growth chart to
know whether they are being fed well by their mothers or not. When the weight of the child falls
below or above normal on the growth chart, the mother is then referred to the nutrition unit for
further advice and monitoring. Vaccination against the six childhood killer diseases also takes
place at the CWC.

The Table below is the number of registrants at the child welfare clinic at the Vitting health

center for the past one year.

Tabel 1.5 1CWC attendance for 2020

Year 0-11 months 12-23 months 24-55 months

2020 2,000 9 1

27
  Child immunization

The Expanded Programme on immunization (EPI) was launched in 1974 by the World Health

Organization (WHO) and adopted by Ghana in 1978. With initial six antigens, Ghana has

progressively expanded the antigens used in the Programme and currently has 13 vaccine

preventable diseases (VPDs) on its EPI schedule. In Ghana, the Expanded Programme of

Immunization (EPI) has helped reduce infant mortality. There has also been a significant fall in

morbidity rates of vaccine-preventable diseases such as measles and poliomyelitis. For example,

since 2003, there has been no death caused by measles, while in 2011, Ghana was certified as

having attained elimination status for maternal and neonatal tetanus. However, many children,

especially those who live in inner cities and dense parts of urban areas and some in hard-to-reach

areas have not been reached and are exposed to vaccine-preventable diseases at an early age

The immunization of children is really taken serious by the mothers. In order to help reduce the

childhood killer diseases in the Vitting community, they immunize all their children against the

Childhood killer diseases at the health center.

Table showing the national immunization schedule for children;

28
Tabel 1.6 1national immunization schedule for children

AGE VACCINE DOSE ROUTE OF

ADMINISTRATION

At Birth BCG 0.05ml Intra-dermal, right upper arm

OPV 0 2 drops oral

6 Weeks OPV 1 2 drops oral

DPT-HepB-Hib 1 0.5ml Intra-muscular, left thigh

Pneumococcal 1 0.5ml Intra-muscular, right thigh

Rotavirus 1 1.5ml oral

10 Weeks OPV 2 2 drops oral

DPT-HepB-Hib 2 0.5ml Intra-muscular, left thigh

Pneumococcal 2 0.5ml Intra-muscular, right thigh

Rotavirus 2 1.5ml oral

14 Weeks OPV 3 2 drops oral

DPT-HepB-Hib 3 0.5ml Intra-muscular, left thigh

Pneumococcal 3 0.5ml Intra-muscular, right thigh

IPV 0.5ml Intra-muscular, right thigh (2.5cm

away from PCV site)

29
 Rotavirus 3 0.5ml oral

6 Months Vitamin A 100,000 I.U oral

9 Months Measles-Rubella 1 0.5ml Sub-cutaneous, left upper arm

Yellow fever 0.5ml Sub-cutaneous, right upper arm

12 Months Vitamin A 100,000 I.U oral

18 Months Measles-Rubella 2 0.5ml Sub-cutaneous, left upper arm

Men A 0.5ml Intra-muscular, right upper arm

Vitamin A 200,000 I.U oral

After 18 months Vitamin A is given for every 6 months till the child is 5 years old. At the 18 th

month Long Lasting Insecticide Treated Nets (LLINs) are given to the child.

 Vitamin A supplementation compared, Half-year, 2019-2020, Vitting

Tabel 1.7 1Vitamin A supplementation for 2019-2020, vitting health centre

FACILITY 6-11 MONTHS 12-59 MONTHS TOTAL

Vitting HC 737 760 1497

Kotingle 132 407 539

Lahagu 526 879 1405

Zuo 178 430 608

Tugu 132 409 541

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 Pagazaa 103 207 310

Tabel 1.8 1EPI Coverage, half-year, 2021

Antigen Vitting Lahagu Kontingle Tugu Zuo Pagazaa

BCG 1232 121 607 153 111 175

OPV1 1190 71 703 172 131 79

OPV2 1054 94 681 142 142 61

OPV3 996 122 696 145 139 61

PENTA 1 1304 106 703 221 147 57

PENTA 2 1227 126 681 189 153 73

PENTA 3 1245 141 696 196 145 73

PCV1 1272 106 703 221 147 57

PCV2 1200 126 681 189 153 73

PCV3 1214 141 696 196 143 73

 Store room

The store room of the facility is where almost all the medical supplies and equipment are stored.

It’s also practically the office of the in- charge. Some of the medical supplies available in the

store room are Cotton wool, Surgical mask, Stethoscope, Oxygen mask, Eye chart, Scales, Blood

pressure monitor, Pregnancy testing kit, Thermometer, Resuscitator, Bandages, Sling, Bandage,
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First aid kit, Syringe, IV, Examining table, Urine sample, Dropping bottle, Dropper, Scalpel,

Needle, Stitch, Antiseptic, Alcohol, Basin, Defibrillator, Wheelchair, Gurney, Scrubs, Cast,

Tweezers, Pill, Tablet, Doctor Medical clamps ,Plasters, Gloves, Face Masks, Infusions, Normal

Saline, Toiletries, and many more. There are also drugs for ANC purposes and general drugs.

The following is a list of staffs at the vitting center:

 Physician assistant: 1

 Nursing officer: 1

 Senior staff nurse: 3

 Staff nurse: 5

 Disease control officers: 2

 Community health workers: 16

 The casual workers: 5

The sixteen (16) community health workers work at the four (4) functional community-based

health planning and services (CHPS) compounds.

Accessibility of Health Facility

The health center is located at Vitting in the Tamale metropolitan. The health facility is not far
from majority of the houses in the Vitting north but to those across the road, it’s quite a distance
for them. Members of the community patronize the health center mostly in the mornings. They
usually come by foot and sometimes bicycles and motorbikes. Even though the accessibility is
quite impressive but during raining season, the place gets flooded so the people hardly go to
clinic and this is actually as a result of the untarred road and the poor drainage.

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Affordability of the Health Facility
The clinic is a government clinic and NHIS accredited. However, patients without insurance
have to pay for services provided to them at the health center, and when they had to be given
drugs, they are given prescriptions to go buy them from pharmacies themselves. Even with the
cases the patient has to pay, is fairly affordable. So, in general the facility is very affordable.

Utilization of Health Facility

Majority of the people in the community seek their healthcare from the Vitting Health Center.
They go there for services like antenatal care, child welfare care and deliveries, etc.

Skills acquired at the facility

 Rapid Diagnostic Test:
1. Malaria

2. Syphilis and HIV-1

 Examination of the gravid uterus

 Examination of the new born

 Growth monitoring of the infants

 Vaccination of the infants

 Registration of the client at first for ANC

 Monitoring of vital signs

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Health System and Health seeking behaviors
Health
The people of Vitting-Dagboshie either resort to Traditional medicine or utilize the modern
health system in ill health conditions. The modern health systems comprise the health facilities
and Pharmacies. Traditional medicine consists of Traditional Birth Assistants (TBAs), bone
setters and other traditional healers some of which are believed to be backed by some spiritual
forces. Majority of the population rely on the modern health system in ill health states. Most the
people who visit the health center normally do so within the hours of 8:00 am and 1:00 pm on
weekdays.

Health seeking behaviors

The people of Vitting have a health seeking behavior worth recommendation, even though it
admits lots of such challenges as inadequate health professional and drugs in the health center.

Concerning the National Health Insurance Scheme, majority of the people are registered. The

records we obtained from the NHIS officials, during our data collection and people visiting the

Vitting Health Center suggests that about 90% of the people have the NHIS. The NHIS covers

most of the drugs in the dispensary. As such, they do not wait until their diseases become worse

but rather report to the health facility with the slightest signs of ailment. Most of the inhabitants

too resort to Pharmacy and Over the counter for their therapeutic needs.

Vital events of the community

Data from the health center indicate that from January to September this year, there has been 26
live births,15 males and 11 females. The table below summarizes the vital events of Vitting
community within the past months in the year.

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Table 1.9 1Vital events for past one year, Vitting health centre

Month Male Female

January 2 2

February 1 2

March 2 1

April 2 0

May 2 2

June 2 0

July 0 2

August 1 1

September 3 1

Death
From research, the health center has not recorded any mortality case since it was established.

 Top Ten causes of morbidity over the past one year

Morbidity is the rate of disease or illness in a population. Many people reported to the health

facility with a variety of diseases and Injuries over the past one year. Some were severe and

others were minor cases.

The table below shows the top ten causes of morbidity in the past one year as well as their ranks.

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Table 2.0 1Top 10 morbidity cases

Disease conditions Number of cases Rank

Uncomplicated Malaria 6605 1st

Hypertension 5032 2nd

Ulcer 1906 3rd

Typhoid 1794 4th

Anaemia 1183 5th

Septicemia 1015 6th

Acute Urinary Tract Infection 1003 7th

Diarrhoea 944 8th

Pneumonia 922 9th

Acute Eye Infection 178 10th

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Challenges at the Health Facility
 The Health Facility just like any other in the town lacks a constant supply of water,
sometimes affecting some hospital procedures.

 Supply of some drugs and vaccines are sometimes not met at the required time leading to

shortage at the facility.

 Inadequate modern equipment to facilitate healthcare.

 Inadequate motor bikes for outreach services.

 Inadequate space in the facility for service delivery.

 Low patronage of family planning services

 Weak surveillance system in the sub-district.

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Nutrition
Food ethnography (dietary patterns and food habits)
Food is a vital source of nutrients for the body’s growth, defense and development. The right
combination of nutrients along with good health practices keep a person strong and healthy.
Since, ‘we are what we eat’, it is therefore critical to observe the dietary patterns and food habits
of the people in the community. The Vitting-Dagboshie community boasts of a wide variety of
foods all year round. Though dietary pattern varies with the changing seasons, the dietary pattern
of the community is fairly stable. By tribal descent and the abundance of certain foodstuffs like
yam, millet and maize, the staple food of the community is T.Z (Tuo Zaafi) with ‘ayoyo’ soup.

Aside the staple foods, the community members eat other foods like banku with groundnut soup

or grounded pepper (with fried fish), boiled yam with beans stew and rice with stew. For

breakfast, they usually take porridge prepared with millet, maize or guinea corn. The community

gets its protein from both plant and animal protein that is, fish, meat, egg, beans, groundnut etc.

A majority of the community members on the average take two meals daily (i.e breakfast and

supper)

Nutritional status of children under five (Anthropometric assessment)

Anthropometric assessment at vitting health center was done by measuring weight and height.
Thus, the center uses the international health practice that provides a readily accessible,
inexpensive, objective method to ascertain the health history, nutritional and health status of the
child. Most children in Vitting according to anthropometric assessment thrive well with just a
few falling below normal. These few are put on nutritional supplements. At the health facility
there is a nutrient supplement known as ‘plumpy nut’ which is given to the undernourished
children to gain all the needed nutrients at a relatively faster rate.

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Table 2.1 1Total children measured for stunting from 2019-2021

Total children measured for 2019 2020 2021

stunting

Total children measured 430 2365 6420

Severe stunting 0 15 0

Moderate stunting 40 62 163

Normal 390 2249 6033

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Chapter six
Community health needs assessment
Community health needs assessment, an objective of this work piece, is a process that describes
the state of health of local people; enables the identification of the major risk factors and causes
of ill health; enables one to identify the potentials within the community itself, that can be used
in addressing their health issues; enables the identification of the actions needed to address these;
assess the strengths and resources/assets that promote well-being in the community and
strengthens community involvement in decision making. Thus, community health needs
assessment mainly involves:

 Gathering information about the disease profile of the community

 identifying the health problems within the community.

 prioritizing the issues that affect their health

 Gathering information about the strength, weaknesses, threats and opportunities available

in the community for solving these problems according to priority.

 Building commitment and support to work on addressing community health.

 Causes and effects of the health problem(s) on the community.

Method used to obtain information

The grouped employed convenient sampling to obtain the information.Well-structured

questionnaires were administered to participants. The contents of the questionnaires and purpose

were duly explained before administration.

We divided ourselves into sub-groups to administer the questionnaires. The problems recorded

during the first phase were noted. The group later went back to the participants to help us

prioritize their health needs using pair wise ranking. This helped us to identify the health needs

within the community and to identify its causes and effects.

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Pairwise ranking
The Vitting-Dagboshie community has several problems, however after response from 30
people, the following problems were brought to our notice which are as follows; Inadequate
toilet facilities, need for constant supply of water, poor road network, poor drainage system,
unavailability of refuse dumps.

Needs Codes

1. Inadequate toilet facilities TF

2. Need for constant supply of water WS

3. Poor drainage system PD

4. Unavailability of refuse dumps RD

5. Untarred roads UR

The table below shows how the ranking of the community problems was done.

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Table 2.2 1Pairwise ranking

Needs TF WS RD PD UR Ranking

TF - TF TF TF TF 1st

WS - WS WS WS 2nd

RD - RD RD 3rd

PD - PD 4th

UR - 5th

It was realized after the prioritization that; the main problem of the community is the need to

provide adequate toilet facilities which is represented with TF in the table above. This is

followed by the need for constant supply of water (WS), the need for supply of refuse dumps

(RD), the need to improve on their drainage systems and finally they plea to the assembly to tar

their roads.

SWOT analysis
SWOT analysis is a technique for assessing the strength, weaknesses, opportunities and threats
of the community under study. The table below shows the SWOT analysis of the Vitting -
Dagboshie community as identified by the group.

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Table 2.3 1SWOT analysis

Developmental Strengths Weaknesses Opportunities Threats

issue

Health Presence of a Inadequate health Existence of 1.Insufficient

health facility personnel and NHIS accommodation

logistics. for health

personnel.

2.insufficient bed

Water Availability of Water borne Well planned Delay of

vast land. diseases recorded community for assembly

at the health these amenities common fund

Centre, improper to be placed at and inactiveness

disposal of vantage points of inhabitants

waste. towards

communal labor.

Toilet facility Vast land to Indiscriminate District assembly Delay of

build more open defecation. to liaise with assembly

public toilet some NGOs to common fund.

facilities construct toilets

Refuse dump site Vast land and Improper Well planned Delay of

43
 vantage points to disposal of community for assembly

place the waste. these amenities common fund

container to be placed at and inactiveness

vantage points of inhabitants

towards

communal labor.

Poor drainage Bigger gutters at 1.Breeding Intervention by No district funds

system the main places for government and allocation for this

roadside mosquitoes stakeholders to initiative

construct gutters
2. Erosions as a
to join main.
result of

uncontrolled

checks

Untarred road Availability of Upper Intervention by Households

untarred roads respiratory tract government and located near the

linking infection stakeholders to untarred roads.

communities. water the dusty

road often

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Conclusion
The research by members of group 12 revealed that Vitting-Dagboshie is blessed with vast land
to construct amenities that may help improve the health status of the community members.

The location of the community health centre makes access very easy but has inadequate health

personnel and logistics. With majority of the members that visit the health centre enrolled on the

NHIS, it can be ascertain that daily attendance to the health facility will increase when adequate

logistics such as drugs, beds for detentions, a medical officer is provided. This will help prevent

self-medication among the members in the community.

The community has a lot of human resources that can venture into their main occupation in the

community, farming. Most people are not venturing into this sector because there are no

financial facilities in the community that will grant loans for them to expand their farms.

Recommendation
 The Ministry of Health (MOH) through community health nurses and other supporting
agencies should give more education sanitation to the people in the community

 The community should practice environment cleanliness to minimise common health

problems like malaria and others which possess threat to their health

 More people should be encouraged to renew their NHIS cards and also enroll in order to

enjoy free healthcare in times of sickness

 Gutters should be constructed in the community to channel waste water and excess rain

water.

 Governments/NGOs should provide them with a water purification system to help purify

the water

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  A proper waste disposal system should be made available

 Credit facilities should be provided to farmers and those engage in small scale industry to

maximize production

Reference
 Vitting Health centre, October 2021
 A profile on vitting community, Tamale metropolitan assembly

Appendices
COBES= Community Based Education and Service

MTN=Mobile Telecommunications Networks

WHO=World Health Organization

G6PD=Glucose 6 Phosphate Dehydrogenase

HRP2=Histidine Rich Protein 2

NGO= Non-Governmental Organization

OPV=Oral polio Vaccine

BCG= Bacille Calmette Guerin

NHIS= National Health Insurance Scheme

ANC =Antenatal Care

CWC=Child Welfare Clinic

LLIN= Long-Lasting Insecticidal Nets

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