CASE STUDY: Field Visit, Binduri Health Centre, Ghana (May 2012).
The Binduri Health Centre is the nearest health centre for the people of Kumpariguga, Bawku West in the northern region of Ghana. It is 2km away from their village. However, the health centre also provides health advice to another 51 communities in the surrounding area, with some having to walk 10km to get to the centre. Roberta, the midwife and Margareta, the Physician’s Assistant describe their experiences working at Binduri.
The health centre detains patients for 24-28 hours, instead of admitting them. If they are unable to get better, the centre will refer the patient to larger hospitals. Some of the most common diseases the centre treats are malaria and measles. Measles is a particular problem in northern Ghana, as it is very prevalent in Burkina Faso, where many people contract it from.
Roberta and Margareta believe that the myth behind a woman delivering her baby within a medical centre, meaning she has been unfaithful to her husband, does not exist anymore within the communities they provide for. Both of them believe that clinics are the preferred place for women to deliver. This is shown with the amount of deliveries the centre deals with every month, with 38-40 babies being delivered per month.
A common problem that is found within the clinic after delivery is the problem with septic rashes.
This is due to the health clinic being small, and therefore there is little time to wash the sheets before needing the bed again, thus, disease is spread easily. Also when the baby goes home everybody wants to hold the newborn, so can pick up infection that way too.
In terms of post-natal care, the mother is told to come back six to seven days after delivery, and then six weeks after that. Positively, almost all return for post-natal care sessions.
Recently, the health centre has noticed a large increase in women coming for advice regarding family planning. Women now want to talk about the options available to them, and discuss the best one for them. They come alone though, not with husbands. It will take a lot of time before husbands join their wives.
It is currently the lean season (as it’s not the rainy season, there is no stagnant water about and incidence of malaria is much lower). During the rainy season, the health centre sees about 30-35 patients a day; almost all are insured. In the wet season this can double to 50-60 a day, and these numbers do not include pregnant women and children who visit the centre for weighing, which can be around 100 a day.
African Initiatives’ Health Programme in Ghana supports communities, particularly women, in registering with the Ghana National Health Insurance Scheme. This entitles individuals and families to free medical care after the initial outlay. Although the scheme has been operative in Ghana for some years there was particularly low take up in the poorer northern region. This project has already seen positive results in increased registrations and renewals.