The Dodowa health and demographic surveillance system (DHDSS) was established 2005 after an initial attempt in 2003 to enable the district health management and research team to have information on the population of the district prior to the setting up of a mutual health insurance scheme. The Dodowa health research centre (DHRC) which established the DHDSS is one of three research centres of the Ghana health service.
The DHDSS is located within the boundaries of Ningo-Prampram and Shai-Osudoku districts of Ghana (formerly known as Dangme West District of Ghana). The area is fairly rural with a total land size of 1528.9sq. The surveillance system monitors health and demographic dynamics, facilitates evaluation of the morbidity and mortality impact of health and social interventions and provides a reliable sampling frame for research activities/projects.Events monitored routinely include pregnancies, births, morbidity, mortality, migrations, marriages, vaccination coverage and Socio economic status of households.
Data Collection Process
The total population currently under surveillance is 117 341 individuals residing in 24 221 households scatted in 382 communities. The two districts have been administratively divided into four (4) sub-districts and data collection in each sub district is overseen by a field supervisor. The supervisor oversees the work of four fieldworkers’ averagely. Community Key Informants (CKIs) are identified and trained to complement the work of field staff by recording early events that occur in the community. The DHDSS have since 2012 moved from a paper-based to an electronic-based system of data collection using Personal Digital Assistant (PDA).
fig. 2, 3 & 4 Fieldworkers using the PDA for data collection and offering support to international students.
Some Key Findings
The population under surveillance has witnessed some steady rise since its first census in 2005. The population is young with about 40.5% being less than 15years which is typical of developing country like Ghana.Women in the reproductive age (15-49) years are 28.22% whiles children below 5 years account for 10.46% of the population. Ante-natal coverage is 94.2%, whiles fertility rate is 3. In terms of mortality, infant and under five mortality is 9 and 19 per 1000 live births respectively. The average household size is five (5) members with a dependency ratio of 68.1%. Farming is the main source of livelihood for the people within the surveillance area. Over eighty percent (83.6%) of the population use unimproved toilet facilities whiles 80.22% have access to portable water. The proportion of males and females population is 46.4% and 53.66% respectively. The Dominant ethnic group is Ga-Dangme whiles Christians constitutes over 80% of the population. Life expectancy for males and females is 69 and 72 years respectively.
Age and sex structure of the population, DHDSS 2013.
In terms of wealth quintiles, whiles the percentage of the poorest HHs reduced from 48.39% in 2006 to 5.52% in 2013, the least poor HHs increased from 7.03% to 23.33% within the same period.
In terms of education, females are more likely to have no or lower education attainment relative to their male counterparts.
The major strength of the DHDSS is the cumulative experience and capacity in health and demographic surveillance built over time. The regular household census updates allow continuous, household-level monitoring of all vital events and health indicators. The DHDSS is also crucial in providing information for better healthcare and local government planning. The HDSS provided data support to the following policy interventions;
- Information on households with pregnant women for targeted interventionsg. ILO conditional cash transfer for pregnant women.
- Information on Households without bed nets and also targeting of households for EPI interventions.
- Information on poorest households for social protection interventions coverage such as Livelihood Empowerment Against Poverty (LEAP).
The operations of DHDSS also collaborates with the two districts assemblies in provision of information on;
- Updates information on various communities within the surveillance area
- House numbering and address systems.
- Periodic and regular updates of the population of the two districts.
The DHDSS has no core funding. Its operations are funded through various projects run in the centre.
We thank the Indepth-Network, the two districts (Shai-Osudoku and Ningo- Prampram) we operate in. Special thanks also goes to the District Health Management Teams, Ghana Education Service and the Birth and Death Registry for their collaboration and support over the years of operation.