INTRODUCTIONThe present Accra Psychiatric Hospital was commissioned in 1906 to accommodate 200 patients. About 110 patients were admitted into the new hospital under the charge of 16 untrained Attendants. The hospital consisted of 4 wards: Criminal, General, Male and Female Wards. And has an Administrative block, Dispensary and office for the Visiting. Medical officer, a store, Gate Keepers room, Night Master’s Room and a kitchen. The Lunatic Asylum later underwent modifications and extension into the Psychiatric Hospital of today with a bed complement of 600.

THE HOSPITAL TODAY

FUNCTIONS OF THE HOSPITAL

The Hospital is responsible for the treatment, welfare, training and rehabilitation of the mentally

ill. The University of Ghana Medical School has a faculty established in the hospital for

undergraduate training in psychiatry and postgraduate training under the West African College of

Psychiatrists (WACP). The hospital thus has a symbolic relationship with the medical school.

Nurses from all over the country are affiliated to this hospital for 6-monmth proficiency training in

psychiatry. It also has facilities which are accredited for postgraduate training in psychiatry with a

Polyclinic sited directly opposite the Hospital serving the whole of Osu-Klottey, with a population

of about 1,200,000. Plans has been on the drawing board to relocate the hospital since the year

2000.

LIST OF DEPARTMENT

General Administration Nursing Administration Accounts Department Social Welfare Department Catering Department Pharmacy Department Stores and Supply Department Estate and Maintenance Department Human Resource Department In-service Training Unit Environmental Department Occupational Therapy Department Out Patients Department (Consulting Rooms, Injection Room)

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Internal Audit Department Mortuary Department Welfare Union Office Laundry Department Records Department

COMMITTEES IN THE HOSPITAL ◦ Quadripartite Committee◦ Management Committee◦ Heads of Department Committee◦ Unit Heads Committee◦ Finance Committee◦ Procurement Committee/Hospital Entity Committee◦ Therapeutic and Rational Drug Use Committee◦ Quality Assurance Committee◦ Entertainment Committee◦ Welfare Committee◦ Arbitration and Disciplinary Committee◦ Hospital Choir◦ Estate and Accommodation Committee◦ Ladies Club

VISION STATEMENT 2

WARDS

Female Rehabilitation WardFemale Convalescence WardChildren’s WardFemale Geriatric WardFemale Infirmary WardFemale Acute WardFemale Ward 1Female Ward 2Male Infirmary Ward 1Male Infirmary Ward 2BHC WardMale Convalescence Ward

Male Rehabilitation WardIsolation WardMale Geriatric WardMale Ward BMale Infirmary Ward 1Ward C1Ward C2Male Admission Ward 1Ward EMale Admission Ward 2Special WardVIP Ward

The Accra Psychiatric Hospital seeks to become the leading Psychiatric Institution in Ghana, providing the best quality psychiatric care to our clients and to foster partnership with other stake holders in providing quality health service.

MISSION STATEMENT

It is to provide the best practice in Psychiatric care to clients through a dedicated work force of health professionals in a client-friendly environment.

• The present Accra Psychiatric Hospital was commissioned in 1906 to accommodate 200 patients.

• About 110 patients were admitted into the new hospital under the charge of 16 untrained Attendants.

• The hospital consisted of 4 wards: Criminal, General, Male and Female Wards.

• And has an Administrative block, Dispensary and office for the Visiting. Medical officer, a store, Gate Keepers room, Night Master’s Room and a kitchen.

• The Lunatic Asylum later underwent modifications and extension into the Psychiatric Hospital of today with a bed complement of 600.

BEST PRACTICES

Hardworking, committed, and dedicated workforce Clean and beautiful environment (external) Management meetings held regularly Excellent team work Excellent human relations on the part of team members Punctuality to work by Hospital Management team Transparency in Management Human centered leader style of Management Excellent collaboration with stakeholders – Metropolitan Assembly, Regional Coordinating

Council, Health Institutions, Religious Bodies, NGO’s on Health, Traditional Authority. Prudence in use of financial and other resources

TARGET FOR 2011

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To introduce reforms aimed at ensuring efficiency and effectiveness in management of resources

Support Clinical care with availability of medical supplies to ensure quality health care delivery

To maintain hospital buildings to ensure their safety

To improve on general security at Hospital.

Improve on Water and Sanitation at Hospital.

To open a staff canteen.

To establish a Public Relations Unit.

To connect gas to kenkey Factory.

To pay off the indebtedness of Hospital to suppliers.

To recruit, retain and maintain staff through the provision of motivation packages.

To construct Hospital Mortuary .

NEW CONSTRUCTIONS ESTIMATED BUDGET

GH¢

Construction of Mortuary 250,000.00

ACHIEVEMENTS FOR 2011

Hospital run successfully for 24/7 for the past 12 months without interruption. Some development projects undertaken from the Hospital’s meager resources Secure, safe, clean and beautiful environment Regular supply of some psycho-therapeutic medicines, and non-medicine consumables

which enabled provision of quality health care to patients Close collaborations with all other Units/Dept: Hands-on approach to problem solving at all

Units/Dept The provision of democratic/participatory environment devoid of intimidation, animosity

which ensured the provision of quality health care to patients. Staff motivated for the first time with end-of-year package 94 retired staff and 4 staff in active service rewarded

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50% of Hospital’s indebtedness settled Dramatic improvement in quality and quantity of food to patients Limited resources used efficiently

HUMAN RESOURCE MANAGEMENT

Introduction

The Hospital provides specialist services as well as outpatient services to the public; the facility accepts patients from all the regions of this country as well as our neighbouring states.

HR activities conducted

NOMINAL ROLL UPDATE: Efforts to remove Names of;

Dead staff

Vacation of post etc

Retirees’ names go off automatically

Try to get names of staff transferred in onto the payroll. Sometimes, we need to do follow-up twice or thrice to get the names on our payroll.

In the case of the transfers out, officers take a long time before their names are taken-off our payrolls.

PAYROLL RECONCILIATION: This activity is carried out by the Accounting staff. Now that, I have become familiarized with the staff (both junior and senior), I intend playing an active Roll in this direction. However, there is no cause for alarm, since my delegatory process has not been abused, even once.

IPPD INPUTS:

I have 2 Executive Officer who handle Inputs. I have absolute control of the inputting process since no input goes for the Hospital Administrator’s signature without my knowledge.

Capturing inputs to reflect on payroll is a very slow process. However, experience shows that a wait of four (4) months is usual. This length of time to staff, especially, new entrant staff nurses is unusually long.

The Unit prepared inputs for over Seventy Three (73) new entrants for year 2011. All been paid except one (1)

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POSTINGS: For the year under review we received a Medical Doctor, Eighty Three (83) Nurses Psychiatric, one (1) Executive Officer.

NO CATEGORY 2010 2011

1. Medical Officer 1 1

2 Staff Nurse 57 83

3 Executive Officer 1 1

4 Cooks 4 -

5 Hospital Orderlies 3 -

6 Stenographer 1 -

7 Drivers 1 -

8 Security Men 1 -

TOTAL 69 85

PROMOTIONS:

The year under review (2011) saw a vigorous progarmme to have all qualified working staff, promoted. Fifty – Two (52) Staff Nurses were promoted to Senior staff Nurse

However, during the year under review, the following were interviewed and a report submitted to HRDD. We are expecting their promotion letters if and only if the Ghana Health Services Council approves it. They include, Professional Nurses (9), Principal Pharmacist Technician (1), Supt. Enrolled Nurses (2) and Senior Catering Officer (1). A few upgrading and conversions are yet to be effected.

RECRUITMENTS

NO CATEGORY NUMBERS

2009 2010 2011

Medical Doctors - 1 1

1. Professional Nurses (Psychiatry) 57 21 83

2. Biomedical Scientists - - -

3. Executive Officer - 1 - 6

4. Cooks - 4 -

5. Hospital Orderly - 3 -

6. Stenographer - 1 -

7. Drivers - 1 -

8. watchmen - 1 -

9. Conservancy labourer - 0 -

10. Enrolled Nurses (Reappointment) - 0 -

HR STATISTICS BY CATEGORY (3 YR TREND)

No. CATEGORIES 2009 2010 2011 1. Medical Doctors 4 5 6

Medical Assistants (2 are on course) 7 7 7 Biomedical Scientist (Laboratory) 3 3 4 Laboratory Technologists 1

2. Pharmacy Deputy Director of Pharmaceutical Services

1 1 1

Pharmacists 2 2 2 Principal Pharmacy Technician 1 1 1 Pharmacy Technicians 3 3 4 Principal Dispensing Attendants 2 2 1 Dispensing Assistant 1 Died 1 1 0

3. Accounts Department

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Deputy Chief Accountant 1 1 1 Principal Accounts Officers - 2 3 Senior Accounts Officers 5 3 2 Finance Officer 0 0 1

4 Administration Deputy Chief Health Service Administrator

1 1 1

Human Resource Manager 1 1 1 Executive Officer 1 2 Secretaries/Typists 6 7 7 Labourers 11 11 11 Laundry 1 3 1 Senior Security Guard 1 1 Head Watchman 1 2 2 Watchman 1 2 2 Principal Estate Officer 1 1 1

Principal Artisan, Mechanical Engineering

1 1 2

Mechanical Engineering Technician 1 1 4 Senior Artisan, Mechanical Engineering 4 4 4 Artisan, Mechanical Engineering 4 4 4 Transport Officer 1 1 1 Drivers 3 4 4

5 Nurses Professional Nurses 196 280 Superintendent Enrolled Nurses 43 43 Principal Enrolled Nurses 21 17 Senior Enrolled Nurses 5 2

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Enrolled Nurses 1 1 6 Anaesthetics 0 0 2 7. Catering

Assistant Chief Catering Officer 1 1 1 Senior Catering Officer 1 1 1 Senior Staff Cook 3 3 3 Head Cook 8 8 4 Cooks 2 6 6 Kitchen Assistant 2 2 2 Staff Cook Supervisor 9 9 9 Diet Cook Supervisor 2 2 2

8 Health Assistants Principal Health Assistants 22 22 19 Senior Health Assistants 45 45 40 Health Assistants 2 2 3

9 Orderlies Head Hospital Orderlies 77 77 63 Senior Hospital Orderlies 6 6 2 Hospital Orderlies 1 4 7

10. Principal Occupational Therapists Assistants

6 8

11. Stores Senior Supply Officer 1 1 1 Supply Officers 0 0 2 Senior Store Keeper 1 1 1

12. SNR.Technical Officers 2 6 6 Technical Officers 6 4 4 Senior Biostastics Assistant 0 4 4 Biostatistics Assistant 5 1 1

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Age Distribution Chart – Prof. Nurses And Enrolled Nurses As At 31/12/11

Prof. Nurses Enrolled Nurses

<29 184

30 – 34 56

35 – 39 6

40 – 44 2

45 – 49 3 1

50 - 54 6 15

55 - 60 20 46

<29 30 -34

35 -39

40 -44

45 -49

50 - 54

55 - 60

050

100150200

Prof. NursesEnrolled Nurses

Age Distribution of Orderlies and Health Assistants

Orderlies Health Asst.

<30 12

30 -34 19

35 - 39 5 10

40 - 44 4 1

45 - 46 5 1

10

50 – 54 20 8

55 - 60 35 11

Attrition

Type of Attrition Number

2009 2010 2011

Deaths 7 5 7

Retirement (Compulsory) 17 21 19

Vacation of Post 2 3 3

Dismissals - - 0

Transfers (out) 1 7 11

ACHIEVEMENTS

Carried out a recruitment interview for over 200 newly qualified Registered Mental Health Nurses and successfully got Eighty Three (83) posted to the Hospital – the highest ever.

For once, we recommended and got admission for Two (2) nurses to pursue the community Medicine Programme two (2) for Anaesthesia, and Two (2) Medical Assistants to pursue the Degree Top-Up at Kintampo.

The HR Manager’s office had a brand new split air-conditioner installed which has helped enhance service delivery.

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CHALLENGES

Lack of training to bring staff abreast with latest Health Sector Policy Drive enshrined in HR documents.

Delays in obtaining financial clearance for contract staff and its attendant problems. Director is tackling the problem.

Inability in getting newly recruited staff inputted, promptly.

Ageing Enrolled Nurses-without replacement.

An ageing Hospital Orderly cadre with the resulting negative effect on Service delivery at the ward level.

WAY FORWARD

Increase block of flats to accommodate staff

Develop staff by organizing workshops – staff are prepared to pay for some of the workshops

Need for collective effort to introduce the Health Assistants (Clinical) training and call them Mental Health Assistant.

Need for concerted efforts, attention and collaborative support from all concerned to improve HR service delivery

Support required in carrying out planned training programmes for staff to keep them abreast with new trends in HR Policy Direction Assurances received from Management to handle Appraisal Review update and other related Human Resource issues during the year .

NURSING ADMINISTRATION

INTRODUCTION

The Accra Psychiatric Hospital is a specialist mental health institution that has a primary function to manage mental illnesses.

RESPONSIBILTIES

• Treatment of mental illnesses.

• Welfare of mental patients. 12

• Rehabilitation of mental patients.

Training of students to achieve professional competence in psychiatry.

The above responsibilities are achieved through the execution of roles and functions of the various units and departments of the hospital.

Nursing division is one of such categories and has the largest workforce of 385, 302 of whom are professional nurses and 83 being enrolled nurses of all categories. The division is made up of twelve (12) units which comprises wards, specialized department and administrative offices.

BROAD OBJECTIVES FOR 2011

• To ensure quality nursing care to all patients.

• To pursue an agenda of networking all wards, consulting rooms and administrative offices to enhance communication and information flow through the hospital as a system and beyond.

• To provide in-service training for all staff.

• To instill and ensure adherence to professional ethics and discipline among nursing staff.

• To liaise with the offices of the national coordinator, community psychiatric nursing and social welfare to ensure smooth repatriation of discharged patients to the community.

SPECIFIC OBJECTIVES FOR 2011

• To advocate early installation of the mortuary equipment for the hospital.

• To provide a balustrade fencing at the front view of the nursing administration to reduce heat and the persistent scorching of the doors, windows and walls of the nursing administration offices by the sun.

• To ensure installation of computers and accessories in all offices of nursing administration and wards to ensure proper documentation and speed up administrative and nursing work.

• To ensure continuing education in the form of orientation, structured remedial and special courses to update and upgrade the knowledge and the behavior of staff.

• To train and update knowledge and skills of visiting students on affiliation to perform their duties through the IST programmes.

• To ensure that training and teaching as core objectives of the hospital is carried out with dispatch.

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• To speed up the proposal to revisit hospital sewage pathways and their possible reconstruction.

• To encourage staff on the ward and OPD to educate relatives on their responsibilities for patients when discharged.

• To expedite action on decision to renovate the floor of the dormitories of patients with cracks and dents.

• To encourage OPD staff to create mental health awareness through an open discussion and interaction with patients and relatives at the OPD.

• To ensure proper referral of patients to the community through the office of the community psychiatric nurse.

• To ensure that staff adopt planned preventive maintenance strategy to ensure system maintenance and cleanliness.

• To ensure that patients on admission are dewormed at least three times in the year.

• To see to the provision of changing and rest rooms for staff.

• To ensure regular fumigation of the wards to eradicate rodents and lice.

• To take steps to ensure that adequate water is available for use in the wards throughout the year.

• To ensure improvement in security around the wards and units.

• To take actions that will ensure punctuality and the use of the attendance book by staff.

• To encourage wards to provide themselves veronica buckets to improve on hand washing procedures.

BROAD ACHIEVEMENTS

• Despite the occasional ECT complications that occurred and were managed successfully, no death occurred out of the therapy that was done for 118 patients throughout the year under perspective, 82 of whom were females and 36 being males.

• Establishment of the 72- hour Observation ward to screen patients and ease stress and congestion of the already over stretched wards.

• Eighty- three (83) newly recruited staff nurses joined the Nursing Division from the two(2) psychiatric nursing institutions.

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• Former F1 ward was renovated by a philanthropist. F1 ward now renamed, “Alkot Foundation ward.”

• Aeration at the OPD significantly improved through installation of wall fans and roof extension by Data Bank

Body lice infestation is significantly reduced in special ward and admission II, i.e. two of the congested wards.

SPECIFIC ACHIEVEMENTS

• Nursing Administration received one new Dell table top computer to enhance administrative work.

• F 1 ward is now Alkot Foundation ward after having been renovated with a befitting nurses’ station by a philantropist, Albert A. Akoto of Alkot Foundation.

• Patients were dewormed quarterly to reduce incidence of warm infestation.

• Fewer rodents are seen nowadays.

• 90% of wards using veronica buckets or wall taps with sink attachment.

• Security around the wards improved

• General water situation improved.

BROAD CHALLENGES (LOGISTICS)

Staff shortage.

Lack of computers to enhance ward data collection and report keeping

Lack of vehicle solely reserved for nursing administration for prompt external engagement.

Lack of library to support the work of IST programmes.

IST has not been able to issue logbooks to nurses for the past five years.

Lack of sterilizing machine, e.g. Boiler, to sterilize instruments, especially at the infirmary ward.

Lack of ambulance to ensure continuous patient care on transit to the general hospitals for better patient management.

OFFICE SPACE

• Lack of adequate rooms to be used as offices, demonstrations, store rooms and rest rooms.

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• The existing structure of IST needs refurbishment and expansion.

LACK OF TRAINING

• IST has not been earmarked any fund for workshop for a long time now.

• No logbooks for staff to login their training experiences acquired through seminars, workshops, short courses, etc.

SPECIFIC CHALLENGES

• IST could not have any educational visit occurring during the year.

• There has been some repulsive stench emanating from possibly blocked sewage pathway to most of the female and male wards.

• No staff common room.

• Lack of befitting nurses station or office in most wards.

• Lack of adequate bed sheets and mattresses.

• A lot of patients who can be managed at home are still on the ward.

• Lack of proper privacy for staff in most wards.

• Most wards are congested with patients.

• Most wards need to be renovated

• Lack of sluice end for the infirmary wards.

• Lack of illumination light at vantage point during power outages

• Lack of resuscitation equipment for ECT, the infirmaries and other wards.

• Inadequate water flows to the OPD and the wards is severely hampering nursing work.

• Faulty door locks and rotten wooden frames of most wards are common.

• Overcrowded wards, therefore resulting in most patients sleeping on the floor and open air on mats.

• Lack of proper time-out rooms have made handling occasional restless and aggressive bevahiour difficult.

• Shortage of benches on the wards is affecting smooth organization of patients’ group meeting and therapeutic community activities.

• Lack of sufficient male nurses to assist in handling aggressive and restless patients. 16

• There are serious leakages of roofing of most patients’ dormitories.

• Lack of regular visit by doctors to review patients’ condition.

• General water situation in the hospital improved but significantly lacks on the wards and consulting rooms.

TABULAR REPRESENTATION OF DATA

Tabular data representations that follow are the annual state of affairs of patients and staff movements and retention as at 31st December, 2011 under Nursing Administration. At certain times, two or more years are compared to appreciate developmental trends as regards patients and staff movements.

WARD STATE AS AT 31 ST DECEMBER, 2011

NAME OF WARDS(MALE)

VOL SPEC VAG SLEEP TOTAL

ADMISSION- 1 145 - - 145 145*

ADMISSION- 2 67 - - 67 67*

MALE INFIRMARY- 1 8 1 1 10 10

MALE INFIRMARY- 2 5 1 - 6 6

WARD B 15 2 5 22 22

SPECIAL WARD 117 85 11 213 213*

B. H. C. 8 - - 8 8

CONVAL 9 - 1 10 10

WARD E 111 - - 111 111*

C 1 15 - - 15 15

C 2 4 - 38 42 42

V. I. P. 9 - - 9 9

72 HOURS 13 - - 13 13

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GERIATRIC WARD 19 2 6 27 27

KIDS 8 - 7 15 15

TOTAL 554 91 69 714 714

NAME OF WARDS (FEMALE) VOL SPEC VAG SLEEP TOTAL

ALKOT FOUNDATION WARD (FEMALE WARD- 1)

51 2 34 87 87*

FEMALE WARD- 2 42 - 2 44 44*

FEMALE ACUTE 18 - - 18 18

FEMALE REHAB. 5 - - 5 5

FEMALE GERIATRIC 8 1 3 12 12

FEMALE INFIRMARY 5 - 1 6 6

72- HOUR 4 - - 4 4

FEMALE CONVAL 7 - - 7 7

KIDS 6 - 3 9 9

TOTAL 146 3 43 192 192

SUMMARY OF PATIENTS POPULATION AS AT 31 ST DECEMBER, 2011

PATIENTS FEMALE % MALES % TOTAL

VOLUNTARY 146 20.9 554 79.1 700

SPECIAL(court order) 3 3.2 91 96.8 94

VAGRANT 43 38.4 69 61.6 112

TOTAL 192 21.2 714 78.8 906

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A TWO- YEAR COMPARISON OF PATIENT POPULATION AT 31 ST DECEMBER

YEAR 2010 2011 2010 2011 2010 2011

PATIENTS FEMALE FEMALE MALE MALE TOTAL TOTAL

VOLUNTARY 192 146 619 554 811 700

SPECIAL(C/O) 5 3 144 91 149 94

VAGRANT 28 43 23 69 51 112

TOTAL 225 192 786 714 1011 906

NB: General drop in all statuses of patients stay except vagrant that rose during the period, i.e. two (2) years under perspective.

PROFESSIONALS STRENGH AS AT 31 ST DECEMBER, 2011

PROFESSIONALS

FEMALES

MALES

TOTAL

DDNS 1 1 2 PNO 4 6 10 PMO - - - SNO 4 3 7 SMO 1 - 1 NO 3 - 3 MO 1 - 1

SSN 39 12 51 SSM 1 - 1 SN 155 51 206 SM 1 - 1 TOTAL 210 73 283

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E/N STRENGTH

ENROLLED NURSES FEMALES MALES TOTAL

SUPT. E/N 22 27 49

P.E/N 14 12 26

S.E/N 2 4 6

E/N - 2 2

TOTAL 38 45 83

HEALTH ASSISTANT STRENGTH

HEALTH ASSISTANT

FEMALE MALE TOTAL

P.H/A 16 4 20 S.H/A - 1 1

H/A - - - TOTAL 16 5 21

HOSPITAL ORDERLIES STRENGTH

HOSPITAL ORDERLIES FEMALE

MALE TOTAL

20

HEAD HOSPITAL ORDERLIES

34 15 49

SENIOR HOSPITAL ORDERLIES

5 3 8

HOPITAL ORDERLIES - - - TOTAL 39 18 57

STUDENTS FIELD PLACEMENT (IN-SERVICE EDUCATION UNIT)

SCHOOL/ COLLEGE STUDENT CATEGORY NUMBER

KORLE-BU NTC RGN 523 KUMASI(KANTC) RGN 259 AGOGO NTC RGN 118 PANTANG NTC RMN 183 ANKAFUL NTC RMN 11 KORLE-BU MTC RM 275 KUMASI(KAMTC) RM 107 KINTAMPO RHTS CHMO 36 MA PSYCHIATRY MA PSYCH. 2 UG LEGON B.Sc. PAEDIATRIC

NURSIN G 30

UG LEGON L/300 B.Sc. PSY/SOCIOLOGY

1

UNI. OF GHANA LEGON M. PHIL CLINICAL PSYCHOLOGY

5

UNI. OF CAPE COAST L/400 B. Sc. NURSING 1

UNI. COLLEGE OF EDU.- WINNEBA

SPECIAL EDUCATION 3

WESTERN HILLS, ACC. HEALTH ASS. CLINICAL 135

MARTIN LUTHER,TEMA HEALTH ASS. CLINICAL 84

NYANIBA,TEMA HEALTH ASS. CLINICAL 128

HEALTH CONCERN,ACC HEALTH ASS. CLINICAL 136

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KETA HEALTH ASS. CLINICAL 113

NARH-BITA,TEMA HEALTH ASS. CLINICAL 1

HEALTH EXT. WORKERS N.Y.E.P. 71

TOTAL NO. OF STUDENTS

2222

ELECTORCONVULSIVE THERAPY

MONTH NO. OF MALES

NO. OF FEMALES

TOTAL NO. OF PATIENTS

DEATH

JANUARY 2 10 12 NIL

FEBRUARY 7 6 13 NIL

MARCH 2 5 7 NIL

APRIL 4 11 15 NIL

MAY 6 10 16 NIL

JUNE 4 7 11 NIL

JULY 4 3 7 NIL

AUGUST 3 3 6 NIL

SEPTEMBER 1 9 10 NIL

OCTOBER 2 4 6 NIL

NOVEMBER - 7 7 NIL

DECEMBER 2 6 8 NIL

OBSERVATIONS (ECT)

Most of the patients who had ECT during the year recovered fully from their conditions and have been discharged home.

No deaths were recorded in the year under perspective.

No adverse complications were recorded during treatment

The department now has two anaesthetists

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THE WAY FORWARD (Plans for the year, 2012)

Decongestion of the wards should be given a priority.

Outstanding projects should be executed to lessen the stress and burden on staff.

Blocked sewerage pathways producing offensive odour should be given some priority attention. Stench emanating from them poses severe health risk to patients and staff.

Provision of portable autoclave machine to ensure proper sterilization of instrument and equipments should be considered.

Nursing Administration will seek to work closely with the Human Resource Office to organize more seminars and workshop for staff to enhance professional practice which eventually leads to quality service delivery and work output.

Planned Preventive Maintenance (PPM) should be fully adopted and practice.

Quality assurance activities should be streamlined and revamped and core group named with terms of reference.

Effort should be made to improve staffing situation.

CONCLUSION

Though burdened with numerous challenges, the Nursing Division will continue to cooperate with other units and sectors to work closer than before to provide quality care to our patients who are the focus of our combined endeavours.

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CLINICAL STATISTICS AND PERFORMANCE

INTRUDUCTION

Data are collected or aggregated at level of health care systems.

But are they used as a resource, leading to improvements in health care? If the right data are collected, if they are converted into information and put to work in making decisions, the answer can be yes.

Information can provide a firm basis for health service management, because it can indicate what is really happening within the system-which is being served, whether targets are realistic and whether they are being met in the specific period of time.

The Record office ensures that the health care data collected can be transformed into useful information: information that can be used to improve the overall effectiveness of the health care system.

The Record Department makes it possible to monitor trends in programme performance over time.

CLINICAL STATISTICS

OUT PATIENTS ATTENDANCE JANUARY-DECEMBER. 2011

new old total

Age group male female male female male femaleUNDER 1

1-4 15 6 97 87 112 935-9 46 26 369 279 405 30510-14 77 62 537 506 614 56815-17 98 98 654 682 752 78018-19 150 152 775 785 925 93720-34 850 664 4959 5702 5809 636635-49 463 1209 4481 6172 4944 738150-59 131 203 1730 2980 1861 318360-69 41 63 802 1341 843 140470+ 37 61 1156 717 1193 778TOTAL 1908 2538 15550 19251 17458 21795

GRAND TOTAL 4446 34801 39253

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A total of 39,253 patients were attended to at the out –patients department(OPD) of the hospital

Age group

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

1000

2000

3000

4000

5000

6000

7000

new oldSeries3

Graphical representation of New and Old cases attendance 2011.

A total of 39,253 patients were attended to at the out –patients department(OPD) of the hospital, 4446 new cases with males 1908 and 2538 females and total of 34801 old cases with 15550 males and 19251 females were all seen at the O.P.D s for 2011, as against a total of 36829 OPD cases in 2008 with 4857 new cases and 31972 old cases,33227 OPD cases with 2927 new cases and 30300 old cases in 2009 and a total OPD cases of 58398 with 9417 new cases and 48981 old cases in 2010.

Note: an average of about 3271 patients are attended to every month of the year, around 812 patients weekly and an average of 116 daily attendances.

ADMISSIONS

NEW OLD TOTALAge group MALE FEMALE MALE FEMALE MALE FEMALEUNDER 11-45-910-14 4 2 2 8 6 10

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15-17 26 16 8 6 34 2218-19 37 15 15 215 52 23020-34 598 364 539 388 1137 75235-49 280 247 306 130 586 37750-59 70 63 90 37 160 10060-69 32 32 31 15 63 4770+ 17 9 14 10 31 19TOTAL 1064 748 995 789 2059 1537GRAND TOTAL

1812 3390 3596

Age group

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

100

200

300

400

500

600

700

NEWSeries2

Fig1.9. Graphical representation of patient’s admission new cases 2011.

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Age gro

up

UNDER 1

15-1718-19

20-3435-49

50-5960-69

70+0

100

200

300

400

500

600

OLDOLD

Fig2.0. Graphical representation of patient’s admission old cases 2011.

From the table above, a total of 3596 patients were admitted into the hospital, of these patients, 1812 were new cases with 1064 males and 748 females, a total of 1784 old patients were also admitted within year 2011 with 995 males and 789 females, as against a total of 2152, 3918 and 3648 patients which was admitted in 2008.2009 and 2010 respectively.

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ADMISSIONS OF PATIENTS UNDER EIGHTEEN

Age group UNDER 1 15-17 18-190

50

100

150

200

250

NEWSeries2OLDSeries4

Fig.2.3. Graphical representation of admitted cases under the age of eighteen 2011.

A total of 297 patients under the ages of eighteen were admitted into the hospital during the year 2011 with 67 new cases and 230 old cases.

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NEW OLD TOTALAge group MALE FEMALE MALE FEMALE MALE FEMALEUNDER 11-45-910-14 4 2 2 8 6 1015-17 26 16 8 6 34 2218-19 37 15 15 215 52 230TOTAL 67 230 297

DISCHARGES

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

100

200

300

400

500

600

700

800

900

MALEFEMALE

Fig.2.1.Graphical representation of discharges 2011.

The hospital discharged a total of 2873 patients as part of the repatriation exercise in the first quarter of the year with voluntary discharges, 1779 males and 1094 female were discharged as against a total of 2460, 1232and2920 discharges for year 2008, 2009and2010 respectively.

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AGE GROUP MALE FEMALE TOTALUNDER 11-45-910-14 2 1 315-17 21 16 3718-19 27 22 4920-34 773 501 127435-49 514 329 84350-59 242 130 37260-69 147 66 21370+ 53 29 82TOTAL 1779 1094 2873

PATIENTS UNDER THE AGES OF EIGHTEEN (O.P.D ATTENDANCE)

new old totalAge group male female male female male femaleUNDER 11-4 15 6 97 87 112 935-9 46 26 369 279 405 30510-14 77 62 537 506 614 56815-17 98 98 654 682 752 78018-19 150 152 775 785 925 937TOTAL 302 1560 1862

Age group UNDER 1 15-17 18-190

100

200

300

400

500

600

700

800

900

new oldSeries3

Fig1.8.Graphical representation of patients under the ages of 18 years.2011.

A total of 1862 patients under the ages of eighteen were recorded during 2011, with 203 new cases and 1506 old cases, of these new cases, 150 were males and 152 females on the other hand, 1506 old cases with 775 males and 785 females were also recorded at hospital as shown the table and graph above.

30

ADMISSIONS OF PATIENTS UNDER EIGHTEEN

NEW OLD TOTAL0

50

100

150

200

250

Age groupUNDER 1Series3Series4Series515-1718-19

Fig.2.3. Graphical representation of admitted cases under the age of eighteen 2011.

A total of 297 patients under the ages of eighteen were admitted into the hospital during the year 2011 with 67 new cases and 230 old cases.

31

NEW OLD TOTALAge group MALE FEMALE MALE FEMALE MALE FEMALEUNDER 11-45-910-14 4 2 2 8 6 1015-17 26 16 8 6 34 2218-19 37 15 15 215 52 230TOTAL 67 230 297

REFERRAL (IN) CASES JANUARY – DECEMBER 2011

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

102030405060708090

100

MALEFEMALE

Fig.1.1. Graphical representation of referral (in) cases.

Graphic representation of referral (IN) cases January-December 2011.From the table and graph above a total of 325 patients were referred from other hospitals and health centers into the hospital, 175 were males and the majority in the age group of 20-49 while 151 females were also reported in the year 2011.

32

AGE GROUP MALE FEMALE TOTALUNDER 11-4 1 15-9 4 3 710-14 7 9 1615-17 10 18 2818-19 8 5 1220-34 91 67 15835-49 39 29 6850-59 8 8 1660-69 6 6 1270+ 2 5 7 TOTAL 175 151 326

33

CATEGORY NUMBERS

VARGRAT CASES

AGE GROUP

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

5

10

15

20

25

30

MALEFEMALE TOTAL

Fig.1.2. Graphical representation of vagrants’ cases January-December 2011.

A total of 12 patients were brought into the hospital as vagrants by the social welfare or good Samaritans in the year 2011, with 38 males and 19 females. As shown the table above.

34

AGE GROUPMALE FEMALE TOTAL

UNDER 11-45-910-1415-17 1 4 518-19 4 2 620-34 15 10 2535-49 18 2 2050-5960-69 1 170+TOTAL 38 19 57

TOP TEN PATIENTS DIAGNOSIS

Schizophrenia, Depression, Epilepsy, Acute Psychosis and Substance Abuse recorded the highest diagnosis of the patients in the hospital during 2011, while dementia and mental retardation recorded the lowest respectively. Substance Abuse recorded 368 males and 43 females with most of them in the age group of 20-29 years, while the year 2010 recorded a total of 1025 patients diagnosed with Substance Abuse. (Alcohol, Cocaine, Wee, etc), year 2009 and 2008 also recorded a total of 110 and 583 cases of Substance Abuses respectively.

35

DIAGNOSIS MALE FEMALE TOTAL PERCENTAGE

SCHIZOPHRENIA 416 395 811 18

DEPRESSION 192 372 564 12

EPILEPSY 226 195 421 9

SUBSTANCE ABUSE 368 43 411 9

ACUTE PSYCHOSIS 176 231 407 9

DEMENTIA 69 84 153 3

HYPOMANIA 133 154 287 6

NEUROSIS 60 44 104 2

MENTAL RETARDATION

102 86 188 4

OTHERS 166 176 342 7

TOTAL 1908 2538 4446 100

SCHIZO

PHRENIA

DEPRES

SION

EPILE

PSY

SUBST

ANCE ABUSE

ACUTE PSY

CHOSIS

DEMEN

TIA

HYPOMANIA

NEUROSIS

MENTA

L RETA

RDA...

OTHER

S0

50100150200250300350400450

Series1MALEFEMALE

Fig.1.6. Graphical representation of patient’s diagnosis 2011

36

DEATH CASES

UNDER 1

15-17 18-19 20-34 35-49 50-59 60-69 70+0

5

10

15

20

25

MALEFEMALE

Fig.2.2. Graphical representation of death 2011.

From the above graph and table, a total of 64 deaths were recorded with 46 male and 18 female.

The following were the leading courses of the death, anemia, and gastro entries. C. V. A.

37

AGE GROUP MALE FEMALE TOTALUNDER 11-45-910-1415-1718-1920-34 12 1235-49 23 12 3550-59 3 3 660-69 5 2 770+ 2 1 3TOTAL 46 18 64

PLANNED ACTIVITIES FOR 2011

Hope to have newly employed record officers to replace the retired officers

Hope for the provision of the following basic equipments to the records department to assist

the staff to render their services easily:

More office chairs

Two or three additional computers to the old one.

A printer to print our report and data.

More cabinets to file Master Index and MHIS forms.

Air condition for the computers.

ACHIEVEMENTS

The department delivered efficient and effective services

Management provided the department with the following:

Three set of LG Air Conditioners.

Nine set of office chairs and two office tables

One additional computer to the old ones

A printer

PROMBLEMS

Inadequate workshop for the staff: there have not been enough workshops to upgrade staffs

knowledge in the department.

Patience deceptive: Patients refusal to report to the hospital with their appointment cards

makes it difficult to trace the folder which leads to waste of time.

Inadequate storage facilities such as cabinets for storing master index cards and MHIS

forms.

The department needs expansion to accommodate more folders; since there is always the

problem of battling with lack of space every year.

Unhygienic conditions of the archive’s premises such as the defecation at the entrance and

attacks by patients on the staffs has also been a major problem to the department

The issue of filling of the MHIS forms by some doctors and nurses has been a major worry,

and the hand writing of those who fills the MHIS can hardly been read into.

38

THE WAY FORWARD FOR 2012

Staffs have geared up to face any challenges in the coming year by timely delivery of

reports for compilation.

Plans are underway to set up a complain desk to address patients who have problems with

their folders and other information and this will go a long way to enhance effective and

efficient delivery of services.

To ensure that quality and accurate data are provided for the hospital, the following

department would be included in our data capturing, psychology department, CPN, and

social welfare department.

Medical and nursing staffs would be encouraged to continue to fill the MHIS forms for

accurate data to be captured and maintained when necessary.

We want to make passionate request to the management that national service personnel

should be requested for the department to support the existing staff every year

39

O.P.D ATTENDANCE TREADS 2008-2010 ACCRA PSYCHIATRIC HOSPITALS.

NEW CASES

years males females total

2008 2628 2229 4857

2009 1518 1409 2927

2010 5254 4163 9417

total 9400 7801 17201

years 2008 2009 20100

1000

2000

3000

4000

5000

6000

Series1Series2

Fig.1.0.

From the graph and table above, a total 17201 new cases were seen at the out-patients department of the hospital from 2008-2010, a total of 4857 new cases were seen in 2008 with 2628 males and 2229 females. In 2009, the figure came down to 2927 with 1518 males and 1409 females while the year 2010 recorded the highest of 9417 new cases with 5254 males and 4163 females new cases.

40

O.P.D ATTENDANCE TREADS 2008-2010 ACCRA PSYCHIATRIC HOSPITALS.

OLD CASES

years males females total

2008 15178 16794 31972

2009 13851 16449 30300

2010 24565 24416 48981

total 53594 57659 111253

years 2008 2009 20100

5000

10000

15000

20000

25000

30000

Series1Series2

Fig.1.1.

The table above shows the O.P.D attendance tread of old cases from 2008-2010 in the Accra Psychiatric Hospital, a total of 31972 old cases were seen with 15178 males and 16794 females in 2008 while a total of 48981 cases was also seen in 2009 however, year 2010 again recorded the highest figure of 48981 old cases seen in the hospital.

41

PATIENT’S DIAGNOSIS TREND 2008-2010

42

DIAGNOSIS 2008 2009 2010 TOTAL PERCENTAGE

SCHIZOPHRENIA 940 248 3262 4450 26

DEPRESSION 525 146 3462 4132 24

ACUTE PSYCHOSIS830 301 253 1384 8

EPILEPSY 551 144 1205 1900 11

SUBSTANCE ABUSE 583 110 1025 1718 10

hypomania 408 114 522 1044 6

NEUROSIS 430 107 418 955 5

DEMENTIA 309 19 258 586 3

OTHERS 563 273 61 897 5

TOTAL 5139 1462 10466 17066 99

SCHIZO

PHRENIA

DEPRES

SION

ACUTE PSYC

HOSIS

EPILE

PSY

SUBST

ANCE ABUSE

hypoman

ia

NEUROSIS

DEMEN

TIA

OTHER

S0

5001000150020002500300035004000

Series1Series2Series3

Fig.1.2. From the graph above, schizophrenia, depression, epilepsy and substance abuse were the leading top ten diagnoses of patients , representing 26%,24%,11% and 10% respectfully, of the hospital top ten diagnosis from 2008-2010. However, neurosis, and dementia recorded the lowest percentage (s) of 5% and 3% respectively.

Age group 2008 2009 2010 T0TAL

Under 1

1-4

5-9

10-14 11 28 184 223

15-17 48 94 420 562

18-19 110 221 550 881

20-34 1028 1992 318 3338

35-49 630 979 1311 2920

50-59 223 400 726 1349

60-69 59 128 100 287

70+ 43 76 39 158

TOTAL 2152 3918 3648 9718PATIENT’S ADMISSION TREND 2008-2010

43

YEARS Under 1 15-17 18-19 20-34 35-49 50-59 60-69 70+0

500

1000

1500

2000

2500

Series1Series2Series3

Fig.1.3. Figure above indicates that, a total of 9718 patients (males and females) were admitted into the hospital during the period of three years (2008-2010). Majority of these patients were under the age group of (20-34), (35-29) and (50-59) representing about 76 percent of all admitted patients. Meanwhile, the aged group of (60-69) and 70 years and above also represented a total percentage of 4.5.while patients under eighteen years got a percentage of 8 as shown above.

44

PATIENT’S DISCHARGES TREND (MALES) 2008-2010

AGE GROUP 2008 2009 2010 T0TAL PERCENTAGE

Under 1

1-4

5-9 1 1 2

10-14 5 2 8 15 .2

15-17 115 32 65 212 3

18-19 267 66 63 396 6

20-34 547 166 84 797 12

35-49 297 287 918 1502 23

50-59 149 87 375 611 9

60-69 35 23 208 266 4

70+ 11 11 .1

TOTAL 2460 1232 2920 6612 99.5

45

AGE GROUP

Under 1

15-1718-19

20-3435-49

50-5960-69

70+0

500

1000

1500

2000

2500

Series1Series2Series3

Fig.1.6.

From the table above a total of 6612 male patients were discharged from the hospital from 2008-2010.

23 percent were in the age group of 34-49 as the highest, while the age groups of (1-4) and (70 +) represented a percentages of 0.2 and 0.1 respectfully.

46

PATIENT’S DISCHARGES TREND (FEMALES) 2008-2010

AGE GROUP 2008 2009 2010 T0TAL PERCENTAGE

Under 1

1-4

5-9 1 1 3 5 .1

10-14 6 2 41 49 2

15-17 65 19 48 132 5

18-19 127 67 40 234 8

20-34 374 125 521 1020 36

35-49 259 215 328 802 28

50-59 166 108 176 450 16

60-69 47 31 24 102 3

70+ 11 11 .3

TOTAL 1045 568 1192 2805 99.6

47

AGE GROUP

Under 1

15-1718-19

20-3435-49

50-5960-69

70+0

500

1000

1500

2000

2500

Series1Series2Series3

Fig.1.7.

From the table above a total of 2805 female patients were discharged from the hospital from 2008-2010, 36 and28 percent were in the age group of (20-34) and (35-49) respectfully, while the age group of (70+) and (10-14) represented 3 and 0.1 percent respectively

Manpower ratio trends 2009-2011.

48

2009 2010 2011

1 Medical Doctors /prescribers patients ratio

1:3020 1:4866 1:3019

2 Professional Nurses (Psychiatry) patients ratio

1:582 1:2780 1:485

ESTATES UNIT

Health infrastructure and equipment constitutes a high proportion of the budgetary allocation for Ghana Health Service (Accra Psychiatric Hospital). It is therefore of primary importance that these facilities are kept in very good physical condition in order that they perform the required functions to provide a sound environment for our clients, staff as well as visitors

The Estate Management Unit is to ensure proper management and development of infrastructural Facilities and equipment in the Hospital.

We provide direct services to the Hospital and out-reach technical support services to all BMC’s. Some of the main activities of the unit is to manage capital investment programme, General maintenance, PPM etc.

Staff Strength

• PRIN. Estates Manager 1

• Carpenter Prin. Artisan 1

• Carpenter Artisan 1

• Carpenter Snr. Artisan 1

• Carpenter Casual worker 1

• Plumber Prin. Artisan 1

(Plumber) Artisan 1

Major concerns at beginning of the year 2011

Improving PPM programmes

Preparation of hospital Asset Register, Inventory and Labeling (Embossments) of assets

Deplorable state of some structures (wards and other units)

Physical implementation of Mortuary project

Monitoring of Health Estates activities

49

OBJECTIVES

To ensure that all projects are procured and executed in accordance with specifications (Act 663, 2003)

To facilitate timely completion of projects

To provide sustainable clean and friendly environment

PRIORITIES

Monitoring, inspect all on-going projects

Carrying out rehab./repairs of staff residence, facilities and office buildings

Monitor planned preventive maintenance activities with necessary technical support at the hospital

Collaborate effectively with other units

Co-ordinate health estates activities

Ensure preparation of assets register and inventory document

KEY ACTIVITIES CARRIED OUT

Constructional works

Rehabilitation/repairs works

Supported Environmental activities/sanitation activities

Facilitated in pruning down tree branches in and around the hospital

Collaborated with external partners

Updated hospital housing facilities DATA

Labeling of some items.

50

ACHIEVEMENTS

Labeling of hospital staff accommodation blocks

Provision additional lights on hospital compound (security lights)

Construction of dwarf wall and screening works at catering department

Renovation staff quarters No. B10 (for Dr Owusu Antwi)

General repairs /replacements – plumbing, carpentry, electricals (day to day activities) carried out.

Trimming/Pruning of tree branches.

Renovation of hospital staff quarters B10 (Estates Manager).

Painting and other works on 72 hour observation ward.

Painting inner fence wall and security house (Face-Lifting)

General painting of VIP ward

General repairs/Servicing of some air-conditioners in the hospital.

Labeling of donated mattresses.

External painting of nursing administration block

Construction of kitchen cabinet at staff quarters A3( for Hse. Man H/serv Admin

Exterior painting of female infirmary block

Servicing gas at the catering department

Mending of roof leakages at selected areas.

Painting and minor renovation of general administration

Replacement roof work at the special ward.

Fabrication and mounting sun-breakers(canopies) at OPD

Renovation work at staff quarters no. B14 (for Anaesthetics

Renovation of staff quarters no.B6 (for Nurses)

Provision and installation industrial gas cookers.

Replacement of broken slabs at the sewerage treatment plant.

Major renovational work at F1 (Now Alkot foundation)

Expansion 4 inches asbestus sewerage line to 6 inches PVC pipe

Changing wooden doors to metal doors at special ward

Expansion of gas system kenkey factory

Provision of 2 no. large size gas oven

Repair of broken-down of laundry machines

51

SPECIAL DONATION

Prophet T B Joshua donated 10 no. TVs and 2no. Strong tv decoders

Major rehab work by ALKOT Foundation.

Hospital Infrastructure which needs rehabilitation

General office block (major rehabilitation)

Hospital conference hall (Major roof work etc)

Main pharmacy block (Major rehabilitation)

O T wooden structure (Remodel into Canteen).

Special ward block (Highly deterioted)

Pavement to staff Resi block B (Suroundings)

On-going works and Progress

Floor tilling of consulting rooms- progressing steadily

Renovation of male admission 2- Progressing steadily

Rectification of roof leakages and other works at the telephone exchange – in progress

Construction of bed side cabinets for VIP & BHC wards –ongoing at workshop.

STAFF ACCOMMODATION

The general accommodation (Office & Residential) situation in the hospital is of great concern.

Accommodation is woefully inadequate and the few available are in deplorable state.

Efforts being made to rehabilitate those in deplorable state.

CONTRAINTS/CHALLENGES AND HOW MANAGED

Absence of adequate and artisans in estates Unit.

Used external artisans’ necessary/staff replacement.

Un-availability of adequate funds for the rehabilitation of staff accommodation and other facilities.

Delay in getting transport to carry out activities promptly

WAY FORWARD

52

To carry out technical support visits to Units

Funds should be made available for the completion of all intended projects.

Intensify awareness creation and commitment to the culture of planned preventive maintenance

by all workers/Mgt.

PROJECTIONS FROM THE UNIT ON WORKS

To commence and complete inventory taking exercise and prepare assets register by the end of

first half of the year, 2012.

To remodel and furnish the hospital conference hall. (Standard type) by the middle of March, 2012

To commence and complete the rehabilitation of general office block by the end of March, 2012.

To service all fire extinguishers which are far over-due for servicing, provide additional ones and

also conduct user/fire-fighting training for staff by the middle of February 2012 due to the

emergency nature of the exercise.

To commence and connect mechanized bore-hole water to all wards/Service areas by at most, the

middle of February, 2012. To service the hospital stand-by generator by the first week of

February, 2012 and follow up with standardized periodic maintenance system.

To regularize the mode of occupancy of the hospital staff quarters and document appropriately for

tenants to pay rent for the maintenance of the same facilities

To service the hospital stand-by generator by the first week of February, 2012 and follow up with

standardized periodic maintenance system.

To regularize the mode of occupancy of the hospital staff quarters and document appropriately for

tenants to pay rent for the maintenance of the same facilities. To renovate and furnish the

hospital in-service training centre by the end of May, 2012

To renovate the 2no. Public urinals on hospital premises (By the gen. office & pharmacy) by the

end of June, 2012.

To rehabilitate and remodel the wooden OT structure into hospital canteen.

To fill and make-good (Level) undulating grounds at the hospital. To implement mortuary

construction project by April, 2012

53

To co-ordinate comprehensive rehabilitation works on the hospital sewerage lines, toilet facilities

and cover all man-holes, inspection chambers and septic tanks with durable concrete slabs.

CONCLUSION

Health Infrastructure is key for health care delivery and requires the attention of everybody since

we need decent and serene environment to work in.

Let’s therefore together plan, build and maintain.

54

INTRODUCTION

What we do

Investigations to aid Diagnoses and Treatment of Patient management as well as Teaching and

Research.

ACTIVITY EARMARKED FOR 2012.

Bacteriology Unit of the lab will be set up all things being equal.

This to a large extent will depend on the availability of space.

CHALLENGES

Information flow though has improved there still remains yet more to be done.

Space within the lab.

Non-existence of in-service training/workshop programmes.

The chairs in the department are not ergonomically friendly.

ACHIEVEMENTS

Functional and operational lab that has stood the test of time and able to perform lab investigations.Significant contribution towards the internally generated funds (IGF) of the hospital.

By the quality of our work, we continue to attract the confidence and trust of other health care facilities. We continue to optimize the use of available resources to the satisfaction of patients and clients.Introduction of more lab tests such as Hb Genotype, G-6-PD.

RECOMMENDATIONSThe department is furnished with every relevant information on time.

Possible expansion of the lab to create more room for other equipment and further investigations.

Capacity building in the form of in-service training, workshop or professional courses for staff.

Replacement of chairs with adjustable swivel chairs.

Daily supply of newspapers to the lab.

Supply of lab coats to the staff.

Inscription of the hospitals name on all lab equipment.

Adequate representation of the Dept. on management team.55

CONCLUSION

We hope to further improve upon our total work output and client satisfaction taking into account

the quality of service and the overall interest of the hospital.

We hope management will be more supportive to ensure the smooth running of the lab.

56

CATERING DEPARTMENT

INTRODUCTION

Hospital catering is as old as when health care came into existence, tracing its roots from the

Florence Nintingale Era. Through the mercies, grace and love of God we were not consumed, we

have lived to see a new year with beams of hope. Catering section still catering for patients

numbering about One Thousand Two Hundred. Since diet therapy /hospital feeding has been of

immense help contributing to the healing of patients; breakfast, lunch, supper never failed.

Without food the efficacy of drugs administered will not be seen.

In February, new administrator came with new ideas and innovations that helped boost up the

image of the hospital and also activated dead policies. These ideas were implemented with the full

support of the Medical Director and his team members.

Our source of finance was from the government and non-governmental organizations and a

couple of individuals. This was done through cash and goods.

CHALLENGES

We were faced with the challenge of cutting down cost and controlling wastage. Another

challenge to get replacement for the four cooks who went on retirement and to get fresh hands to

augment the strength of the failing ones.

Discipline was also another challenge especially the first half of the year. Misunderstanding

between some staff members brought about a whole lot of confusion. Indiscipline was the order

of the day, petty squabbles and quarrels, all emanating from greed and pride.

ACHIEVEMENTS

By the intervention of management all the problems that were solved were within their means.

Ranging from staff issues, equipment and utensils (maintenance and replacement) sanitation. The

most remarkable ones were the installation of gas stoves and gas connection to the bakery and

oven for the smoking of fish. The flooring for washing dais in the main kitchen and the kenkey

section was also attended to. Also a dwarf wall was erected to separate the kenkey preparation

area and the cooking area to prevent heat.

57

The last but not the least was the end of year package to all members of staff including casuals.

We say Bravo to the Medical Director and his management team members.

WAY FORWARD

It is our fervent wish that catering department will put in much effort the coming year so that our

ambitions will be to help push the hospital forward to attain its set goals by serving palatable

nutritious meals in a well sanitized environment.

Therefore it will not be news when catering department emerges as the best department in 2012.

It is our prayer that the good Lord who saw us through 2011 will see us through the coming year.

CONCLUSION

Long live The Medical Director and his team members, long live Accra Psychiatric Hospital, and

long live Ghana.

58

ENVIRONMENTAL AND SANITATION DEPARTMENT

MAN POWER/STAFF STRENGTH

Chief Environmental Officer 1

Principal Environmental Asst. 1

Conservancy Permanents 5

Conservancy Casual 5

Sanitary Labourers Permanent 4

Casual Labourer 1

Ward Orderly 2

Total 19

CLEANLINESS OF THE FACILITY

The general cleanliness of the entire environment appears clean and tidy

WATER SUPPLY IN THE FACILITY

Water Supply in the facility is mainly pipe bone, but as and when the taps are closed, the hospital

falls majority on Two (2) dug bore holes, one at the frontage of VIP ward and another at the

frontage of the Occupational Therapy Department.

However, there are wards and areas within the facility that cannot get access to the boreholes, in

this regard, the hospital then falls again on water tanker services, during these hard times which is

really draining our coffers

REFUSE DISPOSAL WITHIN THE FACILITY

Two big trenches has been dug 120 yards away from the main sewage plant, where both wet and

dry refuse are sort out and burnt. Also, there is an incinerator sited nearer to the dumping site

which is been used for the incineration of Gauze swabs, only use syringes from wards and

laboratory department.

SEWERAGE PLANT

There is a sewerage plant, sited in between the refuse dump, where finally all liquid waste from

various wards and sections of the facility comes as the final place of disposal with the efferent

passing through necessary circulation and finally a bye product is formed as Gas for use at the

Catering Department.

59

TOILETS FACILITIES WITHIN THE FACILITY

Toilet facilities within the facility has always been a big problem, and since the hospital is an old

institution of over a hundred and six years old, the asbestos sewer lines used are all rotten in the

ground, making the lines to be choked frequently, with the effluent overflowing its banks. Giving

rise to a lot of nuisance and health hazard to the patients and staff as a whole.

DISINFECTION/DISINFESTATIONS

Fumigation was carried out in all the wards, which were infested with Bodylice, Bedbugs.

Mosquitoes, Dangerous reptiles, Cockroaches, rodents and termites within the facility. Late in the

year, there was also Cholera outbreak, which affected some wards of which that was also taken

care of with fumigation of the affected wards.

PROBLEMS ENCOUNTERED DURING THE YEAR 2011

Shortage of staff e.g. Conservancy and Sanitary Labourers.

Improper disposal of refuse within the facility. (NB)

Improper Drainage systems. (NB)

Reports from various wards about broken-down toilets and sewer lines.

Indiscriminate littering of the environment by out -patients and staff as a whole.

Sitting of dust bins at vantage points within the facility.

No changing room for Conservancy Labourers to change themselves as or keep their wares, even when it is raining or shinning. Attention should be drawn on the urinals with the facility.

Urinals for outpatients and staff not the best.

We need Aug 2144 insecticides and not izal which is out mode in the system since suppliers don’t supply correct izal only water.

Two trenches dug at the refuse dump meant for disposal of refuse within the faulty are all full, now refuse is been thrown haphazardly at the sites, but, without the burning of most refuse, there will be serious problems.

60

SUGGESTION/SOLUTIONS

Ward Orderlies should follow patients to the dumping site, to ensure proper disposal of refuse. (NB) Digging of trenches since.

Recruitment of conservancy and sanitary labourers to the Environmental Department, since most of the labourers are retiring and even some too old to perform efficiently.

Much and immediate attention should be drawn on the changing room for the Conservancy labourers at the main sewerage plant. Consistent Medical attention for the conservancy labourers. NB

Dust bins with filling covers be sited at vantage points with the facility, to avoid littering of the environment by out patients and staff as a whole.

We need AUG 2144 for our daily routine services and not izal which has been diluted with plenty water and not helping to kill the coats in the ward, toilets and cutters within the facility.

The change of asbestos sewer lines in the grounds which is over age and are creating a lot of nuisance within the facility to PVC’s.

Working Gear should be provided to the conservancy and sanitary labourers 2012.

NB. IMMEDIATE CONNECTION OF THE BOREHOLE TO THE WARDS, TO AVOID SPENDING SO MUCH ON WATER. WITHOUT WATER THE ENVIRONMENTAL DEPARTMENT CANNOT PERFORM.

THE WAY FORWARD

Much and immediate attention should be drawn on the problems facing the Environmental and Sanitation Department, since they play a vital role to the upkeep of sanitation within the facility.

Sanitation is a way of life. it is the quality of living that is expressed in a clean home, the clean farm, the clean hospital and a clean community being a way of life, it must come from within the people, its nourished by knowledge and grows as an obligation, and has an ideal in human relations” (who).

“Sanitation key to god health”

61

LAUNDRY DEPARTMENT

Introduction

• The Laundry Department is responsible for constant supply of clean lines daily to all wards and various departments of the facility. Our duties include receiving of dirty linens, washing, ironing, folding and dispatch them on daily basis.

STAFF STRENGTH

Principal Leading Launderer 1

Head Hospital Orderly 1

Senior Washman 2

Senior Artisan 1

Causal 1

Total 6

LAUNDRY EQUIPMENT

Washing Machines 4

Drying Machines 2

Calendar Machines 2

Hand Ironing Board 2

Pumping Machine 1

Main Switch Board 1

Sewing Machine 1

Laundry Plastic Containers 4

Water Reservoirs 2

ACTIVITIES

62

We make sure to maintain the machines and report the fault to avoid any major breakdown and

to promote good work done. There was no shortage of water in 2011. The machines are in good

shape. When we report the fault immediate step is taken.

CONSTRAINTS

Some of the patients are left on their own to bring the lines to the laundry department.

Shortage of staff.

ACHIEVEMENT

As from January to December, 2011 our returns 97, 632 linens received.

The year 2010 it was 129,808 linens. We also work for Nima-Clinic and earn GH¢263 for the good order.

SUGGESTION/SOLUTION (THE WAY FORWARD) CONCLUSION.

We recommend proper and frequent maintenance of Laundry machines in order to promote high productivity. Provision of additional ceiling fans to cool the machines and keep the temperatures

at required levels. Nurses to accompany the patients in collection of their lined before and after

washing. Motivation of laundry staff, would promote us to work efficiency and effectiveness.

63

SOCIAL WELFARE DEPARTMENT

Patient Population as at 31st December, 2011

Patient population as at 31st December, 2011 is Nine Hundred and Six.

Male – 714 and Female 192.

CONTACT WITH RELATIVES/EMPLOYERS

Sixty one male cases were handled and fifty nine female cases were also tackled with either relatives or employers during the year under review.

INSTITUTIONAL CARE OSU CHILDREN’S HOME

Four cases were referred to the Osu Children’s Home during the year review. One of the patient’s relatives have been contacted but are yet to come for the baby whilst efforts are being made to contact the rest.

ABSCOND CASES

Three Hundred and Sixty Six (366) patients absconded from the hospital during the year under review. Letters were sent to their relatives in that regard

DISCHARGES

Six Hundred and Eighty three (683) patients were discharged during the year under review. Out of this number two hundred and twenty one (221) fell under the operation 600 repatriation

SEMINARS/DURBARS/CONFERENCES/WORKSHOP ATTENDED

The 3rd Preceptor Training was held at Kintampo Rural College from the 11 th to 17th September, 2011. The main objective of the workshop was to promote mental health service delivery in the country as a whole.

MASS REPATRIATION OF RECOVERED PATIENTS

64

Under the code name OPERATION 600, the Department of social welfare in collaboration with the Community Psychiatric Unit carried out a mass repatriation of about two hundred and fifty seven (257) recovered and discharged patients to the ten region of the country.

Most of the affected patients were vagrants whilst some were drawn from the various wards of the hospital

THE MAIN OBJECTIVES OF THE EXERCISE WERE

To decongest to the wards so as to cut down the cost of running the hospital more effectively and efficiently.

To enhance effective welfare and rehabilitation programmes for patients in their own Local environment.

To reunite the affected patients of abandonment with their families to ease their plight.

FIELDWORK PLACEMENT OF STUDENT FROM INSTITUTIONS

During the year under review, fifty students from the University of Ghana, Legon and the School of social work in Accra had their fieldwork placement at the hospital.

They were taken through a thorough orientation on the activities of the social welfare agency after the background history of both the hospital and the social welfare unit had been discussed. Under the orientation, social work was redefined and the roles/functions of the hospital social work, theory and practice, objectives of welfare/rehabilitation processes were all brought to the fore. Case work principles/values on some key professional issues were also observed.

Students were later taken to the various wards of the hospital in the company of social welfare facilitators. The aims of ward rounds were:

To get the exposure of the environment in which they were to work.

To identify clients with social problems and interact with them.

To study the practicality of cases referred to the unit and how the unit addresses them.

To observe interpersonal relationship between clients and ward Nurses, and also between the agency staff and the clients.

To identify challenges faced by both ward staff and clients. Again students were involved in the handling of some life cases through interviews with patients/clients and some duties on the field

65

to follow up on some old cases under investigation within the Accra Metropolis. By the end of

their placement there was an overview of work done, case work discussion, problem identification, solution and suggestion

MAIN CONSTRAINTS FACING THE AGENCY

IMPREST: This is a major concern to the smooth running of the agency. The unavailability of this facility retards the effective and efficient running of the agency and always put the image of the hospital in a negative light. Patients who come to the agency for assistance are numerous and their problems mainly concern transportation to their various homes. We are compelled to use our own meager resources to assist these unfortunate patients.

LOGISTICS: The state of the agency’s official stamps is all in poor state. It is recommended that this particular issue should be prioritized.

CONCLUSION/RECOMMENDATION:

There should be proper record keeping at the hospital. A good database must be maintained to provide up to date information about the patients.

It is hope the problems enumerated above will be given the necessary attention in the supreme interest of both patients and staff.

PHARMACY DEPARTMENT

INTRODUCTION

Pharmacy department consists of two units: main dispensary (near the school) and the second unit at the OPD (ward) Serves the hospital, CPNs, and some private the general public hospitals.

STAFFING

Pharmacists 3

Dispensing technicians 5

66

Revenue officer 1

Health assistant 1

Dispensing assistants 2

Total 12

OBJECTIVES

To obtain a television stand for the patients waiting area to lessen the discomfort of waiting

Organize one CME each month for the department

Organize one staff meeting each month

Improve on ward visitation

Reduce patient waiting time

Improve infrastructure

Activities

No. of inpatient folders served: 16,800 folders/yr, average 70 folders/day

Cmes organized

Staff meetings held: 5 Total no of OPD Rxs served: 40,515; averaging 161/day; highest in Sept. 3,942; lowest in Oct. 2,816 (all minus “lost” Rxs); (ref next slide

month  

JANUARY 3,551

FEBRUARY 3,050

MARCH 3,516

APRIL 2,979

MAY 3,532

JUNE 3,728

67

JULY 3,658

AUGUST 3,836

SEPTEMBER 3,942

OCTOBER 2,816

NOVEMBER 3,214

DECEMBER 2,693

 Total 40,515

1 2 3 4 5 6 7 8 9 10 11 12 -

500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500

no. of Rxs served/mth

months

no. o

f Rxs

Achievements

Patient waiting time relatively reduced

Improved pharmaceutical services:

Carrier bags for patients’ medicines

Prescription interventions

Improvement in dispensing errors prevention

Improvement in pharmaceutical interventions

68

Staff meetings were successful

Record keeping – an improvement upon the previous year.

CHALLENGES

Lack of lab coats

Dilapidated working environment

Not enough benches for patients (especially for Tuesdays and Thursdays which are very heavy clinic days)

Television for waiting area still not installed

Staff strength still not enough to measure up with the patient number and needs

Shortage of medicines?

Could not improve on ward to ward visitation.

Activities earmark for 2012.

Improve infrastructure hopefully this year

Install TV unit at waiting area

Ward visitations-once a month to each ward

Staff meetings- to be held every quarter

CME every month.

69

IN-SERVICE TRAINING UNIT

INTRODUCTION

The core functions of the units in the form of orientation structured remedial and special courses

to update and upgrade staff to excel in the performance of duties were adhered to. The unit did

implement, monitor and evaluate teaching – learning activities as well.

In the year under review, 2222 personnel were taken through various courses towards their

practical attachment to the wards and relevant departments.

BREAKDOWN

CLINICAL EXPERIENCE

Registered General Nurses - (Korle-Bu NTC) 523

Registered General Nurses - (Kumasi NTC) 259

Registered General Nurses - (Agogo NTC) 118

Registered Mental Nurses - (Pantang NTC) 183

Registered Mental Nurses - (Ankaful NTC) 11

70

Registered Midwives - (Korlebu NTC) 275

Registered Midwives - (Kumasi NTC) 107

Community Mental Health Officers (Kintampo) 36

Medical Assistants – Psychiatric Trainees (Kintampo) 2

B.Sc Paedeatric Nursing Students (Legon) 30

Level 300 – Psychology & Sociology (Legon) 1

M.Phil – Clinical Psychology (Legon) 5

Level 400 – Nursing (UCC) 1

Special education students (U.C.E –Winneba) 3

Health assistant clinical students (Western Hills) 135

Health assistant clinical students (Martin Luther) 84

Health assistant clinical students (Nyaniba) 128

Health assistant clinical students (Health Concern) 136

Health assistant clinical students (Keta) 113

Health assistant clinical students (Narh-Bita) 1

Health extension workers (N.Y.E.P) 71

ORIENTATION

RMN (Permanent Appointment) - 70

Nurses (Contract Appointment) - 9

Medical doctor (Residency) - 1

Health administrator(Housemanship) - 171

HEW (NYEP) - 8

Re-engagement – Nurse - 1

Practical placement (British) - 1

Clinical practicum (American) - 1

Internship (Dane-German) - 2

Practical attachment – BA Psychology - 1

Voluntary work (British) - 1

Community Service - 15

CONSTRAINS

FINANCE: There was no provision of funds to organize workshops for staff. This development

is retarding the efficiency of staff with regards to modern trends of the profession

TEACHING AIDES:

Acquisition of an over-head projector, laptops, screen and video-appliances among others for

effective teaching-learning activities should be a priority to the authorities.

COMPUTER & ACCESSORIES:

The training unit is without a computer and its accessories. The lack of these equipments is indeed

a major deficit in administrative duties at the unit.

INFRASTRUCTURE:

The training unit needs a major renovation to benefit its status.

FURNITURE:

The old desks at the lecture rooms should be replace with modern ones to create comfort for

participants. The unit was provided with two arm chairs and two benches by the hospital

administrator.

REFRIGERATOR:

The authorities must provide a refrigerator and television to the unit72

WAY FORWARD.

Provision must be made to the unit to befit the status of an in-service training unit. Comport and

accessories and teaching aides should be promptly acquired to the unit.

SPECIAL SCHOOL

INTRODUCTION

The intellectually disabled have the right to quality education just like any other individual so that

they can also live and lead semi-independent or independent lives and contribute their quota to

the development of their environment or community.

As the above statement suggests, it was based on this that the special school was established in

the Accra Psychiatric Hospital to care for and educate children with intellectual disability since

1968.

STAFF

The professional staff stood at six, males – 3 , females -3 during the year under review.

INTERNS

The University of Education, Winneba in September, 2011 sent two students under the out-

segment programmes to practice in the school from September, 2011 to June, 2012.

VOLUNTEERS

Six volunteers have helped in supporting the school.

They were three Dutch volunteers, one American, one German and one Norwegian.

73

They really augmented the staff needs in the severe/profound class.

SCHOOL ENROLMENT

The enrolment at the end of the year stood at fifty-six (56), boys – 40, girls – 16.

The average daily attendance as twenty-three (23).

CLASS ROOMS

The school has two class rooms and the third class room was created under the nim tree due to

the large number of children to the school from the children’s ward.

Specialized services

Physiotherapy

Speech therapy

Occupational therapy

Toilet training skills

Behavior modification

Hydro therapy pool

Sensory programmes

Music therapy

Physical education

LONG TERM GOALS

The school has the following as its main objectives for its long-term goals they are:

Giving the students some employable skills

Preparing the students to be independent or semi-independent

Assisting the students to contribute their quota to the development of their

environment/community.

To prepare the students for transition.

Creating awareness of disability issues in the country.

Creating conducive environment in the school to meet the needs and aspirations of the students,

etc.

SHORT-TEM GOALS

74

Assisting the handicapped to understand their problems

Teaching them some basic skills for their daily lives

Bringing the intellectually disabled closer to the outside world by way of sending them on

excursions.

To modify the inappropriate behaviors of some of these students which would help to give them

the necessary skills needed for their level of functions.

To improve their communication/social skills etc.

SCHOOL PROGRAMMES

A number of programmers have been put in place which catered for the needs and aspirations of

our special needs children.

The school in conjunction with our volunteers from Holland has designed an individual stimulation

programme for the severe/profound intellectual disabled children.

This programme was to stimulate various senses of a severe child.

Academic Skills

English Language

Mathematics

Writing

Reproductive Health and Sexuality

Pre-Vocational Skills

Social Studies

Communication Skills

Verbal

Non-Verbal

Motor Skills

• Gross motor

• Fine motor

ACHIEVEMENTS

The construction of the sanitary facility for the school came as the biggest achievement chalked

due to so many years of intensive search for such a support for over 43 years of the existence of

the school.

75

Most of the pupils inappropriate or deviant behaviors have been changed.

The global schools partnership has helped to a large extent the pupil-teacher relationship to be

improved.

The citizenship session under the global schools partnership increased the support from the higher

ability pupils to the lesser ones.

The cordial relationship between the hospital management and the school and also the nursing

administration promoted the easy travelling of the school to participate in games and cultural

festivals.

CHALLENGES

It was rather a pity that for so many years of persistent complaints to management on the need to

rehabilitate the school to suit its status, no mechanisms have been put in place to suite the status

the school deserves.

The following were the problems or challenges confronting the school or confronted it during the

past year.

The thick smoke that emanated from the kenkey factory of the catering department, this affected

teaching/learning and also some staff members complaining about pains from their eyes.

The headmasters office was more than a warehouse and visitors even had no place to sit.

No stuffy chairs for the headmaster office

No provision of school uniforms for the school

No ceremonial uniforms and foot wears for the children

The provision of snack for the children and the adults was nil

The need for provision of additional classrooms to take care of the severe/profound children did

not materialize.

The computers donated by Teachers Beyond Boarders – UK are still lying idle as there is no room

to install them.

The provision of toiletries to the school was not enough.

THE WAY FORWARD

For the school to function as expected there is an urgent need to attach a permanent health

personnel to it as has been the issue over the years.

76

The school in collaboration with management this year will develop a more pragmatic transition

programme or the pupils, taking their interest and skill areas into consideration.

Provision of quality teaching/learning materials to suit the needs and aspirations of more

especially the severe /profound children.

Periodic visits by the Estates Manager to the school will help to improve the present

infrastructural state of the school.

The school will try to organize more exhibitions/excursions this year.

CONCLUSION

In conclusion, tremendous developments were seen in the year through our volunteers and

partners.

It’s our pray that, one day, the provision of facilities that would make CROSS a model special

school in West Africa.

STORES AND SUPPLY DEPARTMENT

INTRODUCTIONThe supply department has the responsibility for the purchase, receipt, custody and distribution of very large sums of money in the form of goods.The supply function must be managed and operate in a highly efficient way.The stores should be considered as a temporary location for Non-medicine supply

ObjectivesTo liaise with the users department to know their needs in the HospitalTo help in procuring Non-Medicine Consumables and Medicines supplies for the HospitalTo make available a balance flow of component material, equipment and any other commodities necessary to meet Accra Psychiatric Hospital requirementTo receive and issue Non – medicine and donations itemsTo accept and store scrap and other discarded materials as it arises.To account for all purchases, receipts, issues and goods in stockTo provide quality services to the usersTo ensure absolute cleanliness of the storehouse and it environment.

Activities77

The supply department has sub sections of Non consumable, disinfectant, stationary, cleaning materials Electrical, Carpentry and Plumbing etc.as shown Below.

No Description of items Estimated Amount Gh¢

Remarks

1 Disinfectant 213,811.202 Cleaning and Environment 18,934.753 General goods 40,807.754 Stationary and printing 35,737.605 Office Equipment 39,590.376 Food(perishable and non perishable 921,813.007 Laboratory 10,891.258 Pharmacy 38,400.009 Transports spare parts 15,065.0010 Electrical 18,797.5011 Uniform 24,436.8012 Plumbing /Carpentry 19,476.4013 Works(gas networking) 12,273.48

Total Amount ¢ 1,410,035.10

Achievements

The department was able to provide quality services to the wards and department in Accra psychiatric hospital

The department was able to meet the demand of the users

The department was able to control all stock of items procure for the whole year.

Constraints

The storehouse needs to be renovated to fix all necessary facilities like toile etc

78

The shelf is not enough for all the items in the stores

The storehouse is too congested for a free flow of movement

There is no ventilation

Poor lighting system

The storage temperature for storage of stock is very poor.

Recommendation

More in service training program should be organized to improve our services delivery

More shelves to be created to enable effective counting, during stocktaking, and be able to display items for easily identification.

Management should provide air conditioners and lighting system in the storehouse and chemical room.

Way forward

To provide quality services

To ensure continuity of supply

79

FINANCIAL REPORT

HIGHLIGHTS

• The financial statement for year 2011 highlights the following

• Total monies received from Head Office and those generated internally are as follows:

• Received

• and Generated Budgeted variance

• GH¢

• From Head Office 2,825,915 4,517,435 (1,691,520)

• IGF Service 53,797 51,700 2,097 F

• IGF Drugs 16,204 15,200 1,004 F

•

ACCRA PSYCHIATRIC HOSPITAL

REVENUE AND EXPENDITURE STATEMENT

FOR THE YEAR ENDED 31ST DECEMBER 2011

80

I G F G O G

S B S /

23.23

% S E R V I C E

26.19%

D R U G

S

(51.47%) SERVICE

(8.41) ADMINISTRATION

380.6%

D P F

100.65%

T O T A L

2011 2010 2011 2010 2011 2010 2011 2010 2011 2010 2011 2010

Revenue 53,797 43,654 33,184 12,840167,94

5 346,095 551,745 602,4152,106,22

5 438,249 2,912,896 1,443,

253Less: Expenditure Item 1. Casual Hands 2,600 6,870 - 2,300 - - - - 27,100 4,800 29,70013,970

Item 2. Administration Exps. 28,796 24,254 - 2,012 - - 551,320 602,415 827,669 277,350 1,407,785

906,031

Item 3. Service Expenses 636 2,260 18,473 -

164,892 342,097- -

1,200,627 126,328 1,384,628

470,615

Item 4. Investment Expenses - - - - - - - - - - -

Total Expenditure 32,032 33,384 18,473 4,312

164,892 342,027 551,320 602,415

2,055,396 408,478 2,822,113

1,390,616

Net Income/(Deficiency) 21,765 10,270 14,711 8,528 3,053 4,068 425 - 50,829 29,771 90,783 52,637Expenditure Analysis Casual Hands 2,600 27,100 29,700 Water 4,750 25,095 29,845 Telecommunications - - - 5,572 13,932 19,504 Postal Charges - - - - 535 535 Sanitation Charges 2,450 - - 11,852 35,975 50,277 Armed Guard & Security 6,265 - - - 10,580 16,845 Cleaning Materials - - - 255,501 68,732 324,233 Contract Cleaning Service - - - 32,915 32,915 Stationery - - - 27,541 16,863 44,404 Refreshment 803 - - - 9,463 10,266

81

ItemsDrugs and Medical Supplies 5,445 18,473 - 11,584 17,783 53,285 Electrical Accessories - - - 55,132 4,552 59,684 Purchase of Publications 105 - - - 3,573 3,678 Per Diem and Inconv. Allowance - - - - 2,540 2,540 M'tce & Repairs of Official Vehs. 500 - - 25,300 18,707 44,507 Travel Allowance 100 - - - 1,310 1,410 Running Cost - Official Vehs. 850 - - 20,000 40,000 60,850

Repairs of Residential Buildings - - - - 6,717 6,717

Repair of Office Building 7,528 - - 46,326 86,877 140,731

M'tce of Funiture & Fixture - - - 26,436 47,460 73,896

M'tce of Machinery & Plant - - - 33,161 39,942 73,103

M'tce of General Equipment - - - - 43,122 43,122

Car Maintenance Allowance - - - - 12,720 12,720

Meeting Allowance - - - - 4,180 4,180

Fuel Allowances - - - - 18,330 18,330

Funeral Grants - - - - 3,873 3,873

Awards & Rewards - - - - 30,718 30,718

Tools Allowance - - - - 432 432

Sub-Total for Items: 01 & 02 31,396 18,473 - 551,320 644,735 1,245,924

Hire of Venue - - 2,200 - 1,944 4,144

Refreshment Items - - 6,108 - 2,610 8,718

Seminars, Confrence & Workshops - - 21,380 - 23,442 44,822

Training Materials 636 - - - 3,670 4,306

Uniform & Protective Clothing - - 2,100 - 1,497 3,597

Feeding Cost - - 37,590 - 1,269,923 1,307,513

Chemicals, Detegents etc. - - 41,058 - 107,575 148,633

Stationery - - 9,545 - 9,545

82

Purchase of Publications - - 2,305 - - 2,305

Night Allowance - - 6,366 - - 6,366

Local Travel Cost - - 11,540 - - 11,540

Fuel & Lubricant - - 10,580 - - 10,580

Local Hotel Accommodation - - 14,120 - - 14,120

Sub-Total for Item: 03 636 - 164,892 - 1,410,661 1,576,189

Grand Total 32,032 18,473 164,892 551,320 2,055,396 2,822,113

REVENUE ANALYSIS - IGF SERVICE 2011

FOLDER LAB. VIP PRIVATE NURSING TOTAL

SCHOOL

JANUARY 1,892 1,164 1,190 - 4,245

FEBRUARY 1,500 1,178 510 519 3,707

MARCH 2,028 1,386 770 1,170 5,354

APRIL 1,521 1,425 630 150 3,726

MAY 1,827 1,258 910 1,060 5,055

JUNE 2,000 708 - - 2,708

JULY 1,836 1,345 - 2,750 5,931

AUGUST 1,821 1,351 - - 3,172

SEPTEMBER 2,194 1,029 - - 3,22383

OCTOBER 1,717 822 4,365 1,920 8,824

NOVEMBER 1,561 887 1,295 - 3,743

DECEMBER 1,7601,403 945 - 4,108

TOTAL 21,657 13,956 10,615 7,569 53,797

Procurement of Regents 11,188

Net Revenue 2,768

PRESBY NTC

PRESBY NTC

NYANIBA HEALTH ASST. TRAINING

37 MILITARY HOSPITAL

MARTIN LUTHER HEALTH TRAINING

IGF DRUG MONTHLY RECEIPTS,

•

• JANUARY 2011 1,187.00

• FEBRUARY 2011 1,004.00

• MARCH 2011 1,150.00

• APRIL 2011 1,034.00

• MAY 2011 1,194.00

• JUNE 2011 1,738.00

• JULY 2011 1,470.00

• AUGUST 2011 1,764.00

• SEPTEMBER 2011 1,736.00

• OCTOBER 2011 1,413.00

• NOVEMBER 2011 1,395.00

• DECEMBER 2011 1,119.00 84

• 16,204.00

IGF REVENUE PROJECTION FOR YEAR 2012

JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC TOTAL

LODGE - - - - - - - - - - - - -

RETEN. 5,433

4,711

6,504

4,760

6,249

4,446

7,401 5,745 7,195 4,832 5,224 5,813 68,313

TOTAL 5,433

4,711

6,504

4,760

6,249

4,446

7,401 5,745 7,195 4,832 5,224 5,813 68,313

BUDGET PROPOSAL FOR YEAR 2012

CODE INPUT DESCRIPTION 2012

2210200 UTILITIES GH¢

201 Electricity Charges 200,000

202 Water 89,000

203 Telecommunication 48,000

204 Postal Charges 8,600

205 Sanitation Charges 99,000

206 Armed Guard & Security 58,800

207 Fire Fighting Accessories 9,800

513,200

2210300 GENERAL CLEANING

85

301 Cleaning Materials 800,000

800,000

2210500 TRAVEL & TRANSPORT

502 Maintenance & Repairs - Off. Veh. 66,400

505 Running Cost of officer veh. 76,000

511 Local Travel Cost 25,000

513 Local Hotel Accommodation 39,000

514 Foreign Travel Per Diem 15,000

515 Foreign Cost Expenses 48,800

270,200

2210600 REPAIRS & MAINTENANCE

602 Repairs of Residential Buildings 78,000

603 Repairs of Official Building 760,000

604 M'tce of Furniture & Fixtures 86,000

605 M'tce of Machinery & Plant 65,000

86

606 M'tce of General Equipment 60,000

617 Street lights (Security Lights) 70,000

1,119,000

2210700 TRAINING, SEMINARS, CONF.

701 Training Materials 25,000

704 Hiring of Venue 8,600

705 Hotel Acommodation 16,000

707 Recruitment Expenses 15,000

708 Refreshment 75,000

709 Sem./Confer./Wksh. Meeting Exp. 64,000

710 Staff Development 50,000

87

711 Public Education & Sensitization 100,000

353,600

2210100 MATERIALS & OFFICE SUPPLIES

101 Printing Materials & Stationery 194,000

102 Office Facilities, Supplies & Accessories 25,000

103 Refreshment Items 75,000

104 Medical Supplies 86,000

106 Oil and Lubricants 26,000

107 Electrical Accessories 80,000

112 Uniforms & Protective Clothing 160,000

113 Feeding Cost 1,900,000

116 Chemicals & Consumables 900,000

117 Teaching & Leaning Materials 15,000

118 Sports, Recrectionals & Cultural Materias 78,000

119 Household Materials 50,000

88

120 Purchase of Petty Tools & Implements 35,000

3,624,000

Awards/Indebtedness to Creditors 1,841,828

Total 8,521,828

SCHEDULE OF CREDITORS (GENERAL SUPPLIERS & SERVICE PROVIDERS) AS AT DECEMBER 31ST, 2011

No. Award Date

Company Name Items Supplied/Service Provided Amount

1 16/02/11 Cap Noble Agency Uniform Materials 24,436.80

2 21/02/11 Build Up Ventures Sweeping Brushes, Brooms etc. 17,163.75

3 21/02/11 Terest Co. Ltd. Omo, Key Soap, T. Rolls etc. 10,603.00

4 21/02/11 M.R. Koteco Ventures Electrical Materials 18,797.50

5 21/02/11 Gabiko Enterprise 10 Drums of Dettol 10,580.00

6 03/03/11 Cap Noble Agency Thermometer and Stethoscope 13,110.00

7 06/04/11 Gabiko Enterprise Eight (8) Air Conditioners 13,050.50

8 26/05/11 J. A. Biney Fifteen (15) Drums of Liquid Soap 9,300.00

9 31/05/11 Jonfiaks Enterprise Thirty (30) Drums of Parazone 18,768.00

89

10 31/05/11 Emiknad Trading Co. Ltd.

Jet 3 and Aug 2144 22,540.00

11 18/05/11 Central Empire Computers 10,207.30

No. Award Date Company Name Items Supplied/Service Provided

Amount

1 16/02/11 Cap Noble Agency Uniform Materials 24,436.80

2 21/02/11 Build Up Ventures Sweeping Brushes, Brooms etc. 17,163.75

3 21/02/11 Terest Co. Ltd. Omo, Key Soap, T. Rolls etc. 10,603.00

4 21/02/11 M.R. Koteco Ventures Electrical Materials 18,797.50

5 21/02/11 Gabiko Enterprise 10 Drums of Dettol 10,580.00

6 03/03/11 Cap Noble Agency Thermometer and Stethoscope 13,110.00

7 06/04/11 Gabiko Enterprise Eight (8) Air Conditioners 13,050.50

8 26/05/11 J. A. Biney Fifteen (15) Drums of Liquid Soap

9,300.00

9 31/05/11 Jonfiaks Enterprise Thirty (30) Drums of Parazone 18,768.00

10 31/05/11 Emiknad Trading Co. Ltd.

Jet 3 and Aug 2144 22,540.00

90

11 18/05/11 Central Empire Computers 10,207.30

12 31/05/11 Nyamefa Ventures Fifteen (15) Drums of Izal 19,776.00

13 20/07/11 Spring Flow Co. Ltd. Printing of Patients Folders 11,000.00

14 20/07/11 Cap Noble Agency Uniform Materials 11,895.00

15 Up to 31/12/10 J. A. Biney Detergents 51,300.00

16 11/07/11 Spring Flow Company Ltd. Patients Index cards 11,000.00

17 15/08/11 Kodez Medical Ventures HB Electrophoresis set 3,018.75

18 29/08/11 Emiknad Trading Ent. Jet 3 perfume 16,560.00

19 29/08/11 J. A. Biney & Co. Ltd. Liquid Soap 17,800.00

20 29/08/11 J. A. Biney & Co. Ltd. Parazone 15,600.00

21 29/08/11 Terrest Company Ltd. Dustin Bins 8,280.00

91

22 29/08/11 J. A. Biney & Co. Ltd. Bine 20 23,400.00

23 29/08/11 Ekuli Enterprise Aug 2144 7,416.00

24 29/08/11 Danny Dee Enterprise Izal 24,720.00

25 29/08/11 Danny Dee Enterprise Dettol 20,085.00

26 11/10/11 Beautiful Creations Co. Ltd Syringe & Needle 9,360.00

27 14/10/11 Terrest Company Washing powder 4,760.00

28 31/10/11 Lynch Medical Services Microscope bulb (lab. Reagent)

6,372.50

29 04/11/11 Gabiko Enterprise 13 Plate Battery 2,415.00

30 22/12/11 Diagnopharma Ltd. Olanzepine 10mg 20,400.00

92

Total 453,715.10

INDEBTEDNESS TO FOOD CONTRACTORS.

• BUSINESS NAME AMOUNT

•

• Edevico Enterprise 230,371.50

• Hapilla Enterprise 197,832.70

• Pale Enterprise 55,322.00

• LB Food Supply 253,262.15

• Bright Candle Enterprise 156,549.25

• Gozingstock Enterprise 46,727.00

• NBS Food Supply 168,444.00

• Nahocha Enterprise 157,979.00

• Mettatron Enteprise 121,625.00

• 1,388,112.60

93

• 1. Cash Balances: GH¢

• SBS/DPF - 165,188.50

• GOG Service - 432.88

• IGF Service - 23,339.68

• IGF Drugs - 17,564.29

• Comfort Fund - 5,244.22

•

•

• 2. Creditors/Indebtedness:-

•

• Food Contractors - 1,388,112.60

• General Suppliers/Service Providers - 453,715.10

• 1,841,827.90

• 3. Staff Debtors - 29,180.00

• 4. Repatriation of Patients - 5,402.0094

• 5. Special Drugs for December only - 16,190.00

95