EXECUTIVE SUMMARYDemographic characteristics
The population of the region is concentrated in a few distri
cts. The Kumasi metropolis alone accounts for nearly one-third of the region’s population. Slightly over half, 51.5 per cent, of the population of the region is in four districts. While more than half of the population in the region resides in urban areas, in 15 of the 18 districts, over half the population live in rural areas. The high level of urbanization in the region is due mainly to the high concentration of the population in the Kumasi metropolis (which has almost about a third of the region’s population).
Males outnumber females in eleven districts. The age structure of the population in the districts is skewed towards the youth. The dependent population in the districts is high, ranging from 42.2 per cent in the Kumasi metropolis to 57.3 per cent in the Ahafo Ano South District. Total Fertility Rates (TFRs) are high in most of the districts, except in the following four: Adansi West, Asante Akim South, Kumasi metropolis and Afigya Sekyere, where TFRs are lower than the regional average of 4.7. The TFR in the Ahafo Ano South District (9.4) is particularly high.
Social characteristics
All the districts in the region have more than a quarter of households headed by females with the lowest (26.9%) in Ejura Sekyedumase, and the highest (40.1%) in the Ejisu-Juaben, Districts. Children constitute the greater proportion of household members in most of the districts, except in three: Kwabre, Sekyere East, and Ahafo Ano South, where “other relatives” outnumber children. In each district, children and other relatives account for more than 50.0 per cent of household members.
Information on the levels of educational attainment and literacy show that between 40.0 and 50.0 per cent of the population in the districts, particulary, females either have no formal education or have only pre-school education. The proportions of the population with basic education vary from 67.7 per cent in the Kumasi metropolis to 86.9 per cent in the Amansie West District. Between 51.3 per cent (Kumasi metropolis) and 73.0 per cent (Amansie West) of the population currently in school are in the primary school. The proportions in JSS are low, ranging from 16.1 per cent to 22.4 percent, tapering down further to lower proportions at higher levels of education.
Illiteracy levels are high in the districts and higher for females than the males; the level is also higher in rural areas than in urban areas. Illiteracy rates vary from 26.0 per cent in Kumasi metropolis to 64.7 per cent in the Ejura Sekyedumase District. Only three Districts, Kumasi metropolis, Adansi West and Ejisu-Juaben, have illiteracy levels lower than the regional average of 40.4 percent.
Economic characteristics
The proportion of the economically active population varies from 71.4 in the Kumasi metropolis to 85.2 per cent in the Amansie West District. Only five districts have proportions lower than 80.0 percent. The major occupation in all the districts is Agriculture/Animal Husbandry/Forestry, except in the Kumasi metropolis, where Sales workers predominate. The proportion of females in Sales is higher than that of males in all the districts.
The proportion of females in Agriculture/Animal Husbandry/Forestry is also higher than that of males for the region as a whole and for the following three districts: Kumasi, Ejura Sekyedumase, and Offinso. Residents in the rural areas are mostly in Agriculture whereas those in urban areas are mainly in Sales and Production work. Majority of the economically active population are self-employed, mainly in the private informal sector, which provides job opportunities, particularly for females with little or no formal education.
Housing characteristics
The population per house is high, between seven and 10 people in 13 districts and exceeds the regional average of 11 people in four other districts. Compound and separate houses are predominant in all the districts. While a high proportion of the population in the districts, particularly those in rural areas, own the dwelling units they live in, the proportion of households living in rented dwelling units is also relatively high, in districts with a high urban population.
Apart from the Kumasi metropolis, a high proportion, over 30.0 percent, of households in the districts, do not have access to potable water. Public toilets and pit latrines are commonly used. Between 66.6 and 87.1 per cent of households dispose of solid waste using public dumps. Solid waste is also disposed of by either throwing it on the street (14.2%to 62.6%) on the compound (18.0% to 45.9%) or into the gutter (59-58.7%). Wood and charcoal are the two main sources of fuel for cooking, used by over 70.0 per cent of households in the districts.
Kerosene is the main source of fuel used for lighting in 15 of the 18 districts. The other three districts, Kumasi metropolis (88.4%), Adansi West (61.3%) and Kwabre (53.1%), use mainly electricity. Kumasi is the regional and district capital, Adansi West has Obuasi, the home of Ashanti Goldfelds and the adjourning urban centres, and Kwabre is initially a spillover district of the Kumasi metropolis.
Community facilities
Apart from traditional healers, community facilities such as schools, hospitals/clinics and telephones, all of which contribute to the improvement in the living conditions of people, are scarcely found in all the districts, except the Kumasi metropolis. In most of the localities in the districts, the nearest facility is located more than 10 kilometres away. Traditional healing is the only facility that is mostly found in the localities or within a short distance.
Policy implications
In many of the districts, the main occupation of a very high proportion of the predominantly rural population is Agriculture. The Poverty Reduction Strategy of the Government should therefore be focused on Agriculture in order to achieve the desired impact. In particular, the Ministry of Food and Agriculture needs to collaborate with the District Assemblies to develop schemes that will assist those engaged in agricultural and related activities.
Fertility is very high in all the districts in the region. The National Population Council, the Ministry of Education, Youth and Sports and the District Assemblies need to collaborate with the relevant agencies to intensify education on the benefits, to the family and the nation, of having smaller numbers of children. Family Planning awareness campaigns have to be intensified, particularly in the following Districts: Ahafo Ano South, Sekyere East, Ejura Sekyedumase, Kwabre, Atwima and Bosomtwe/Atwima/Kwanwoma, where the TFR is particularly high.
Illiteracy levels are high in all the districts with differences between males and females in educational attainment. The Free Compulsory Universal Basic Education (fCUBE) programme has to be fully implemented, particularly targeting females in order to expand access to educational opportunities for the large youthful population. The District Assemblies, the Environmental Protection Agency and other relevant organizations should educate the population to desist from the indiscriminate throwing of waste materials and the use of charcoal and wood for cooking.
As a means of improving on the environmental situation in the urban areas, waste disposal containers should be placed at vantage points so that people can drop waste materials in them. Serious efforts should be made by the regional and district administrations to increase the number of Health Education and Communication facilities in the districts to improve upon the living conditions of the people. Appropriately effective punitive measures should be enforced to ensure that waste material is not disposed of indiscriminately.
Background of the region
Briefly discussed as background to the Ashanti Region, among others, are the history, location and physical features, modern political and traditional administration, cultural and social structure, religion, tourist attractions, demographic characteristics and the major economic activities.
Location
The Ashanti Region is centrally located in the middle belt of Ghana. I t lies between longitudes 0.15W and 2.25W, and latitudes 5.50N and 7.46N. The region shares boundaries with four of the ten political regions, Brong-Ahafo in the north, Eastern region in the east, Central region in the south and Western region in the South west.
Physical features
The region occupies a total land area of 24,389 square kilometres representing 10.2 per cent of the total land area of Ghana. It is the third largest region after Northern (70,384 sq. kms) and Brong Ahafo (39,557 sq. kms) regions. The region has a population density of 148.1 persons per square kilometre, the third after Greater Accra and Central Regions. More than half of the region lies within the wet, semi-equatorial forest zone.
Due to human activities and bushfires, the forest vegetation of parts of the region, particularly the north-eastern part, has been reduced to savanna. The region has an average annual rainfall of 1270mm and two rainy seasons. The major rainy season starts in March, with a major pick in May. There is a slight dip in July and a pick in August, tapering off in November. December to February is dry, hot, and dusty.
The average daily temperature is about 27 degrees Celsius. Much of the region is situated between 150 and 300 metres above sea level. The region is endowed with a spectacular geography-lakes, scarps, forest reserves, waterfalls, national parks, birds and wildlife sanctuaries. Notable among them are the Owabi Arboretum and Bomgobiri wildlife sanctuaries. The region is drained by Lake Bosomtwe, the largest natural lake in the country, and Rivers Offin, Prah, Afram and Owabi. There are other smaller rivers and streams which serve as sources of drinking water for residents of some localities in the region.
Brief history
The Asante (Ashantis) constitute the largest of the various subgroups of the Akan, who trace their origins partly to Bono-Manso and Techiman, in present-day Brong Ahafo Region. They constitute 14.8 per cent of all Ghanaians by birth, and 30.1 per cent of the total Akan population of 8,562,748 in the country. Various oral traditions have it that the Ashantis migrated from various places through Bono-Manso/Takyiman (Techiman) to present day Ashanti Region.
As a united people, they started with a nucleus of the Oyoko clan around Asantemanso. After several years of subjugation by other empires, such as the Akwamu and the Denkyira, Asante eventually grew to be a very powerful empire founded by King Osei-Tutu I (1695-1717), after defeating the Denkyira King Ntim Gyakari during the battle of Feyiase (Buah, 1998).
Ironically, King Osei Tutu I had spent his childhood days in the court of the Denkyira King, according to custom, and had escaped from there to Akwamu where he met his lifelong friend and spiritual mentor, the legendary Okomfo Anokye. It is believed that it was through Okomfo Anokye’s extraordinary supernatural powers that King Osei Tutu founded the Ashanti Empire; as he is said to have commanded the Golden Stool to fall from “the heavens”, the stool which, to this day, serves as the symbol of the spirit, unity and strength of the Ashantis.
At the height of its glory, the influence and culture of the Asante Kingdom stretched beyond the borders of the present day Ghana. The Ashanti were able to preserve what was best in Akan culture, including the use of gold dust as currency and gold weights as a measure, which system was actually originated by the great Bono (Brong) King Akumfi Ameyaw I (1328-1363) (Buah, 1998).
The Asante fought many successful wars against the Denkyira and their allies including the Wassa, the British, the Fante, and even the Bonos (Brongs). Indeed it was the Ashanti King Opoku Ware I who defeated the Bonos in 1723 and destroyed Bono-Manso, forcing the Bono Empire to move its capital from Manso to present day Techiman. The Ashanti Empire eventually collapsed with the defeat and exile of King Prempeh I, first to El-Mina Castle and eventually to the Seychelles.
Not even the last stalwart stand by the great warrior Queen Yaa Asantewaa could revive the fame, fortune and power of Ashanti. However, the culture, kinship and social structure of Ashanti, like many of the other Akan groups, has been preserved and maintained to the present day, and underlines the cultural heritage, not only of the Asante, but of the entire Akan ethnic group. The present Asanti King (Asantehene) Osei Tutu II, is a direct matrilineal descendant of Osei Tutu I.
Political administration
There are 18 administrative districts in the Ashanti Region including the Kumasi metropolis The region also has 33 constituencies and 840 electoral areas, the highest in the country. A Member of Parliament represents each of the 33 constituencies at the nation’s 200- member legislature.
The Regional Minister is the political Head of the region, and the Chairman of the Regional Co-ordinating Council. Other members of the Regional Co-ordinating Council include the Regional Co-ordinating Director (Secretary), all the 18 District Chief Executives and Presiding members, as well as two representatives from the Ashanti Regional House of Chiefs. All Regional heads of department are ex-officio members of the Regional Co-ordinating Council.
The District/Metropolitan Assemblies are headed by Metropolitan/District Chief Executives. The District and Metropolitan Chief Executives are nominated by the President of the Republic and approved by two-thirds majority of the respective Metropolitan/District Assemblies. The Chief Executives, like the Regional Minister, are assisted by District Co-ordinating Directors. For effective administration, the Kumasi Metropolitan Assembly (KMA) has been sub-divided into four sub-metros, namely Asokwa, Subin, Bantama and Manhyia. The following three additional districts have been created, to bring the total number in the region to twenty-one (21).
Social characteristics
Nationality and ethnicity
Majority of the region’s population are Ghanaians by birth (87.3%) with about five per cent naturalized Ghanaians. A smaller proportion (5.8%) of the population originate from outside Ghana, made up of 3.7 per cent mainly from the five Economic Community of West African States (ECOWAS) and 2.1 per cent from other African countries.
The non-African population living in the region is 1.8 per cent of the total population. Akans are the predominant ethnic group in the region, representing 77.9 per cent of Ghanaians by birth. A high proportion (78.9%) of the Akan population is Asante. The non-Akan population in the region comprises the Mole- Dagbon (9.0%), the Ewe (3.2%), the Grusi (2.4%), the Mande-Busanga (1.8%) and the Ga- Dangme (1.4%). The other smaller ethnic groups form about 1.3 per cent of the population of the region.
Cultural and social structure
The region has 36 Traditional Councils, each headed by a Paramount Chief. The Traditional Councils are the decentralized units of administration by traditional rulers and are used to mobilize the people at the local and community levels for development. The spiritual head of the region is the Asante King, the Otumfuo Asantehene. All the Paramount Chiefs in the region are members of the Ashanti Regional House of Chiefs, with the Asantehene as the President of the house. The main language spoken in the region is Twi. Several festivals are celebrated in the region, the major ones being the Akwasidae and AdaeKese. These are religious festivals celebrated by some members of the Akan ethnic group of which the Ashantis belong.
The festivals are celebrated to remember past leaders and heroes. Though they are dead, their spirits are supposed to be alive and taking interest in the affairs of the living, watching their doings and consulting with them at Adae.
Literacy of population
It reveals that 35.0 per cent of the population, 15 years and older in the region are not literate. A little under half (48.1%) are literate in both English and a Ghanaian language. Only 3.2 per cent are literate in a Ghanaian language only, while less than 1.0 per cent are able to read and write in other languages.
There are differences between the sexes in terms of literacy. More than half (55.8%) of the males are literate in English and a Ghanaian language compared with two fifth (40.4%) of the females. On the whole, the illiteracy level for the region (35.0%) is lower than that of the national average (42.1%).
Religion
The dominant religion in the region is Christianity (77.5%) followed by Islam (13.2%). The proportion of Christians is higher than the national average (68.8%), while that of Moslems is lower than the national average (15.9%). All other religious groups constitute insignificant proportions of the population. The proportion with no religion is however relatively high (7.3%).
Population characteristics
The region is the most populous and one of the most rapidly growing regions in the country. The region’s population is 3,612,950, representing 19.1 per cent of the country’s population. The region’s share of the national population increased steadily from 16.5 per cent in 1960 to 17.3 per cent in 1970 but remained almost the same (17.0%) in 1984 before increasing to its current level (19.1%).
The region’s population growth rate was 2.9 per cent per annum in 1970, dropped to 2.5 per cent per annum in 1984 and increased to 3.4 per cent in 2000, 1.3 times higher than the national average growth rate of 2.7 percent. The population growth rate of the region in 2000 is the second highest in the country, after the Greater Accra Region (4.4%). Although the region is the most populous, its density (148.1/sqkm) is lower than those of the Greater Accra (895.5/sq km) and the Central (162.2/sq km) Regions.
A number of factors, particulary high fertility and migration, may account for the rapid population growth in the region. The Total Fertility Rate, (TFR) which measures the number of children a woman, in her reproductive age, would give birth to, is high (4.8), compared with the national average of 4.0. The completed fertility by women 15-49 years (5.6) is lower than the TFR by 0.8; which implies a slightly lower current fertility schedule. The other reason for the growth is the centrality of the region and its economic potentials in the cocoa and mining industries, which attract people from other parts of the country to the region.
Age and sex structure
There are slightly more males (50.3%) than females (49.7%) in the region. This translates into a sex ratio of 101.3 males to 100 females in 2000. In 1960, the male population (51.2%) also exceeded that of females (48.8%) but in 1970 and 1984, the female population exceeded that of males.
The region has a youthful population with about two-fifths (41.9%) below 15 years of age. This proportion has declined consistently from 1970 (49.3%) and 1984 (45.3%), an indication of a decline in fertility. On the other hand, the proportion of the population aged 65 years and older has increased from 2.5 per cent in 1960 to 3.0 per cent in 1970 and 3.6 per cent in1984 to the current level of 6.1 per cent in 2000.
Rural-urban population
The urban population (51.3%) in the region exceeds that of the rural population (48.7%). The region is currently the second most urbanized in the country, after Greater Accra (87.7%). The growth of the mining industry in Obuasi and the increase in commercial activities in Kumasi may account partly for the relatively high urban population in the region.
One other factor that has also contributed to the high urban population in the region is the growth in some of the localities which were hitherto considered as rural settlements, but have now attained urban status (localities with population of 5000 and above).
For example, Atimatim in the Kawabre district, which had a population of 836 in 1970 and 1,123 in 1984, increased to 14,017 in 2000. Ahwiaa also in Kwabre, has grown from 2,110 in 1970 to a large town of 19,729. Both have grown mainly due to population spillover. Abuakwa in the Atwima district has grown from a small village of 970 people in 1970 to the largest town in the district, with a population of 16,582 in 2000, mainly due to to the establishment of industries such as the cocoa pesticide formulation plant and the Darko Farms. In the Kumasi metropolis itself, areas such as Ayigya, Dikyemso (Dichemso) and Tarkwa Maakro, which were small communities in 1960 and 1970, have grown into densely populated residential areas with 20- 40,000 people.
Migration
Migration is one of the three important factors of population change in a locality. Over the years, the region has attracted migrants from within and outside the country because of its economic potentials and its centrality as a nodal region. The non-migrant population of the region is 66.8 percent, having increased from 58.3 per cent in 1960, 56.8 per cent in 1970 and 63.8 per cent in 1984. Both the proportions of the intra-regional and inter regional movements decreased almost steadily from 1960. The proportion of the intra-regional migrants decreased from 21.4 per cent in 1960 to 13.1 per cent in 2000, while the proportion of the interregional migrants also decreased from 20.3 per cent in 1960 to 11.1 per cent in 2000.
Place of birth of population
About four-fifth (79.9%) of the population in the region were born in the region. This is 3.5 percentage points lower than in 1984. However, there are relatively more Ghanaians by birth and parenthood born in the locality of enumeration in 2000 (66.8%) than in 1984 (63.7%).
Whereas the proportion of the population born in another locality in the same region decreased by 6.6 percentage points, between 1984 and 2000, the proportion born in other regions during the same period increased by 1.9 percentage points. Ghanaians by birth in the region, born outside the country, increased for those born in ECOWAS and other African countries.
Economic activity and employment
The economically active population in the region is engaged mainly in Agriculture (excluding Fishing), with 44.5 per cent of them employed in the branch of activity. This represents a decline from the 1984 level of 61.9 percent. The next highest proportion of the economically active population is employed in Wholesale and Retail Trade (18.4%), followed by Manufacturing (12.2%) and Community, Social and Personal Services etc., (9.9%). These four major economic activities employ a total of 85.0 per cent of the economically active population, which is lower than that of 1984 (94.4%).
The proportion of the economically active population engaged in other economic activities is less than 5.0 per cent in each case. Water and Transport, Storage and Communications, Electricity, Gas and all the other activities increased their proportions of the economically active population employed in 2000 compared with 1984, except Agriculture, Hunting and Forestry.
Housing stock
The housing stock in the region is 329,478, of which 37.1 per cent are in urban areas and 62.9 per cent in rural areas. This is in constrast to the 17.4 per cent of houses in urban, and 82.6 per cent in rural, areas in 1970. The total stock also represents an increase of 86.8 per cent over the stock in 1984. The relative increase in the proportion of urban housing is a reflection of the increase in urbanisation. As a result, the region’s share of the national housing stock has increased over the years from 14.6 per cent in 1970 to 15.1 per cent in 2000.
A measure of the quality of dwelling is its size relative to the number of occupants, measured in terms of persons per room. There are more households per house in the region (2.1) than in the other regions. The average household size in the region (5.3) is higher than the national average (5.1) but lower than the three Northern Regions.
ECONOMIC CHARACTERISTICS
Type of economic activityThe proportion of the economically active population in the districts varies from 71.4 per cent in the Kumasi metropolis to 85.2 per cent in the Amansie West District. The proportion of the economically active population in the districts, who worked, for at least one day, ranges from 72.5 per cent in the Kwabre District to 92.4 per cent in the Offinso District.
The proportion of the unemployed population in the region varies from 4.5 per cent in the Ahafo Ano North District to 16.0 per cent in the Kumasi metropolis. The proportions exceed 10.0 per cent in eight districts. In thirteen districts, the level of female unemployment is comparatively higher than that for males. The unemployment rates are more pronounced in urban areas than in rural areas in 14 districts. This general trend is the same for both sexes, and may be due to the high rural-urban drift, apparently in search for jobs, which are difficult to come by, in urban areas.
Students form the highest proportion of those who are not economically active, in all the districts; while the aged, together with those who have retired from work, form a relatively high proportion also, ranging from 11.8 per cent in the Adansi East District to 23.0 per cent in the Sekyere East District. The proportion of those whose economic inactivity is due to disability is also relatively high, particularly in the Amansie East (6.5%), Asante Akim North (7.8%) and the Bosomtwe-Atwima-Kwanwoma (10.3%) districts.
Policies aimed at improving the lives of the aged and persons with disability should be tailored more to the rural areas. There should also be concerted efforts by Government and other stakeholders, to make the rural areas more attractive in order to stem the exodus of rural dwellers to the urban centres.
Occupation
Agriculture/Animal Husbandry/Hunting/Fishing (42.3%), Production/ Transport/Equipment (19.9%), Sales (17.8%), and Services (6.4%) are the main occupations in the districts. The major occupations for males are Agriculture and related work (40.8%), Production (24.8%), Sales (11.7%), Clerical and related work (7.7%), and Professional/Technical and related work (7.5%). Females are mainly in Agriculture and related work (43.9%), Sales (24.3%), Production/ Transport/Equipment (14.6%) and Services (8.5%).
Except in the Kumasi metropolis and the Kwabre, District, Agriculture and related work is the dominant occupation for both males and females in all the districts in the region. The proportion of the population in Agriculture is higher in rural than in urban areas, for all the districts. Sales and Production work, which are the major occupations in the Kumasi metropolis and the Kwabre District, also tend to be the main occupations in the urban areas.
The fact that the Kumasi metropolis is the main commercial and industrial centre in the region, may partly account for the large proportion of the population in Sales and Production work. The Kwabre District is one of the districts adjoining the Kumasi metropolis and may attract the spillover population from the Kumasi metropolis, which therefore accounts for the high proportion of people in Sales and Production. The proportions of the economically active population in Professional and Technical work are relatively small in all the districts.
Industry
Agriculture/Hunting/Forestry is the major source of employment for majority of the people in the districts. Except in three districts, Agriculture provides employment to more than half of the economically active population in the region. Trade, which is the next most important economic activity in twelve districts, employs between 3.1 and 20.7 per cent of the economically active population. Manufacturing is the second largest industry in terms of employment in the remaining six districts,
The Adansi West District where the Ashanti Goldfields Company has its largest operational mine in Ghana, has a relatively high proportion (19.4%) of its population engaged in Mining/Quarrying. The proportion engaged in Mining/Quarrying activity is not significant in the remaining districts.
In all the districts, rural dwellers tend to be engaged more in the agricultural sector than urban dwellers, except in the Kumasi metropolis, which has no rural population. On the other hand, higher proportions of urban dwellers are in Manufacturing and Sales than the rural dwellers.
Employment status
A high proportion (71.0%) of the economically active population in 15 of the 18 districts are self-employed, majority of whom are without employees. These range from 60.8 per cent in the Kumasi metropolis to 87.2 per cent in the Amansie West and Adansi East (85.6%) districts. The three remaining districts, Ahafo Ano South (65.1%), Adansi West (65.2%) and Kumasi metropolis (60.8%), have less than 70.0 per cent of their economically active population in selfemployment.
The high figure of 10.1 per cent of the self-employed with employees in the Ejura- Sekyedumase District may be due to medium to large-scale commercial farmers employing many farm hands. The Ejura area is well-known for large cereal and yam farming, which could be labour-intensive. Employees (15.0%) constitute the second highest proportion in all the districts, except in the Adansi East District (5.4%) where the employee category comes third, after unpaid family workers.
In the districts, except Kwabre, the proportion of unpaid family workers which is higher in rural areas, than in the urban, tends to be more female based than male. In the rural areas, unlike in urban centres, most people tend to help in family enterprises without direct cash remuneration.
Employees, who are more often males than females, are in greater proportions in urban areas than in rural areas. Majority of the self-employed are engaged in the private sector, while employees are engaged mainly in the public sector. The proportion of apprentices is particularly high in urban areas.
Institutional sector of employment
About 90.0 per cent of the economically active population is engaged in the private sector in the districts except Ahafo Ano South (86.6%) and the Kumasi metropolis (87.1%). Majority of them are in the private informal sub-sector of the economy. The public sector (6.3%) is the next important sector employing between 2.7 and 9.0 per cent of the total workforce in the districts.
Public sector workers are in greater proportions in urban areas, compared to rural areas. The reverse is however the case for those employed in the private sector. The data further indicate that males in the public sector are in greater proportions compared to females. On the other hand, females are in relatively higher proportions in the private sector than males. This may be due to the high proportion of females in small-scale farming and trading activities.
The government’s policy of making the private sector the engine of growth of the economy needs to be encouraged, since a greater proportion of the population in the district tends to be engaged in this sector. The private sector, as presently constituted with such high proportions of single person enterprises, cannot be an engine of growth. Such enterprises do not expand to absorb the ever-increasing labour force. Moreover, they contribute next to nothing to taxes. Policies aimed at improving the private sector and creating an enabling environment, should therefore aim at capacitating such enterprises to expand their base in order to be able to absorb extra labour.
The self-employed without employees, in the private informal sector, many of whom are not even properly registered, also raise problems of mobilisation for such social welfare issues as social security and health insurance, which are becoming important concerns for Government. Appropriate policies to intergrate this sector into the various social sector schemes will therefore need to be evolved. Such integration can even have an indirect positive effect on the growth and expansion of such private sector enterprises.
Type of activity and employment status of economically active children (7-14 years)
slightly less than a tenth of children, (8.7%) aged 7-14 years in the region, worked for at least one day within the seven days prior to the Census. In the districts, between 5.5 per cent 16.4 per cent of chidren 7-14 years in the Kwabre District and in the Sekyere West District worked during the period.
In six of the districts, the proportions exceed 10.0 per cent and apart from the Ejisu Juaben District, the proportion of children in rural areas who engaged in economic activity is higher than those in urban areas. The proportion of females who worked during the period is higher than that of males in nine districts. According to the 1998 Children’s Act, children less than 13 years of age are not expected to work while those aged 13-15 years can only do light work.
As established by the Ghana Child Labour Survey (Ghana Statistical Service, 2001), such children have to work in order to support the family mainly because of poverty. Government and other child support organizations should take advantage of new data on working children to implement more effectively the projects and programmes intended to enhance the welfare of children.
The data reveal that a high proportion of children, aged 7-14 years who are working, are mainly in agricultural activities in the rural areas and in wholesale/retail trade in the urban areas. A high proportion of the working youth (7-14 years), are in the private informal sector. In more than half (11) of the 18 districts in the region, over 70.0 per cent of the children in this age group engage in activities in the private informal sector. In the Kumasi metropolis (49.9%) and the Kwabre District (49.8%), less than 50.0 per cent of children in this age group worked in this sector.
Majority of the working youth are either self-employed without employees or are unpaid family workers. The proportion in self-employment without employees varies from 30.2 per cent in the Bosomtwe-Atwima-Kwanwoma District to 64.7 per cent in Asante Akim South District. On the whole, districts with large rural populations tend to have more of the youth in self employment without employees while districts with large urban populations tend to have relatively higher proportions of unpaid family workers or apprentices.
Since at their ages, these children are not expected to be employed, according to the existing laws in Ghana, they therefore are normally engaged in jobs such as selling on the street and farming activities, in order to supplement household incomes. The high proportion of male children in Bosomtwe-Atwima-Kwanwoma (10.6%), who are engaged in economic activity, are mainly in fishing in Lake Bosomtwe, where they dive into the lake to set fishtraps and disentangle fishing nets.
This dangerous undertaking sometimes results in the death of children. Government and other child support organizations should take advantage of new data on working children to more effectively implement policies that would retain children at school. Investment in ensuring effective implementation of the child worker/working child policies will, in the long run, assist in formulating acceptable policies and solutions for the child/youth worker issues.
HOUSING AND COMMUNITY FACILITIES
Housing
Stock of houses
Trends in stock of houses
The number of houses in the region has steadily been increasing since 1960, from 94,459 to 328,751 in 2000, representing a 3.5 fold increase, compared with almost the same increase, 3.3 folds, in the population, during the 40 year period. The largest intercensal increase in both the stock of houses (87.2%) and the population (72.9%) occurred in the 1984-2000 period.
The population per house, which however remained almost unchanged, around 11 persons, during this period (1960 – 2000) is the highest in the country, bracketing with Upper West Region. The region has the highest share of both the national housing stock (15.1%) and the national population (19.1%) in 2000.
The distribution of housing units in the region varies from district to district. The Kumasi metropolis, which accounts for about a third of the share of the population (32.4%), has one fifth (20.5%) of the housing stock in the region. Amansie East has the second largest share of the housing stock, (9.1%) followed closely by Adansi West (7.8%) and Atwima (7.6%). The share in six districts, range from 4.0 to 5.5 per cent while in six other districts, it varies in a narrow range of 3.4 to 3.7 percent. Ahafo Ano North (2.2%) and Ejura-Sekyedumase (2.7%) have the smallest shares of the housing stock in the region.
Households per house
All the districts in the region have more than one household per house. The average number of households per house in the districts ranges from 1.4 households in Adansi East, to 3.4 households in the Kumasi metropolis. In four districts, the average number of households per house is lower than 1.5 and in ten districts; it varies between 1.5 and 1.9. In two districts, Kwabre (2.6) and Kumasi (3.4), it is higher than the regional average (2.1). The relatively large number of households per house in Kumasi may be due to the relatively large population in the metropolis.
Population per house
The average population per house in the region is 11 persons. In four districts, the average population per house exceeds this average, while in 13 districts; it is between 7 and 10 persons. It is higher than 10.0 per cent in 5 districts, particulary in Kumasi (17.3) and Kwabre (13.7), when the relatively large households per house account for the high population per house.
Housing condition
Dwelling unit
The region has a total of 700,636 dwelling units. In 2000 the typical dwelling unit in the districts is the compound house. In three districts, Ejura-Sekyedumase (62.1%), Kwabre (60.8%) and Afigya Sekyere (59.0%), about 60 per cent of the households live in compound houses.
The separate and semi-detached housing units are next in importance after the compound house. The proportions of the population in the districts living in separate houses range from 18.5 per cent in Ejura-Sekyedumase to 46.0 per cent in Adansi East. In twelve districts, the proportions of households living in separate houses exceed 20.0 per cent.
The other dwelling units, flat/apartment, hut/buildings, and hotel/hostel, are not very common in the districts. Makeshift dwelling units such as tents, kiosks, containers or attachments to shops and offices represent an insignificant proportion of the dwelling units. The Kumasi metropolis, however, has a relatively large proportion of households (2.4%) living in kiosks and containers an indication of housing scarcity in the metropolis.
Ownership
In 13 districts, 50.0 per cent or higher of households own the houses they occupy. It is only in the Kumasi metropolis that the proportion living in houses owned by private individuals exceeds those in owner-occupied houses. This may be due to the large number of migrant workers in the metropolis. The proportion of those who live in their own houses ranges from 33.6 per cent in the Kumasi metropolis to 74.1 per cent in the Adansi East district.
The next important ownership type across all districts is the “Other private individual”. The proportions of households in the districts occupying such houses range from 9.8 per cent in the Amansie West to 37.1 per cent in the Kumasi metropolis. The proportions exceed 30.0 per cent only in the Kumasi and Adansi West districts. In four districts, the proportions range from 20.0 to 30.0 percent.
The proportions of households occupying houses belonging to relatives who are not household members vary between 7.5 per cent in Adansi East and 26.8 per cent in Bosomtwe-Atwima- Kwanwoma. In six districts, the proportions exceed 20.0 percent. The “Private Employer”, “Public or Government Owner” and “morgaged” categories are not very common in the districts. For example, housing facilities owned by private employers range from 1.3 per cent in Sekyere East to 9.7 per cent in Adansi West, which may be due to the provision of housing facilities by the Ashanti Goldfield Company for its workers. The proportions exceed 5.0 per cent in eight districts.
Rooms occupied
The Kumasi metropolis has the highest proportion of single room occupancy (64.4%). The proportions recorded in the adjoining districts are also high. This is an indication of the extent of room shortage in the Kumasi metropolis and a possible spill-over to the adjoining districts.
Although Adansi West is not an adjoining district to the Kumasi metropolis, it also has a relatively high proportion (57.6%) of households sleeping in one room. This district has the largest mining town in the country, Obuasi. The gold mining industry which generates other collateral activities attracts in-migrants who put pressure on available housing, which may account for the shortage of rooms. On the whole, six districts have more than 50.0 per cent of their households in single rooms. Large households occupying single rooms tend to have health implications, especially where the population per room is large.
Construction materials
Materials for construction of walls
The most commonly used material for the construction of walls of dwelling units in the region is mud/mud brick/earth. The proportion of walls constructed with mud/mud brick/earth ranges from 9.3 per cent in the Kumasi metropolis to 84.8 per cent in Adansi East. More than 50.0 per cent of the walls in twelve districts are constructed with mud/mud brick/earth. Only Kumasi, Kwabre and Adansi West have more than 50.0 per cent of walls of dwelling units in the region made of cement blocks/concrete.
The use of other materials for the construction of walls of dwelling units is not very common in the districts. For example, the proportion of dwelling units with sandcrete/landcrete walls ranges from 1.4 per cent in the Kumasi metropolis to 10.8 per cent in Asante Akim South. The proportion of dwelling units with wooden walls varies from 1.7 per cent in Afigya Sekyere to 5.8 per cent in Ahafo-Ano South.
Roofing materials
Corrugated metal sheet is the main roofing material in all the districts followed by palm leaf or thatch. The use of palm leaves or thatch as roofing material is more predominant in Ejura- Sekyedumase than in any other district. Another roofing material that is common and second in importance in the Kumasi metropolis is the cement or concrete roof. Bamboo, mud or mud bricks, slate or asbestos, concrete or ceramic roofing tiles, are less common in all the districts
Floor materials
An overwhelming majority of the floors of houses in the districts are constructed with either cement/concrete or mud bricks/earth. The use of ceramic or marble tiles in the construction of floors of dwelling units is common only in the Kumasi metropolis.
Household facilities
Main source of drinking water
The main source of drinking water varies among districts in the region. Between 1.7 per cent (Ahafo Ano South) and 82.5 per cent (Kumasi metropolis) of households in the districts have main pipe-borne (both inside and outside), for their main source of drinking water. While in Kumasi metropolis (82.5%), Atwima (37.1%), Adansi West (36.2%) and Offinso (39.3%), the proportion of households using pipe-borne water as their main source of drinking water exceeds 30.0 percent, the corresponding proportion in eight districts is lower than 10.0 per cent.
The next major sources of drinking water, for all districts, are boreholes and wells. Except Kumasi and Asanti-Akim North, where pipe-borne water constitutes the largest single source of drinking water, boreholes and/or wells are the largest single sorces of drinking water in all other districts.
The proportions of households in the districts, whose main source of drinking water is the borehole, range from 1.5 per cent in the Kumasi metropolis to 55.4 per cent in Ahafo Ano South. In four districts, the proportions exceed 50.0 percent. In six districts, the proportions range from 30.0 per cent to below 50.0 percent, and in the remaining eight districts, the proportions are below 30.0 percent. The borehole has therefore proved to be a major contributor to the provision of potable water in all the districts, compared to pipe-borne water.
It is relatively cheaper to construct, expecially for small communities. If the negative problems associated with borehole water in certain localities, such as salinity and high iron content, could be overcome, they could serve as an effective way of solving the potable water problem of many localities. The water could even be piped into one community reservoir and redistributed into households, ran in taps.
The proportions of households in the districts, whose main source of drinking water is the “well”, range from 7.7 per cent in Sekyere West to 36.5 per cent in Ejisu-Juaben, the only district where the proportion exceeds 30.0 percent. In six districts, the proportions range from 20.0 per cent to less than 30.0 percent. In ten districts, the proportions are lower than 20.0 per cent but not below 10.0 percent. The proportion is however lower than 10.0 per cent in only Sekyere West.
The proportions of households in the districts whose main source of drinking water is the river, stream, pond and lake, range from 1.5 per cent in the Kumasi metropolis to 40.8 per cent in Sekyere West. In four districts, the proportions of households using river, stream, pond and lake as main source of drinking water exceed 30.0 percent. In seven districts, the proportions exceed 20.0 per cent but less than 30.0 percent. In the remaining seven districts, the proportions are lower than 20.0 percent.
On the whole, six districts, namely Adansi East, Afigya-Sekyere, Ejisu-Juaben, Asante Akim South, Sekyere West and Sekyere East, have more than 50.0 per cent of households not enjoying adequate potable water (pipe-borne, tanker services and borehole). Even in these districts, boreholes (19.0 to 39.0%), and pipe-borne water (4.0 to 25.5 %) constitute the major source of potable water. The inadequacy of potable water has very serious health implications for these districts.
Main source of lighting
The kerosene lamp is the main source of lighting in most districts in the region. The proportions of households that use the kerosene lamp for lighting in the districts range from 9.6 per cent in the Kumasi Metropolis to 92.1 per cent in Ahafo Ano South. In four districts, the proportions exceed 80.0 per cent and range between 70.0 and 80.0 per cent in three districts. In eight districts, the proportions vary between 50.0 and 70.0 percent, and in the remaining three districts, they are below 50.0 per cent.
The proportions of households in the districts using electricity for lighting vary from 6.1 per cent in the Ahafo Ano South district to 88.4 per cent in the Kumasi metropolis. In addition to Kumasi, two other districts, Adansi West (61.3%) and Kwabre (53.1%), have more than 50.0 per cent of households using electricity as a source of lighting.
The proportions of households in the districts using other sources of energy for lighting are relatively small. On the whole, the proportions range from 0.6 per cent in Asante Akim South to 2.2 per cent in Amansie East, the only district with a proportion higher than 2.0 percent. Other sources of lighting such as the gas lamp and solar energy are not popular in all the districts and should be promoted, as they tend to be cost effective.
Main fuel used for cooking
Firewood and charcoal are the main sources of fuel used in the districts for cooking. The proportions of households that use firewood for cooking range from 3.9 per cent in the Kumasi metropolis to 90.7 per cent in Amansie West. The proportions exceed 80.0 per cent in nine districts. In five districts, they range from 70.0 to 80.0 percent, while they are below 70.0 per cent in the remaining 4 districts.
The use of charcoal for cooking is also widespread in all the districts, ranging from 6.0 per cent in the Amansie East district to 70.9 per cent in the Kumasi metropolis. In Adansi West, Kwabre and Ejura Sekyedumase are the only districts where more than 30.0 per cent of households use charcoal as the main source of fuel for cooking.
The relatively high use of firewood and charcoal as the main fuel for cooking has serious implications for the already depleted forests. Some of the districts that used to have large tracts of their landmass as forest are becoming grasslands. One of such districts is Ejura Sekyedumase. Offinso, a former timber producing area, now has virtually no major timber concession.
Attempts at re-afforestation have started in some districts, including teak plantations in Afigya Sekyere, Sekyere West and Asante Akim South. These and other afforestation programmes should be extended to the other areas which used to be major forest reserves to stem the possibility of turning larges areas of the Ashanti region into savanah.
The other sources of fuel used for cooking are relatively less important. For example, the proportions of households in the districts using gas for cooking range from 0.6 per cent in Ahafo Ano South to 10.8 per cent in the Kumasi metropolis. In seven districts, the proportions are less than 1.0 percent. The fact that people in the rural communities have easy access to fuel wood, at relatively no cost, explains why they tend to use more of it than the other sources, particularly gas and electricity.
As a measure to conserve forests, efforts should be made to promote the use of alternative sources of fuel such as gas. Even though gas is cheaper and more efficient per unit than charcoal, its use is less widespread because of the heavy initial capital outlay for equipment, unlike charcoal which can be bought in small quantities at a time. Promotion of gas as cooking fuel should therefore aim at producing small cheaper single-ring gas cylinder cookers.
Bathing facility
Different types of bathroom facilities are available in the districts, the commonest being the shared bathroom. The proportion of households in the districts using this facility ranges from 28.3 per cent in Adansi East, the only district with the proportion below 30.0 percent, to 54.4 per cent in Ejisu-Juaben. In five districts, the proportions of households exceed 50.0 percent. In eleven districts, the proportions are between 30.0 and 50.0 percent.
The proportion of households using “own bathrooms” ranges from 11.4 per cent in Ahafo Ano North to 31.6 per cent in the Adansi East. In six districts, the proportions are between 20.0 and 30.0 percent. Many households in the districts share open cubicles as bathrooms, ranging from 9.0 per cent in Amansie East to 23.1 per cent in the Ejura-Sekyedumase.
The use of open spaces around dwelling places as bathrooms is also common, varying from 4.3 per cent in Adansi West, to 13.5 per cent in Sekyere East. Households using the exclusive open cubicles as bathrooms vary from 3.2 per cent of households in Kumasi metropolis to 15.7 per cent of households in Ahafo Ano North. In Kumasi and Kwabre, the proportions are less than 5.0 percent. The proportion of households using bathrooms in other houses ranges from 1.4 per cent in the Kumasi metropolis to 13.6 per cent in Amansie West. The proportions 112 exceed 10.0 per cent in only Amansie West and Amansie East. The use of other types of bathing facilities such as rivers, lakes, ponds and public bathrooms is not common in the districts.
Toilet facility
In-house pit latrines and public toilets, which may be pit, KVIP or bucket latrines, are the main toilet facilities used in the districts. The proportions that use public toilets vary from 36.8 per cent in the Kumasi metropolis to 63.5 per cent in the Ahafo Ano South. In six districts, the proportions exceed 50.0 percent.
The use of the pit latrine in the districts ranges from 12.0 per cent of household in the Kumasi metropolis to 43.8 per cent in Adansi East. The proportions exceed 30.0 per cent in three districts, including Adansi East. In eleven districts, the proportions are between 20.0 and 30.0 per cent and less than 20.0 per cent in three districts. The use of KVIP, which is not widespread in the various districts, ranges from 2.7 per cent in Ahafo Ano South to 18.3 per cent in Asante Akim North. The proportions exceed 10.0 per cent in only three districts and are less than 5.0 per cent in three districts.
The analysis also shows that between 2.1 per cent of households in Ahafo Ano South and 15.2 per cent in the Asante Akim South, use toilet facilities in other houses. Asante Akim South is the only district where the proportion exceeds 10.0 percent. The water closet (W.C) is used by small proportions of households, ranging from 0.5 per cent in Ahafo Ano South to 27.8 per cent in the Kumasi metropolis. Beside Kumasi, the proportions exceed 10.0 per cent in only the Adansi West district (11.6%). These are the two most urbanised dstricts in the region, 114 where Kumasi metropolis and Obuasi town, are located. Houses built for workers by Ashanti Goldfields in Obuasi are likely to be provided with WC facilities.
A number of households in the districts have no access to toilet facilities, and these range from 0.8 per cent in Ahafo Ano South to 15.3 per cent in Ejura-Sekyedumase. When a substantial number of households do not toilet facilities, it is to be expected that their members will defecate anywhere (bush, drains, etc), leading to the spread of diseases, such as typhoid fever, diarrhea and cholera.
Waste disposal
Solid waste
More than two-thirds of households in all districts use the public dump to dispose of solid waste, with the highest proportion (87.1%) in Amansie East. Those household that dump their solid waste elsewhere range from 8.3 per cent in Amansie East to 25.9 per cent in Asante Akim South.
Liquid waste
The prominent method of liquid waste disposal in the districts is throwing it on streets/outside of the dwelling unit. The proportions of households that use this method range from 14.2 per cent in the Kumasi metropolis, the only district with a proportion lower than 30.0 percent, to 67.5 per cent in Ejisu-Juaben. The proportions exceed 60.0 per cent in two other districts, namely, Amansie West and Afigya Sekyere.
The use of appropriate sewerage system for the disposal of liquid waste is not common even in the Kumasi metropolis, which has less than 10.0 per cent (8.8%) of households disposing of their liquid waste by this method. Getting rid of liquid waste on the compound of the dwelling unit is a common practice in all the districts, with the lowest proportion of households in Kumasi (18.0%) and the highest in Offinso (45.9%). On the other hand, throwing liquid waste into gutters is practised to varying degrees, with proportions ranging from 5.9 per cent in the Ejura- Sekyedumase to 58.7 per cent in the Kumasi metropolis.
The practice of households resorting to disposal of liquid waste in gutters is directly linked the development of street gutters in urban areas such as Kumasi. On the other hand, the relatively low corresponding proportions in rural areas, is due to the non-availability of streets with gutters in these areas. Neither of the practices should nonetheless be encouraged. Indiscriminate disposal of solid and liquid waste tends to create filthy environments leading to the breeding of mosquitoes and may increase malaria cases as well as other diseases such as typhoid fever, diarrhoea, and cholera. Furthermore, indiscriminate disposal of waste products 116 especially into gutters and drains can lead to flooding since most of the gutters are often choked during rainy seasons.
The dumping of solid waste into drains, open gutters and even streams and rivers has created a major environmental nightmare for many urbanised districts, particularly Kumasi. The Subin river, which barely forty years ago, was a clean unpolluted stream, is now nothing but a huge dead, open and polluted drain full of all sorts of waste material. Many other small streams which used to be part of the beauty of Kumasi cannot now even be recognized as such. This is a major ecological disaster.
Community facilities
Information on three main facilities – education, health and communication. The availability of these facilities helps to improve or facilitate living conditions. Many of the localities in the districts do not have all the facilities identified in the census, except the Kumasi metropolis where all the localities have all the community facilities. In analyzing the community facilities, those localities that do not have the facilities are analyzed from the standpoint of distance to the nearest facility.
Post office
Localities with a post office are few in the districts. The proportions range from 0.1 per cent in Adansi East and Ahafo Ano North to 3.8 per cent in Kwabre. It is only in 3 districts that more than half of the localities have the nearest post office within 10 kilometres. In most of the localities, one has to travel long distances to the nearest post office. The situation is worst in 4 districts, where the nearest post office, in the case of more than half of the localities, is located more than 20 kilometres away.
Post offices are not many in the region, and the distribution of the few existing ones is unsatisfactory. Kumasi metropolis is particularly best endowed with postal facility in all localities. Three other districts are also relatively well endowed with postal facilities within 10 kilometres Kwabre (86.1%), Afigya Sekyere (74.6%) and Ejisu Juaben (58.7%).
Apart from Ejura Sekyedumase (43.5%) and Adansi West (42.2%), the remaining 12 districts have between 15.0-36.0 per cent of localities within 10 kilometres of a post office facility. Even within 15 kilometres, four districts have only 31.0-38.0 percent, and three have 43.0-48.0 per cent of localities with a post office facility. Although the bulk of the localities in the districts are within 20 kilometres of a post office facility, Amansie West and East and Ahafo Ano North have more than 50.0 of localities with a post office facility beyond 20 kilometres.
Since the Ghana Post is increasingly expanding its services and serving as payment point for public utility services, it is therefore necessary to redress the imbalance in the distribution of post office facilities in the region in addition to increasing accessibility to more remote localities.
Telephone
The Pattern of distribution of telephone facilities follows closely that of post office facilities. All localities in the Kumasi metropolis have a local telephone facility. Kwabre has 60.8 per cent and Afigya Sekyere 47.5 per cent of localities with telephone facility within a 5- kilometre distance and 85.8 and 83.3 per cent respectively within ten kilometres.
No other district has either 20.0 of localities with a telephone within five kilometres and only five districts, Sekyere East (30.5%), Ejura Sekyedumase (31.0%) Bosomtwe-Atwima-Kwanwoma (32.8%) Offinso (36.2%) and Asanti Akim South (40.8%) have between 30.0 and 40.8 per cent of localities with telephone facility within ten kilometres.
Although the Mobile telephone is becoming increasingly widely patronized, not all people can afford either the initial cost or the recurrent cost of replacing telephone units. The line telephone is likely to continue to be used and its expansion to a larger member of localities in the district will facilitate the diffusion of information at the remote local levels in the districts.
Traditional healing facilities
Traditional Healers play a very important and indispensable role in primary healthcare delivery. They are available to most of the population within the locality, or within 5 kilometres of any locality. The region has 3,144 registered traditional medical practitioners (TMPs), constituting 15.8 per cent of all registered TMPs in the country, but evenly distributed throughout all the districts. In contrast over 85.0 per cent of the region’s doctors are in Kumasi, leaving just about 15.0 per cent for the remaining 17 districts. This yields very high population to doctor ratios for all districts except Kumasi.
Traditional healers make traditional health facility very accessible in all districts of the region. The proportions of localities with traditional healers range from 56.5 per cent in Ahafo Ano South to 87.4 per cent in Sekyere West. It is only in two districts (Adansi West and Asante Akim North) that the proportions are below 60 percent. In the other districts, at least two-thirds of the localities have traditional healers. Most of the localities without this facility have the nearest traditional healer within 5 kilometres.
Traditional health practitioners provide healthcare for a large number of the people in the region, particularly in rural areas. The bulk of localities in all districts of the region have access to a traditional health facility within the locality. In fact, in all the districts about 98.0 per cent of localities access a traditional heath facility within five kilometres, except Afigya Sekyere (95.3%) and Offinso (94.0%).
With a population to orthodox medical practitioner ratio of over 30,000 in 14 of the 18 districts, the role of the traditional healer in primary healthcare delivery in the region becomes very important, and should engage the full attention of planners, policy makers and implementers. Districts such as Amansie West may be relying on them considerably for their health needs, but their capabilities are limited, and that may be the reason why the Buluri Ulcer epidemic in the two Amansie districts deteriorated into such serious epidemic proportions before proper treatment could reach the patients. It is most unlikely that health facilities and availability of doctors in these and other deprived districts are likely to improve in the near future.
The upgrading of TMPs could include training in simple disease monitoring techniques so that they could bring any impending epidemic to the notice of appropriate health authorities in good time, since they are more available and more in contact with the general population in all districts.
Hospital
Hospitals are scarcely found in many localities in the districts. The proportions of localities with this facility range from 0.1 per cent in Adansi East and Ahafo Ano South to 4.2 per cent in Ejisu Juaben. Generally, the nearest hospital to the localities without the facility is far. In two districts (Kwabre and Afigya Sekyere), more than 60.0 per cent of the localities have the nearest hospital located within 10 kilometres. In the other districts, the majority of the localities have the facility located over 10 kilometres away. The situation is worst in four districts where between 53.3 and 61.1 per cent of localities have the nearest hospital located beyond 20 kilometres.
Doctors
The Ashanti Region, with 409 doctors, consisting of 353 in the public sector and 56 in the private sector, has the second largest number of doctors in the country, after Greater Accra. But like greater Accra, the distribution of these doctors is grossly skewed in favour of the regional capital. Of the 409 doctors in the region, which constitute 20.3 per cent of all doctors in the country, 346 or 84.6 per cent are in the Kumasi metropolis, whose population is only 32.4 per cent of the region’s total population.
With another 10 doctors each in Adansi West (all in Obuasi) and Asante Akim North (7 in Agogo), this leaves just about 10 per cent of the region’s doctors distributed in all the other districts.
Of the 346 doctors in Kumasi, 293 (84.7%) are in the Komfo Anokye Teaching Hospital. These make up 71.6 per cent of all doctors in the region. Of the 56 private doctors in the region, 53 are in Kumasi, two in Obuasi and one in Konongo. This very unsatisfactory distribution of doctors is reflected in the population to doctor ratios in the various districts. The regional average is one doctor to 8,834 people, which appears to be better than the national average of one doctor to 9,418 people. But this is deceptive in the sense that whereas the population to doctor in Kumasi metropolis is 3,382 persons to one doctor, and Asante-Akim North has one doctor to 12,648 people, all the other districts have over 20,000 people to one doctor, with 10 of the 18 districts having more than 50,000 people to one doctor.
Adansi East has only one doctor to the entire district population of 129,308, and Amansie West, one doctor for the entire population of 108,726. And yet this district is the apical point of the Buluri Ulcer epidemic the country has been facing for the past 10 years. Such a situation makes health monitoring and the detection of epidemics very difficult, and situations can easily get out of hand before they are brought to the notice of the health authorities. The Buluri Ulcer epidemic in the two Amansie districts and parts of Adansi is a typical case in point, which has now spread and become endemic in many other parts of the country.
Health planning should aim at going beyond the current situation of just one or two doctors for an entire district, located in the district capital or district hospital. if some of the better endowed hospitals such as Agogo Presbyterian Hospital, which also carry out training of other health professionals such as nurses and medical assistants, could be upgraded to function as Teaching Hospitals, this could increase the availability of specialists taking up referral cases in hospitals other than the only teaching hospital in the region.
Clinic
There are also few clinics in many of the localities in the districts. The proportions of localities with this facility range from 0.5 per cent in Adansi East to 11.6 per cent in Ejisu Juaben. The proportion of localities with no clinics, but with the nearest clinic at most 10 kilometres away, is in the range of 36.4 per cent in Sekyere West to 87.7 per cent in Kwabre. In most of the localities in the districts, the nearest clinic is not more than 10 kilometres away. It is in Amansie East and Sekyere East that about a third of localities have the nearest clinic located at more than 20 kilometres away. If the Ministry of Health’s aim of making primary healthcare delivery system available and accessible to all communities is to come to fruition, then a lot more needs to be done in providing health facilities in the districts.
Primary school
In spite of the free Compulsory Universal Basic Education (fCUBE) programme, not all localities in the districts have primary schools. The proportions of the localities in the districts with primary schools range from 3.0 per cent in Ahafo Ano North to 25.5 per cent in Amansie East. In all, only 4 districts have proportions greater than 20 percent, with the rest below 20.0 percent.
In most of the districts however, at least half of the localities have the nearest primary school within five kilometres. Apart from Sekyere East (40.7%) and Offinso (51.1%), all other districts have more than 60.0 per cent of localities within five kilometres of a primary school, which is in accordance with the official policy of basic education facilities within five kilometres from localities.
Junior secondary school
Apart from Kumasi metropolis, the proportion of localities with a Junior Secondary School (JSS) within the locality is low. In four districts, Sekyere West (21.1%), Kwabre (25.0%), Ejisu Juaben (25.1%) and Amansie East (25.1%), the proportions are over 20 per cent with a JSS facility. In 14 of the 18 districts, over 75.0 per cent of localities, can access a JSS facility within five kilometers. In three other districts, between 55.0 and 63.0 per cent have this facility within a distance of five kilometres. Sekyere East is the only district with only 40.7 per cent of localities with a JSS facility within five kilometres.
The current distribution of JSS facilities indicates many Priamry Schools in the region do not have complementary JSS facilities. Consequently, after completing the primary school cycle, pupils have either to travel long distances to continue in a JSS facility or end their education at the Primary school level. This situation requires urgent programme action.
Senior secondary school
Localities with Senior Secondary Schools (SSS) are few in all districts. The proportions range from 0.1 per cent in Adansi East, Ahafo Ano South and Ahafo Ano North to 3.8 per cent in Kwabre. Apart from Atwima and Kwabre, which have proportions of at least 3.0 percent, the rest have proportions of less than 2.0 percent. Apart from Kwabre and Afigya Sekyere, where at least seven in every ten localities have the nearest SSS within 10 kilometres, larger proportions of localities in the other districts have SSS at distances exceeding 10 kilometres.
The anaysis on educational facilities indicates that much more has to be done to meet the minimum educational needs of the region at all levels. Although availability of Primary School facility in the region is encouraging, its distribution needs to be expanded to increased locality levels, with the maximum number provided with complemetary JSS facilities.
SUMMARY FINDINGS, POLICY IMPLICATIONS AND INTERVENTIONS
Summary findings
Demographic characteristics
Even though more than half of the population in the region are in the urban areas, 15 of the 18 districts have more than half of the population in rural areas. The Amansie West District, for example, is entirely rural while three other districts, Bosomtwe/Atwima/Kwanwoma, Adansi East and Ahafo Ano South, have more than 90.0 per cent of the population in rural areas. The age structure of the population in the districts is skewed towards the youth. Apart from the Kumasi metropolis, between 40.0 and 47.0 per cent of the population in the remaining districts are below 15 years.
The male population exceeds the female population in 11 of the 15 districts. The proportion of the dependent population in the districts is relatively high, varying between 42.2 per cent and 57.3 percent. The dependent population in the Atwima, Adansi West, Ejisu- Juaben, Kumasi metropolis, Ejura Sekyedumase and Offinso, Districts is less than 50.0 percent. The proportion of the female adult population is higher than that of the male in five districts, namely, the Kumasi metropolis, the Kwabre, Ejura Sekyedumase, Ahafo Ano South and Ahafo Ano North, Districts.
In 11 of the remaining 13 districts, the reverse is the case, while in the Atwima and Sekyere East Districts, the proportions are the same. Although the sex ratio has been stabilising around 100.0, the age sex pattern of an increasing proportion of females, at older ages, deviates from the norm. The observed pattern is a higher proportion of males than females, from around age group 40-44 years and older, in 10 districts, a mixed pattern in six districts.
A higher proportion of males from age groups 44-49 to 54-59 years is followed by a higher proportion of females in the remaining age groups, in one district (Amansie West). It is only in one district, the Ejisu Juaben, that the normal pattern is observed. This pattern is nearing what is observed in the three northern regions of the country. One can not, however, necessarilty attribute this to either a change in the male-female mortality pattern, or an exageration of ages of males, at older ages.
The proportions of in-migrants in the districts vary from 20.0 to 44.7 percent. In two districts, Ahafo Ano South and Ahafo Ano North, more than 40.0 per cent of the population are inmigrants while in nine other districts, in-migrants account for over a third of the population. About two fifths (39.4%) of the people born outside the locality of enumeration in the districts, were born in the region.
Total fertility rates (TFRs) are still high in most districts. Apart from the Adansi West, Asante Akim South, Kumasi metropolis and Afigya Sekyere, Districts, the other 14 districts have TFRs in excess of the regional average of 4.8, which is also high. The TFR in Ahafo Ano South (9.9) is exceptionally high.
Social characteristics
The proportions of male-headed households exceed that of females in all the districts. In 13 of the 19 districts, between 30.0 and 40.0 per cent of the households are headed by females. It is in the Ejisu-Juaben District only that the proportion of female-headed households slightly exceeds 40.0 percent.
Half of the districts have an average household size higher than the regional average of 5.3 people. On the average, two households live in one house in the region. The number of households per house in the districts varies from 1.4 in the Amansie West District to 3.4 in the Kumasi metropolis.
The population per house in the districts is relatively large. Four districts have averages ranging from 11.0 people to 17.0 people, exceeding the regional average of 11 people. In 13 districts, the average population per house is between seven and 10 people. The region’s population per house, which remained unchaged around 11 persons during the 1960-2000 period, is the highest in the country. The region also has the highest share of the national housing stock (15.1%) and the national population share (19.1%) in 2000.
Children constitute the highest proportion of household members in the districts except in three, Kwabre, Sekyere East, and Ahafo Ano South, where the proportions of other relatives are higher. In all the districts, children of the head of household and other relations form more than 50.0 per cent of household members. The proportions of the population in the districts, except the Kumasi metropolis, who are married or are in a consensual union, exceed those who are not in any form of marital union. The proportion divorced is relatively high in three districts, namely, Bosomtwe/Atwima/Kwanwoma (7.9%), Ejisu-Juaben (7.6%) and Amansie East (7.4%).
Illiteracy levels are high in the districts, ranging from 26.0 per cent in the Kumasi metropolis to 64.7 per cent in the Ejura-Sekyedumase District. Only three districts have illiteracy levels below the regional average of 40.4 percent. A high proportion of the population in the region (40.0%- 50.0%), has only pre-school education or no formal education at all. The proportion of females who have no formal education, or have only pre-school education, is higher than that of males in all the districts.
Economic characteristics
Agriculture/Animal Husbandry/Forestry is the predominant economic activity in the districts, with the exception of the Kumasi metropolis, where Sales work is the predominant activity. In the Kwabre and the Adansi West Districts, the proportion of the population engaged in Agriculture/Animal Husbandry/Forestry is relatively low. The proportion of females in Sales work is higher than that of males in all the districts.
Also, the proportion of females in Agriculture/Animal Husbandry/Forestry exceeds that of males in the districts except the Kumasi metropolis, Ejura Sekyedumase, Offinso and Ahafo Ano North, where the reverse is the case. However, the proportion of males is higher than that of females, in all the districts, for the Professional/Technical occupations.
In all the districts, the proportion of the population engaged in Agriculture is higher in the rural areas than in the urban areas, while the proportion in Trade is higher in urban, than in rural, areas. The Amansie West District, which is entirely rural, and the Kumasi metropolis, which is entirely urban, do not follow this general pattern. Majority of the economically active population, in all the districts, are self-employed. The highest proportion of the economically active population is in the private sector, particularly the private informal sub-sector, which accounts for over two-thirds of the economically active population in all the districts.
The public sector employs less than 10.0 per cent of the economically active population. While the proportion of females in the private informal sector is higher than that of males, the proportion of males in the private formal sector, on the other hand, is higher than that of females. The proportion of workers in the public sector in urban areas is relatively higher than that in rural areas, while the opposite is the case for those engaged in the private sector.
Housing characteristics
Compound and separate dwelling units are predominant in all the districts. Makeshift dwelling units such as tents, kiosks, containers, etc, are predominant only in urban areas, particulary in the Kumasi metropolis. In the districts, 40.0 per cent or higher of the households own the dwellings they live in, except in the Kumasi metropolis, where the proportion is about 30.0 percent. The proportion of households living in rented houses is high in the Kumasi metropolis (42.5%) and in the Adansi West District (37.3%).
Too many households live in single rooms. In Kumasi and Kwabre over 60 per cent of households live in single rooms and in 4 other districts 50-60 per cent are in single rooms. In the remaining districts at least 30 per cent of household occupy single rooms. Cement/concrete is used for the construction of the outer walls of over 30.0 per cent of the dwelling units in ten districts In the Kumasi metropolis, majority of the households use pip-borne water as the main source of dringking water except 13.0 per cent who use either the river or the well or other sources of drinking water. In six other districts, less than half of the households have access to potable water, mainly boreholes, while in the remaining 11 districts, over 30.0 per cent of households use water from either the river or the well, as main source of drinking water
Public toilets and pit latrines are the two main facilities used in the districts. A high proportion of households (10.0% – 20.0%) in the districts, have no toilet facility or use toilet facilities in other houses. A high proportion of households in the region dispose of their solid waste using the public dump or throw it elsewhere. Liquid waste is mainly disposed of by either throwing it on the compound on the street or into a gutter, where available.
Wood and charcoal are the two main sources of fuel for cooking. Over 92.0 per cent of households in 14 districts and between 74.8 and 89.1 per cent in the remaining four districts, including the Kumasi metropolis, use either charcoal or wood for cooking. Apart from the Kumasi metropolis, where 10.8 per cent of households use gas for cooking, the proportion of households in the remaining districts, using gas for cooking, is less than 5.0 percent.
Kerosene is the main source of fuel used for lighting in 15 of the18 districts. Even for those districts with higher proportions of households using other sources of fuel for lighting, the proportions that use kerosene are still relatively high. Less than 1.0 per cent of the households use solar energy, as the main source of fuel for lighting.
Community facilities
Apart from traditional healers, all the educational, health and communication facilities are scarcely found in the localities of the districts with the exception of the Kumasi metropolis. Generally, the nearest facility (except traditional healers, clinics and primary schools) is located more than 10 kilometres away. Majority of the localities have traditional healers; those which do not have any, can access them within less than five kilometres.
Policy implications and interventions
The National Population Council, the Ministry of Education, Youth and Sports, the Ministry of Women and Children Affairs, need to collaborate more effectively with the District Assemblies to intensify the education on the relevance and benefits of having a smaller number of children, from the perspective of family and the nation.
A lot more advocacy and awareness creation on population issues and their implications need to be intensified, particularly in the Ahafo Ano South, Sekyere East, Bosomtwe/Atwima/ Kwanwoma Ejura Sekyedumase, Kwabre, Atwima and Amansie East and West, Districts.
Illiteracy levels are still high in all the districts. A High proportion (46.5%) of the population in the region has either no education or only pre-school education. Relatively smaller proportions of the population have attained a level higher than the junior secondary school, with disparities between males and females in educational attainment. The free Compulsory Universal Basic Education (fCUBE) programme should be fully implemented in all the districts in order to expand access to educational opportunities for majority of the large youthful population. The promotion of girls’ education by the Ministry of Women and Children Affairs (MOWAC) and the Girl Child Education Division of the Ministry of Education, should work towards gender equity in education.
There is a sharp drop of the population from primary to JSS in all the districts. This may be due to the fact that some children drop out of school before entering JSS. The other reason may be that there are few new infrastructures for JSS in the district.
Efforts should be geared towards aggressively building more JSS to uptake pupils from the primary schools. The free Compulsory Universal Basic Education programme (fCUBE) is beginning to yield results leading to higher primary school enrolment. The large difference between JSS and SSS enrolment in the districts may be due to the high drop out rate as a result of examination failure, inability to pay for SSS education, or some enrolling in Vocational, Technical or Commercial Schools.
There is therefore much more to do by way of focused planning, programme implementation and greater investment in education in the region, particularly in post JSS education, specifically targeting females, who appear to drop out faster than males, after JSS. The Ministry of Education/Ghana Education Service has however reported that a significant expansion in infrastructure has taken place in all levels of educational system.
In most of the districts, the proportion of rural dwellers is higher than that of the urban areas. Efforts to develop the districts should therefore concentrate on the rural areas. The Ghana Poverty Reduction Strategy (GPRS) programme should be rural focused in order to achieve the desired impact. Agriculture is the predominant occupation in the districts, with the exception of the Kumasi metropolis. The District Assemblies, in collaboration with the Ministry of Food and Agriculture, should therefore develop schemes that will particularly assist the large proportion of the population who are engaged in agricultural production and related activities.
Since the majority of the population in the districts is engaged in basic agriculture, the Government and the District Assemblies should encourage agro-based enterprises that will add value to the raw materials produced by the sector, so as to raise the standards of living of the people.
The private sector plays an important role in providing employment opportunities in the districts. It should therefore be strengthened by providing it with direct support. Policies aimed at improving the private sector and creating an enabling environment, should therefore aim at capacitating such enterprises to expand their base and be able to absorb extra labour.
The selfemployed without employees in the private informal sector, many of whom are not even properly registered, also raise problems of mobilisation for such social welfare issues as social security and health insurance, which are becoming important concerns for Government. Appropriate policies to integrate this sector into the various social sector schemes will therefore need to be evolved; as such, integration can even have an indirect positive effect on the growth and expansion of such private sector enterprises.
A high proportion (52.7%) of households in the region lives in single rooms. The high average household size (5.3) and high room occupancy levels (2.7) may have health implications which need to be effectively addressed at both district and regional levels. The proportion of the population with access to pipe-borne water is relatively low in the districts, including the Kumasi metropolis.
The Barekese Dam in Antwima, from which the Kumasi metropolis gets its main water supply, faces various potential problems that may soon reduce its capacity to provide the metropolis with all its treated water requirements. These hazards include the threat of inuarum of the water hyacinth. The District Assemblies should be encouraged to invest more of their resources in the provision of potable water in the form of pipe-borne water and boreholes or deep wells for the communities. This will help reduce the incidence of water borne diseases among the population in the region.
The borehole has proved to be a major contributor to the provision of potable water in all the districts, compared to pipe-borne water. It is relatively cheaper to construct, expecially for small communities. If the negative problems associated with borehole water in certain localities, such as salinity and high iron content could be overcome, they could serve as an effective way of solving the potable water problem of many localities. The water could even be piped into one community reservoir and redistributed into households, through taps.
The use of gas for cooking is very limited. Charcoal and wood are overwhelmingly used. This has partly caused the depletion of the forest cover in the region and a negative impact on rainfall and farming. In order not to completely deplete the forests, reafforestation programmes should be considerably intensified.
Areas that particularly need immediate attention are Offinso, Kwabre, Ejura-Sekyedumase, District and the Kumasi Metropolis. The use of gas for cooking should be encouraged through the manufacture of cheaper smaller single-ring gas cylindercookers that will be affordable to more people so as to reduce the reliance on wood and charcoal. The methods of waste disposal, particularly liquid waste, are not environmentally friendly.
The indiscriminate dumping of waste tends to pollute the environment with serious health consequences. The Ministry of Health (MOH) Annual Reports for the Ashanti Region indicate that malaria alone constitutes about 45.0 per cent of all hospital outpatient consultations. The sewerage system of waste disposal and other solid waste disposal materials that will improve the situation should be provided in the districts and punitive measures instituted against those who pollute the environment indiscriminately.
Relatively high proportions of households have no toilet facility or use toilet facilities in other houses. The public toilets used by majority of people are usually in an unhygienic state and are badly maintained. This is not a healthy situation. The District Assemblies should therefore encourage and assist communities and individuals to construct hygienic toilet facilities, such as the KVIP.
The Government and the District Assemblies should make conscious efforts towards increasing the number of health, education and communication facilities in the districts. Such moves will improve and facilitate the living conditions of the people.
cts. The Kumasi metropolis alone accounts for nearly one-third of the region’s population. Slightly over half, 51.5 per cent, of the population of the region is in four districts. While more than half of the population in the region resides in urban areas, in 15 of the 18 districts, over half the population live in rural areas. The high level of urbanization in the region is due mainly to the high concentration of the population in the Kumasi metropolis (which has almost about a third of the region’s population).
