Other districts where significant proportions of the localities have clinics located at considerable distances are Wassa West (13.9%), Wassa Amenfi (15.6%) and Aowin-Suaman (25.1%). The four major occupations in the region are agriculture including fishing, animal husbandry and hunting (58.1%), production and transport work (14.5%), sales work (10.2%) and professional and technical work (5.4%). Levels of enrolment are partly a reflection of the ability of the schools to attract adequate qualified candidates nationwide, and this is in turn a reflection of the quality of the school; hence the presentation of tables indicating senior secondary school attendances at the regional and national levels. Coconut husks are also used in Jomoro (6.1%) Juabeso-Bia (4.0%) and Nzema East (0.6%) as a source of fuel for cooking. According to the 2000 Census, there are 410,412 households in the region, occupying 259,874 housing units, which give an average of 1.6 households per house. The low enrolment is due mainly to lack of school buildings, inadequate textbooks and the inability of parents to pay the fees charged by schools (both private and public). In the Shama-Ahanta East Metropolitan Area, the percentage of women in both formal (47.1%) and informal (4.6%) unions is the lowest in each case, compared with the predominantly rural districts. Though lower than the national average, this is still quite high, since most households live in only one or two rooms. Agriculture (excluding fishing) remains the biggest industrial activity in the region, employing more than 50 per cent of workers in all districts except Jomoro (46.4%), Shama-Ahanta East (14.5%) and Wassa West (45.8%). In all the districts, the private sector (both formal and informal), provides employment to more than 80 per cent of the working population. b) Hospitals < The population per publicly owned health facility of 10,140 as at 2001 is slightly below the national average of 11,289, and is the third lowest in the country, coming after the Volta Region (6,984) and Greater Accra (8,605). Juabeso-Bia (12.7%), Wassa Amenfi (12.2%) and Wassa West (12.1%) also account for a substantial proportion of the regional population. Most households (80.0%) in the region use one or two rooms as living quarters. The Central Region accounts for most persons in the southern districts born outside the region, while persons born outside the region but resident in the northern districts are mostly from Ashanti and Brong Ahafo. Households in Shama-Ahanta East, more than any other district, use collection agencies and public dumping sites. This appears more the case for female heads than it is for male heads. The availability of toilet facilities seems to be a major problem in the region, as about 40.0 per cent of dwellings in the region have either no toilet facility or use a public toilet. The region is however one of the most extensively covered by the various mobile telephone operators, probably due to the high usage by the mining and other industries in the region. Liquid petroleum gas (LPG) ranks as the third largest source of cooking fuel in Shama- Ahanta East (11.3%). It is the largest producer of cocoa, rubber and coconut, and one of the major producers of oil palm. At the national level, agriculture (52.1%), mining and quarrying (1.5%), and manufacturing (11.0%) follow in that order. There is however only one standard written Nzema language. The number of medical personnel (doctors and nurses) who man hospitals and clinics is inadequate. More than two-thirds of the economically active population in all the districts of the region are made up of self-employed persons with no employees, except in Shama-Ahanta East (50%). Teledensity in the region is 0.3 telephones per 100 persons, which is below the national average of 0.7. The employment status of the economically active population in the region also follows the national trend; self- employed workers with no employees (68.3%) make up the majority of the economically active. Aowin-Suaman, the most sparsely settled district, with a density of 38.5 persons per square kilometre, together with Wassa Amenfi and Juabeso-Bia, account for more than half (51.5%) of the total land area of the region, but only about 31 per cent of the population. In a number of urban areas of the country, education starts as early as three years in the pre-school; however, school-going age for the 6-year primary education level is pegged at six years, even though many children start a year earlier at five, particularly among the urban middle class, or a year later at seven or more, particularly among the rural farming community. Liquid petroleum gas (LPG) is the third largest source of cooking fuel in Shama-Ahanta East (11.3%). Greater Accra, with the highest teledensity, has only 3.2 telephones per 100 persons. The proportions of economically active persons aged between 7 and 14 years (outside the legal age limits), and 15 and 64 years (within the legal age limits) will be discussed in later chapters. This used to be the case for urination and defecation as well, but are unfortunately no longer the case, even in some of the urban areas. The Pepesa, who are located within the Fiase Traditional area at Dompim, Simpa and the surrounding villages, south of Tarkwa, have their own peculiar dialect more akin to, and understood by the Nzemas, Ahantas, Aowins and Sefwis. These are Elubo, Agona Nkwanta, Aiynase, Dadieso, Mpohor, Aboadze, Sefwi Bekwai and Apowa. This should be of concern to the districts, since every adult person in the productive age group has to support at least one dependant. More females need to be encouraged to go to school to improve their status in society, since studies have shown that educated females tend to be economically more productive. For all districts, there is no departure from the traditional Ghanaian household setting consisting of a head, with his/her spouse, children and other family relations. It is known that there are citizens of the Ivory Coast who owe allegiance to, and rights of succession of chiefs in some of these border districts such as Aowin-Suaman, Juabeso-Bia, Sefwi-Wiawso and Jomoro, and vice versa. For example, Mpohor-Wassa East and Ahanta West are served by wireless telephone (WILL) systems while Sefwi-Wiawso, Awaso in the Bibiani-Anhwiaso-Bekwai, and Juabeso-Bia are served by radio links. The boundaries of the districts do not necessarily conform to the boundaries of the local authorities but are coterminous with regional boundaries. The factors that determine access to schools are the quality of the junior secondary school which determines the capacity of the pupils to pass the entrance examination, and affordability of the senior secondary school to the prospective student, as well as the quality of the senior secondary school into which admission is being sought. Treated pipe-borne water is available mainly in the urban areas while the rural areas rely mainly on surface waters such as rivers, streams small lakes and springs. Christianity is the largest religion in all the districts. The region has the largest share of the country’s rainforest reserves, rich in primary tropical hardwood and very rare species of flora and fauna, which could be threatened with extinction if not properly managed and preserved. The government’s rural electrification programme has apparently not made much impact on the region. Of the 76 transmission locations used by Spacefon to cover various regions of the country, 15 are in the Western Region (19.7%), second to the Eastern Region which is covered through 19 locations (25%). The situation in these two highly urbanized districts is in sharp contrast to rural districts such as Aowin-Suaman where over 60 per cent use rivers, streams, dugouts or spring or rain water as their main source of water, with only 8.7 per cent having access to processed pipe-borne water. Indeed, in all the districts, between 60 and 92 per cent of the localities have traditional healers within the locality. Some of the other districts are served by radio telephone and other systems by private companies such as Capital Telecommunications. The official Ministry of Education policy is that no class should have more than 35 pupils at the primary level and 45 pupils at the junior secondary level, to a teacher. The common practice of the environs of public toilets also serving as solid waste dumps is one of the most serious health hazards posed in many of the urban and peri-urban localities. BACKGROUND INFORMATION ON THE REGION. The societal expectation that a man should be able to provide economic support for his family even in the face of economic hardship tends to delay marriage in such urban settings. Out of the 12,985 fixed lines in the region as at 2000, 11,046 or 86.0 per cent serve the Shama-Ahanta East metropolis. Shama-Ahanta East, being an industrialized urban centre, has the highest percentage of service workers (9.1%). People may move from their place of birth to work in another region or district for a long period of time and then retire back home, or may have found themselves at home on census night. About 33 per cent of dwellings in Shama-Ahanta East also have asbestos/slate and 20 per cent cement/concrete tiles or screeds as roofing materials. Quite a few (10.0%) of households in Shama-Ahanta East use the sewerage system or septic tank to dispose of liquid waste. A map gives the direction and blueprint of the place. Nzema East, Mpohor-Wassa East, Juabeso-Bia and Sefwi-Wiawso have about 30 per cent of their dwellings roofed with thatch/palm leaves. The road network of the region is relatively poor, making many of the rural districts rather inaccessible, especially during the rainy season when many of the areas including some important cocoa growing areas are inaccessible to vehicular traffic. They contributed 3.8 per cent in 1999 and 3.0 per cent in 2000 of the total national intake to Legon, and 5.4 per cent in 1999 and 4.4 per cent in 2000 of the total national intake to KNUST. It is the school language and medium of instruction in lower primary classes in many of the basic schools. These may be foreign nationals from outside Africa prospecting for gold, or working in agro-industrial projects in the district. For those two academic years, the Western Region schools accounted for only 84 students in 1999 and 97 in 2000. Technical and vocational education have not received the sort of attention that should be given to them in a region where there are mining and other industries that will require appropriate middle level manpower. Availability of primary and junior secondary schools. This may be the result of increases in supply of houses or a slow-down in the formation of new households. The situation is more serious in Jomoro, Nzema East and Mpohor-Wassa East, where more than 40 per cent of children in such communities have to travel 30 kilometres and more before attending SSS. Nearly two-thirds (64.3%) of those currently in school are at the primary level, while 21.3 per cent are in junior secondary school.

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