Funds to support public health activities in the communities are fast dwindling in some African Countries like Ghana who have attained the lower middle income status. Donors feel we are of age now so our respective governments should continue and sustain whatever interventions that have been put in place but unfortunately we receive little of such support because of the pressure on the national cake and the priorities of our governments. And we are unable to generate funds from preventive health care delivery, it is supposed to be free of charge.

Our community health workers who are our foot soldiers, though very hardworking, are challenged when it comes to commuting from one community to another especially in districts like Amansie West where I work.  The terrain is rough, road networks are bad, dusty and worsens when it rains. Some communities are far and very hard to reach. There are not enough strong and durable motorbikes, our female community nurses cannot ride and so have to fall on commercial drivers which can be very costly and life endangering sometimes. This makes it difficult to reach the far communities. Residing in some of these zones or communities can sometimes be discomforting because of the unfavourable conditions and lack of certain social amenities but they sacrifice with a little encouragement. Coupled with the devastating nature of illegal mining popularly known as 'galamsey' and it's effects on our water bodies, and the nomadic and transitory nature of the mining communities, we tend to miss a few children here and there who are due for second doses of vaccines and vitamin A, during our routine static and outreach immunization schedules because their parents move out of the district. The District Health Directorate has an old and rickety pickup which easily breaks down and so cannot be used for monitoring regularly.

In the midst of these challenges we devise strategies to overcome them, that's why l am excited about this course. It would help us to further reduce or prevent the challenge of missed children, thank you for reading.