Malaria (approx. 45 per cent of all outpatient attendance), TB, HIV-AIDS (3,1 per cent in 2004) and a high maternal and child mortality rates are the key challenges to Ghanaian health care. Insanity conditions and malnutrition are the two major basic problems of ill-health. This is accompanied by the poor access to healthcare and the shortage of doctors and nurses (many of them have migrated out of Ghana), in 2004 there was 1 doctor available for almost 18.000 people, whereby it should be kept in mind that this even is an average and that access out of cities is even worse. Especially in the rural areas the traditional medicine still plays an important role.