 The Kintampo Health and Demographic Surveillance System, KHDSS, has been used to demonstrate the patterns and trends of population change over time in the Kintampo North municipality and Kintampo South districts of Ghana. The study found that there was a reversal of an earlier fertility decline in 2009, with a slight decrease in mortality across all age groups. Additionally, a large proportion of the working age population was lost throughout migration. Factors such as socioeconomic status were also identified as being important determinants of fertility and mortality. The strengthening of HDSSes could provide valuable information for evidence-based policymaking at the local level. This article was authored by Seth Awusu-Haji, Albert Ernestainetti, Charles Sando, and others.