BACKGROUND: The dearth of health and demographic data in sub-Saharan Africa from vital registration systems and its impact on effective planning for health and socio-economic development is widely documented. Health and Demographic Surveillance Systems have the capacity to address the dearth of quality data for policy making in resource-poor settings. OBJECTIVE: This article demonstrates the utility of the Kintampo Health and Demographic Surveillance System (KHDSS) by showing the patterns and trends of population change from 2005 to 2009 in the Kintampo North Municipality and Kintampo South districts of Ghana through data obtained from the KHDSS biannual update rounds. DESIGN: Basic demographic rates for fertility, mortality, and migration were computed by year. School enrolment was computed as a percentage in school by age and sex for 6-18 year-olds. Socio-economic status was derived by use of Principal Components Analysis on household assets. RESULTS: Over the period, an earlier fertility decline was reversed in 2009; mortality declined slightly for all age-groups, and a significant share of working-age population was lost through out-migration. Large minorities of children of school-going age are not in school. Socio-economic factors are shown to be important determinants of fertility and mortality. CONCLUSION: Strengthening the capacity of HDSSs could offer added value to evidence-driven policymaking at local level.