Did you know?
The Republic of South Sudan became the world's 196th country on July 9th, 2011 ending 50 long years of violent civil war in Sudan.
Ongoing conflict left the country in complete devastation; as a result, the Republic of South Sudan has some of the worst health care conditions in the world. Aggressive diseases sweep through the population; suffering is widespread and life expectancy is short.
Though humanitarian efforts have improved conditions in recent years, it will take significant time and resources to develop entirely new systems for health care, sanitation, clean water and education that were virtually nonexistent due to the continual violence.
As it develops its independence and national systems, the Republic of South Sudan remains in enormous need of health care infrastructure, medical supplies and trained health care professionals to meet the needs of its people.
IMA World Health has a major role the development of a functioning health care system in the Republic of South Sudan. In 2008, IMA began establishing field offices in the capital city of Juba, as well as in Bor and Malakal in the states of Jonglei and Upper Nile, respectively, to provide in-country support for this massive goal.
With support from the Ministry of Health in South Sudan and World Bank, IMA World Health is helping to strengthen the health system at every level to achieve results. Launched in January 2013, the Rapid Results Health Project (RRHP) is an innovative, performance-based contracting approach designed to help all 3.2 million people living in Jonglei and Upper Nile states—the two largest and most geographically challenging states due to rainy season flooding and few passable roads. By supporting 284 providers, RRHP extends the reach of primary health care in the region. It boosts county health departments in 24 counties across both states, building the capacity of health workers and health facilities. And, with the help of proven contractors, the program extends life-saving preventative measures such as vaccination, care for pregnant mothers and children under five, and HIV/AIDS screening and prevention. RRHP builds on successes and infrastructure established during the SuddHealth project, which IMA implemented in the same region from 2008-2012.
IMA works with the Ministry of Health (MOH) of the Government of South Sudan (GoSS) to expand the Basic Package of Health Services (BPHS) to the populations in Jonglei and Upper Nile states, the country’s two largest states. The BPHS is a standard package of care including preventive, primary, and reproductive health services such as immunization, micronutrient supplementation, maternal and child health, family planning, malaria prevention and treatment, HIV/AIDS sensitization/treatment, and curative services for diarrhea and tuberculosis. In coordination with the State MoH, IMA builds the core capacities of the health system and provides delivery of essential health services. Aligned with GoSS’s objectives, the project develops core institutional capabilities of the public health administration, implements a phased infrastructure and equipment investment plan, invests in human resources in health, and develops a pharmaceutical management, supply, and distribution system.
This project has developed health facility databases and trained personnel to manage, maintain, and utilize health information. Preliminary mapping to reflect the approximate location of health facilities in Jonglei and Upper Nile was developed during project inception, assisting implementation planning and project start-up. However, since county-level political boundaries continue to change, and as more accurate facility information becomes available, more precise mapping will provide greater assistance to build management and planning capacity. The health facilities’ databases and the health management information systems software application were also customized to support the unique aspects of SuddHealth project implementation. Other technology tools are also being developed to monitor and evaluate the progress and performance of implementing partners and the program overall through measurement of health systems strengthening according to established, harmonized program indicators. The majority of counties in both states are now reporting service delivery data electronically, and 10 V-Sats with solar power have been installed.
IMA works with the Southern Sudan AIDS Commission (SSAC) and the Ministry of Health to enhance the range of HIV/AIDS prevention, care, and treatment services in six counties in Jonglei and Upper Nile states. These services include training health care workers in behavior change communication and information, education, and communication (BCC/IEC) activities (including provision of condoms), HIV counseling and testing (HCT), prevention of mother to child transmission of HIV (PMTCT), and HIV/AIDS prevention, care and treatment, including the provision of antiretroviral therapy. Training in leadership, management, and monitoring and evaluation is also provided to build state SSAC and local NGO and CBO capacity.
IGAD Nasir "Hot Spot" HIV/AIDS Project
IMA is improving HIV prevention and care activities in Nasir county in Upper Nile state, which is a “hot spot” for increased HIV due to its proximity to the Ethiopian border. Increased economic activity with Ethiopia (high HIV prevalence) puts this population at risk for increased HIV infection. IMA is providing community sensitization and mobilization activities around HIV prevention to increase capacity of HCT, promoting and distributing condoms, and increasing the capacity of health facilities to provide sexually transmitted infection treatment services as well as PMTCT through the provision of drugs and medical supplies.
Increasing Access to Emergency Obstetric Care
A rapid increase in returnees is putting significant pressure on already strained health services, especially in reproductive health and basic obstetric care. Maternal mortality rates are staggering, with conditions such as prolonged labor, twins, breech presentation, infection, and bleeding too often resulting in fatalities. However, many of these complications can be managed with appropriate facilities and trained providers. IMA is addressing these challenges by creating emergency obstetric services (EmOC) in five isolated counties (Maiwut, Ulang, Panyikang, Maban, and Longochuk) in Upper Nile. Thirteen clinical health officers are receiving EmOC training including skilled vaginal delivery, parenteral antibiotics, management of post-partum hemorrhage, treatment of toxemia, management of retained placenta and complications from abortion. Facilities are being rehabilitated with essential medical equipment and commodities such as UNFPA advanced obstetrical delivery kits, beds, solar lighting, refrigeration for medicine, and surgical and lab instruments. Community health workers and traditional birth attendants are being sensitized on referral and transfer guidelines.
Basic Services Fund
IMA is ensuring that the provision of primary health care services is uninterrupted while new mechanisms focused on strengthening the Government systems are created. IMA is collaborating with the County Health Departments (CHDs) in Melut and Manyo Counties of Upper Nile State as well as with the CHDs in Duk County of Jonglei State to support health care facility personnel, supply critical pharmaceuticals to identified primary health care units and centers, and provide EPI and cold chain support as well as essential reproductive health services.
Global Fund Round 7 Malaria
IMA is reducing the malaria burden in Jonglei and Upper Nile states of South Sudan through the distribution Long Lasting Insecticide Impregnated Nets (LLINs) to vulnerable populations including pregnant women, and children under five. Additionally, IMA is building the capacity of the health system to deliver malaria interventions through an enhanced health management information systems and better use of data for decision making.
By Dr. Bill Clemmer, IMA Country Director for South Sudan This post was originally published on Ann and Bill...
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