HealthCare and Child Development in South Sudan, the Forgotten
Country
South Sudan is a new country that got its independence in July 2011 from a large pie of Sudan in the Northern Region of Africa. Their offi cial language is English but people still use Arabic as a language of communication in the markets and the places of work. They still use pound as an offi cial currency in the country but the US dollar is the dominated currency in the market. It has made it harder for the average person to meet family needs in terms of food, health services and regular transportation.
The need for humanitarian organizations is very important. Without them there is a disaster to the whole country especially in terms of basic health care, food supplements and clean water. This year 2022-23, our health care volunteers took tour to the Northern villages not far from the city. The cases of children who are suff ering from preventative child diseases is so scary. Over 180 children have been physically deformed since their birth due to the lack of early prevention healthcare. We will try to post some cases in our social media from time to time for your information. Stay tuned.
Case # 1
In a rare case of a six days child, Pita Martin, in Terekeka County Central Equatoria State a mother, Keji, reported to our health workers that before her labor she experienced pain for about 4months, and she could feel the baby was not normal in her womb. She later had normal delivery at home but after a cut, she realized that the spinal cord line of nerves of the baby was on the back, and the cord, was disconnected from her body.
General physician observation:
The spinal cord injury is below the level of the top edge of the hipbone (above the 2nd lumbar vertebra) and paralysis on the LLs.
. In a similar case
from a mother, Keji Ladu, in Terekeka county. The mother reported that she had a normal delivery to a boy, on the road while she was walking from Terekeka to her village. Suddenly, she realized that the spinal cord of the baby came out of his back. The spinal cord was not connected to the baby
Physician's Observation:
The spinal cord injury is below the level of the top edge of the hipbone (above the 2nd lumbar vertebra) and paralysis is usually fl oppy. This child with spinal bifi da was born to a village household who are poor and cannot aff ord surgery.
General Healthcare System
Poor access to health services, a limited number of health workers and lack of access to health services have produced some of the worst health indicators in the world, with a child mortality rate of 78 deaths per 1,000 live births. Around 75 per cent of all child deaths in South Sudan are due to preventable diseases, such as diarrhea, malaria and pneumonia.
The country´s public health indicators remain one of the lowest globally. As of 2017 to date, access to healthcare services was 28%, immunization coverage is less than 50%, while life expectancy at birth, maternal mortality ratio and under-fi ve mortality are respectively 58 years, 789 per 100,000 live births and 92.6 per 1000 live births. Other factors outside the health system such as weak transport infrastructure, climatic conditions and insecurity due to recurrent inter-communal clashes that render more than half the country physically inaccessible by land for several months of the year further compound the country´s inability to achieve Universal Healthcare Coverage (UHC).
However, there is a ray of hope in the country´s health sector even in the face of this grim situation. The revitalized peace agreement has brought a new impetus for rebuilding the country, including its health system. A Health Sector Strategic Plan (HSSP) has been developed and is being implemented, albeit slowly. In 2019, health partners supported the Ministry of Health in developing and implementing a health sector stabilization and recovery plan that aims to strengthen the health system resilience through accelerated implementation of the HSSP. A Boma(village) Health Initiative (BHI) program which aims to scale up health services delivery at the community level has been launched with support from partners.
Way forward: Moving forward, the country needs to sustain these modest achievements and use them as opportunities to build the foundation for UHC attainment for its people. This requires a strong and people-centred primary health care approach that will ensure that services reach the last mile. Several strategies are required in this regard.
• First, the humanitarian-development nexus should be bridged by ensuring that ongoing humanitarian response lay a foundation for longer-term health system strengthening and resilience building and vice versa.
. Second, using a well-coordinated approach to provide systematic stabilization and recovery of the country´s health system is required.
•Third, the scale-up of community-based health initiatives such as the BHI as platforms for taking health services to the last mile is imperative.
. Fourth, using innovative, appropriate and sustainable technologies such as digital health to accelerate health services delivery would be critical in expanding health services to hard-to-reach areas.
. Fifth, increased advocacy for political commitment to increase domestic funding and development of stronger partnerships among all stakeholders, especially the international organizations are required to increase the fi nancing of the health sector.
• Lastly, strengthened capacity for health stewardship, coordination and evidence-based strategic planning and effi cient allocation and use of resources is critical.
Cite this article to:1) Christian Agenda for Development (CAD) Org. South Sudan ,2) Victoria Achut Anib et al. South Sudan’s road to universal health coverage
References:
1. O´Connell T, Rasanathan K, Chopra M. What does universal health coverage mean? Lancet Lond Engl. 2014;383(9913):277–279.
2. Macharia PM, Ouma PO, Gogo EG, Snow RW, Noor AM. Spatial accessibility to basic public health services in South Sudan. ]
3. World Health Organization South Sudan-strengthening primary health care in fragile settings. 2021. May 20, Accessed November 25, 2021.
Authors’ contributions:
The editorial was conceptualized and written by Francis Limbe, The Chief Executive Offi cer of BC Global, USA, Uganda. and South Sudan