Health care and health systems in South Sudan are faced with great challenges. Since the 2013 returned wars, more than five million people in South Sudan need humanitarian healthcare services. Most health facilities are not functioning and those that are functioning provide minimal services due to drug and staff shortages. Children under age 5 are particularly vulnerable to diseases, including due to the low level of routine immunization and their already weakened state. Women face serious health risks throughout their life cycle. Survivors of gender-based violence have inadequate access to services and women have inadequate access to skilled personnel during pregnancy and childbirth. As the conflict spreads and the economic crisis deepened, people with HIV/AIDS or TB have become cut-off from life-saving treatment, particularly in Greater Upper Nile and Greater Equatoria regions. South Sudan faces highly endemic communicable diseases, with persistent outbreaks of cholera, measles, malaria, hepatitis B/E and kala-azar affecting large parts of the country due to poor living conditions, poor sanitation, and overcrowding. Malaria, typhoid, diarrhea, and pneumonia are the top reasons for outpatient consultations.
Furthermore, most of the population where CMD operates are hard to reach areas where challenges are related to:
• Issue of human resources limitation in most areas of operation: Recruitment of appropriate trained cadres is a challenge since naturally most trained health workers prefer to be in towns and avoid the rural areas. Therefore, some areas of the health projects are implemented by volunteers or students instead of doctors, clinical officers, nurses, CHWs, midwives or other medical cadres. Thus, making proficiency and sustainability of health projects a difficult task.
• Interrupted funding for health projects: Provision of continuous funds to sustain health projects would be beneficial for the population’s overall wellbeing. However, generating sufficient funding for supporting health projects continuously is usually not easy.
• The geographical context: Remoteness of populated villages posing a factor of inaccessibility to distant health facilities; during the rainy season, roads become unpassable making logistical constraints, thus affecting the provision of drugs, equipment, and other necessary items to health facilities and generally limiting access to the population in the remote villages.
• Lack of Inspiration from community members: Heedlessly and cultural barriers of the community in various areas in the country, awareness of health concerns needs to exist and individual and organizational commitments are vital toward making the changes needed to address health trepidations. Most community members do not understand project expectations thus making them not motivated.
- Preventive & health promotion services: Promote prevention by creating awareness on diseases outbreak, disaster preparedness and preventive measures.
a) Primary prevention services and activities include but not limited to:• Vaccination and post-exposure prophylaxis of children, adults and the elderly;
• Provision of information on behavioral and medical health risks, and measures to reduce risks at the individual and population levels;
• Inclusion of disease prevention programmes at primary and specialized health care levels, such as access to preventive services (counseling)
• Nutritional and food supplementation;
• Dental hygiene education and oral health services.
b) Secondary prevention services and activities includes but not limited to:
• Population-based screening programmes for early detection of diseases;
• Provision of maternal and child health programmes, including screening and prevention of congenital malformations; and
• Provision of chemo-prophylactic agents to control risk factors (e.g., hypertension)
• Integrated Disease Surveillance and Response (IDSR)
- Curative services: Enhance quality healthcare services and create awareness and early diagnosis and treatment.• Curative and treatment to alleviate the symptoms or cure a medical condition. It strives to reduce pain,• Improve the quality of life for patients. Include medications, casts and splints for broken bones, conditions, and chemotherapy for with. Nursing Care providers and curative care for patients in various health facilities.• Set up plans for the care of patients, carry out medical treatments, and observed patients, diagnostic testing and evaluating results.
- Rehabilitation of existing facilities and establishment of new facilities. Rehabilitate existing facilities, the establishment of more PHCCs and PHCUs and referral Hospitals. 4. Reproductive health programmes: Reduce maternal and neonatal death through comprehensive emergency obstetric and neonatal care (CEmoNC) Basic emergency obstetric and neonatal care (BMoC) quality services.• Reproductive Health Services (RHS)• Promotion of equitable gender for family healthcare services.• Promotion of VCT/PICT reduction of sexual partners and use of condoms Awareness
- 5. Collaboration and wholehearted coordination with stakeholders and partners: Partaking in a network of stakeholders and partners in the health sector in and out of the community may be advantageous for providing resources and support for health programs. 6. Strategies to overcome inaccessibility to health services: Approaches that give the opportunity to offer the health program remotely or through other technologies. For success, conducting outreach efforts to reach community members would achieve better health outcomes.
- 7. Involvement of community members in the health programs: It is important to make a conscious effort to recognize and understand the population what the health program will serve so that the community can develop appropriate strategies that fit into the context of cultural lines adapting materials, such as information packets, to ensure all program materials are culturally appropriate thus making the health programs acceptable. Involving members from the communities throughout the whole process can help achieve cultural competency, encouraging participation and reduce social stigmas.