Southern Sudan


   Country Statistics
   
   Malaria Consortium in Southern Sudan

   Activities

   Projects currently undertaken in Sudan

   Country Progress

Country Statistics

	Southern Sudan	Sudan (national figure)
Population size (2009)	7.5-9.7 million	42.3 million
Life expectancy (2005)	-	57.4 years
Child Mortality (Deaths Before the Age of 5) (2007)	135 per 1,000 live births	109 per 1,000 live births
Maternal Mortality (2005)	1,700 per 100,000 births	450 per 100,000 births
Percentage of HIV-positive adults (15-49) (2007)	3.1%	1.4%
Percentage of households with ≥ 1 mosquito nets (2007)	-	-
Percentage of Insecticide Treated Net Coverage (2006)	12%	19.5%
Number of reported malaria cases (2007)	-	2,778,207
Number of reported malaria deaths (2007)	-	1,281

Statistical data obtained from DESA, UNDP, UNICEF, UNAIDS and WHO

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Malaria Consortium in Sudan

Sudan is the largest country in Africa. The challenges posed by international sanctions, internal conflicts and geography are immense. Despite this, Malaria Consortium has successfully implemented projects in a diverse range of settings, achieving real results in communicable disease control that have improved health and decreased morbidity and mortality.

Malaria Consortium’s work in Sudan has been focused on Southern Sudan where malaria prevalence is highest and where many health indicators are even worse than those in Darfur.  The signing of the Comprehensive Peace Agreement in 2005 brought to an end a 22-year phase of fighting in a bloody civil war that had raged almost continuously since Sudan gained independence.  This state of almost constant war has left the health infrastructure of Southern Sudan in an extremely poor condition.  Since 2005 the Government of Southern Sudan’s (GoSS) Ministry of Health (MoH) has transformed from a skeletal body with a few staff to a formal Ministry whose capacity is rapidly increasing. In light of this period of rapid growth, non-governmental organisations (NGOs) have been asked to provide a range of health support.  Malaria Consortium has risen to this challenge with its team of 80 staff based in four offices located in Juba, Aweil, Bentiu, and Malakal.  Malaria Consortium has been providing support to Southern Sudan since before the signing of the CPA when the Ministry of Health was an exiled secretariat in Nairobi.  Since 2006 and the stabilisation of the security situation, Malaria Consortium has had a permanent staff presence based in Southern Sudan.

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Activities

• Service Delivery
• Health Workforce
• Information
• Medical Products, Vaccines and Technologies
• Financing
• Leadership and Governance

Malaria Consortium has provided assistance through two broad focus areas.  These include support for health systems strengthening and direct implementation support for communicable disease control services.

Malaria Consortium’s Health Systems Strengthening support is aligned closely to the World Health Organisation’s six health systems building blocks articulated in 2007.  Organisational support includes both high level technical support and contextually relevant hands on support for systems implementation.  Key achievements in each of the building blocks include the following:

Service Delivery:

• Technical support for the revision of the Basic Package of Health Services which guides the delivery of services in Southern Sudan
• Technical assistance to develop the Primary Health Care Unit and Primary Health Care Centre treatment guidelines
• Strengthening of support supervision structures for health workers to improve quality of care
• Implementation support for community fever management to improve case management for the most common childhood illnesses
• Support to the Director for Endemic Tropical Diseases to establish an integrated Neglected Tropical Disease Control Programme, including mass drug administration where indicated based on mapping data .

Health Workforce:

• Mapping of existing health staff by facility in three states.  This data was made available for the development of the MoH payroll
• Training of health workers to build capacity around case management
• Training of laboratory staff for improved diagnostic capacity

Information:

• Mapping of all health facilities in three states in Southern Sudan.  Prior to this the MoH had minimal knowledge of the quantity, location and capacity of its own health services. This data underpins meaningful health sector planning in Southern Sudan
• Mapping of neglected tropical diseases to target and inform mass drug administration activities  including schistosomiasis, lymphatic filariasis, soil transmitted helminths, and trachoma
• Support for the establishment of the Health Management Information system including revision, procurement and distribution of tools along with training

Medical Products, Vaccines and Technologies:

• Technical assistance to draft the essential medicines lists that are kept at community health centres
• Support to update and revise pharmaceutical supply lists based on health facility mapping data, ensuring equitable access to services

Financing:

• Participation in the Health Budget Sector Working Group meetings to plan the MoH annual budget
• Practical support to health sector planning, aiming for efficient use of MoH resources

Leadership and Governance:

• Supporting the MoH to write the Southern Sudan Malaria Strategic Plan
• Technical assistance provided by drafting the Southern Sudan Monitoring and Evaluation Framework which underpins the Health Management Information System
• Supporting the MoH to write a comprehensive review of neglected tropical diseases and their control in Southern Sudan
• Supporting the MoH to develop a Southern Sudan strategic plan for Neglected Tropical Disease control
• Developing an neglected tropical diseases mapping protocol;
• Malaria Consortium is the Secretariat for the Malaria Technical Working Group, which provides technical support to malaria control interventions in Southern Sudan
• Support to states and counties to improve coordination, identify priorities and establish work plans;
• Co-chairing of the NGO Health Forum to improve the coordination of service delivery in Southern Sudan.

Malaria Consortium has also assisted the MoH in the direct implementation of its Basic Package of Health Services.  Key achievements include:

1. The distribution of over 800,000 Long Lasting Insecticide Treated Nets in Southern Sudan providing evidence-based malaria prevention to roughly 1.6 million people for an average of about 3 years.
2. The establishment of Community Medicine Distributors to improve access and availability of treatment for the most common causes of childhood illness—malaria, pneumonia, and diarrhoea.
3. The improvement of Kala-Azar services at Malakal Teaching Hospital including improved stock management and training of ward staff to improve quality of care for patients.
4. The mass drug administration for neglected tropical diseases based on need as determined by risk mapping activities.

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Projects Currently Undertaken in Sudan

Project Title	Funding Organisation
Risk Mapping and Integrated Control of Neglected Tropical Diseases	USAID via RTI International
Comprehensive Control of Malaria in Southern Sudan	Global Fund Round 2 with UNDP as Principal Recipient
LLIN Distribution in Northern Bahr el Ghazal State	Global Fund Round 7 with PSI as the Principal Recipient
Improving Access to Life Saving Treatment Services for the three main causes of childhood mortality among under-served populations of Southern Sudan	UNICEF
Strengthening Systems and Building Capacity for Better Health Outcomes in Southern Sudan	DFID
Primary Health Care and Health Systems Strengthening Programme-Upper Nile	Basic Services Fund via Medair

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Country Progress

Much of Malaria Consortium’s long-lasting insecticidal net (LLIN) distribution activities have been focused in Northern Bahr-el Ghazal state.  In 2006, the Sudan Household Health Survey (SHHS 2006) showed that household availability of nets was 3.6% in the state.  Through its LLIN distribution program, the organisation is distributing LLINs to every household in the state, and will achieve universal LLIN coverage. In accordance with the GOSS MoH policy on LLIN distribution, each household receives one net for every two people and up to a maximum of three LLINs in any one household.   Malaria Consortium intends to continue LLIN distribution in other states as well, subject to funding availability, with the overall goal of achieving universal LLIN coverage across the whole Southern Sudan.  It provide health education at the distribution point for every household receiving LLINs to help ensure the nets are used properly and consistently.  A coverage/retention and use survey is currently underway to evaluate the effectiveness of the distributions.