As South Sudan celebrates the first anniversary of its independence on July 9, the new nation is taking stock of what it has accomplished over the past year.
After suffering through civil war for most of its history (since before Sudan’s independence from the United Kingdom in 1956), South Sudan remains one of the world’s least developed nations. Part of this underdevelopment stems from the fact that South Sudan had an informal health system during the war, which was supplemented heavily by relief agencies. With a lack of skilled health professionals, vast distances between service delivery points, and a dearth of basic health education, the world’s newest country has some of the worst global health indicators, including one of the world’s highest rates of maternal mortality.
Overcoming the vast logistical, technical, political, and social roadblocks to improving health for the population of more than 10 million South Sudanese seems nearly insurmountable. Deficiencies in infrastructure, human resources, supply chains, pharmaceutical management, education, and health policies produce challenges and delays at every step.
In addition to health and development needs, South Sudan continues to be challenged by conflict, instability, and population movements, including refugees fleeing conflict in Sudan and the return from Sudan of more than 400,000 people of South Sudanese origin since October 2010. These conditions are taxing an already strained health system and exacerbating the existing deficiencies.
Despite these challenges, progress is being made. South Sudan’s child mortality rate dropped from 135 per 1,000 in 2006 to 106 per 1,000 in 2010. Infant mortality saw a similar decline from 102 per 1,000 in 2006 to 84 per 1,000 in 2010.
To sustain and expand these positive health trends, USAID is funding the Sudan Health Transformation Project, Phase II (SHTP II). Led by Management Sciences for Health, SHTP II is working closely with South Sudan’s Ministry of Health and local partners to improve access to and demand for health services, while building the skills and knowledge of South Sudanese health workers. One element of the project is the Leadership Development Program, which focuses on teaching health workers and managers how to identify challenges and seek solutions to overcome barriers to providing health services. The program teaches teams to look at areas where they are underperforming, and find ways to achieve measureable progress.
At a recent workshop, Marco Agor, who works in the County Health Department in Tonj South, Warrap state, praised the program, saying, “The Leadership Development Program is very important. In my office, we had a lot of organization problems. Those who had known Thiet in Tonj South before [the program] would say it is a different place. Now, Thiet is the best-run facility.” The program has been so successful in SHTP II-supported facilities that the Ministry of Health is now assessing its own operational challenges using the Leadership Development Program. The Ministry is also currently working to develop a strategy for training even more of the nation’s health workers in this leadership development program.