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South Sudan: How to provide maternal and child health care during crisis

A nurse assessing a sick child in Kapoeta Primary Health Care Centre, South Sudan (Credit: Emmanuel Kenyi/Save the Children)

After South Sudan gained its independence from Sudan in 2011, the world’s youngest country has found it difficult to build a stable nation and a functional health system, leaving many mothers at risk for dying during pregnancy and children at risk for preventable diseases such as malaria and diarrhea.

Donors, stretched with the task of meeting humanitarian needs across the globe – from Yemen and Syria to northern Nigeria – are finding it difficult to fund the crisis in South Sudan. With less funding available to support the fallout of a “forgotten crisis,” mothers and their infants are greatly affected as a result.

“The current appeal is only 40 percent funded, and that’s why we continue to have high rates of child and infant mortality and maternal mortality among the South Sudanese population,” Bester Mulauzi, Save the Children’s program management specialist in South Sudan, told Humanosphere in today’s podcast.

“Donor prioritization, and the fact that a lot of traditional donors’ funding streams have greatly been reduced has affected South Sudan,” he said, arguing that the protracted nature of the conflict has also resulted in “donor fatigue.”

Credit: Emmanuel Kenyi/Save the Children

Bester Mulauzi, director of program management and strategy at Save the Children. Credit: Emmanuel Kenyi/Save the Children

Since independence, a power struggle between President Salva Kiir and his former deputy Riek Machar has plunged the South back into war. So far the conflict has internally displaced over 2 million people and has led to more than a million refugees fleeing to nearby countries such as Uganda, Ethiopia and Kenya.

A recent U.N. human rights report in South Sudan claimed that ethnic cleansing was occurring, involving massacres, starvation, gang rape and the destruction of villages. Kiir rejected the findings.

The war is exacerbating an already chronic health crisis caused by decades of civil war with the north, which destroyed the health system, leaving many without access to care.

Prior to the recent conflict, health care was extremely difficult to access in South Sudan, with an estimated 0.15 doctors per 10,000 patients and 0.2 midwives and nurses per 10,000 people. As of September 2015, 55 percent of the health facilities across the country were no longer functioning, further complicating the delivery of humanitarian aid and health care.

With more than 789 maternal deaths per 100,000 live births, South Sudan has one of the highest maternal mortality rates in the world. Due in part to the high fertility rate, each mother has a one in seven chance of dying in childbirth during her lifetime. And babies are at even greater risk; 25 percent die from common, often preventable illnesses before they reach their fifth birthday. Due to lack of access, it is often near impossible to ensure continued care for mothers and their newborns.

Faced with a failing health system, the Save the Children South Sudan project works with community health workers to plug gaps in health-care coverage.

“We strengthen and form linkages between home health promoters and community based antenatal care and post-natal care as well as outreach immunization services in the communities that we support,” said Mulauzi.

Mulauzi is an experienced humanitarian and development practitioner specialized in program design and quality. He is currently working for Save the Children’s South Sudan country program as the international director of program development and strategy. Muluazi’s career has been dedicated to designing and managing quality and impact of NGO’s work, having worked for several international NGOs and multilateral organizations in Malawi, Sierra Leone and South Sudan over the past 10 years.

Before the chat, producer Imana Gunawan and chief-in-editor Tom Paulson talk about the recent headlines, including a Kenyan mobile money transfer app that can help lift some people out of poverty; Peru’s efforts to reduce discrimination toward indigenous groups; and the link between a Rohingya insurgent group in Myanmar with Saudi Arabia and Pakistan.

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About Author

Charlie Ensor

Charlie Ensor is a Nairobi-based freelance journalist, focusing on refugee rights, development and humanitarian crises in East Africa. His work has also featured on the Guardian and WhyDev; he also writes his own blog on development and aid issues. Charlie tweets @charlieensor, and you can contact him at