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Sami S, Mayai A, Sheehy G, et al. Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan. Confl Health. 2020;14:34doi: 10.1186/s13031-020-00272-2.
Sami, S., Mayai, A., Sheehy, G., Lightman, N., Boerma, T., Wild, H., Tappis, H., Ochan, W., Wanyama, J., & Spiegel, P. (2020). Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan. Conflict and health, 1434. https://doi.org/10.1186/s13031-020-00272-2
Sami, Samira, et al. "Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan." Conflict and health vol. 14 (2020): 34. doi: https://doi.org/10.1186/s13031-020-00272-2
Sami S, Mayai A, Sheehy G, Lightman N, Boerma T, Wild H, Tappis H, Ochan W, Wanyama J, Spiegel P. Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan. Confl Health. 2020 May 27;14:34. doi: 10.1186/s13031-020-00272-2. eCollection 2020. PMID: 32514299; PMCID: PMC7254670.
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Confl Health. 2020 May 27;14:34. doi: 10.1186/s13031-020-00272-2. eCollection 2020.

Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan.

Conflict and health

Samira Sami, Augustino Mayai, Grace Sheehy, Nicole Lightman, Ties Boerma, Hannah Wild, Hannah Tappis, Wilfred Ochan, James Wanyama, Paul Spiegel

Affiliations

  1. Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
  2. University of Juba, and The Sudd Institute, Juba, South Sudan.
  3. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
  4. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
  5. Centre for Global Public Health, University of Manitoba, and Countdown to 2030 for Women's, Children's and Adolescents' Health, Winnipeg, Canada.
  6. Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305 USA.
  7. United Nations Population Fund South Sudan, Juba, South Sudan.

PMID: 32514299 PMCID: PMC7254670 DOI: 10.1186/s13031-020-00272-2

Abstract

BACKGROUND: Decades of war left the Republic of South Sudan with a fragile health system that has remained deprived of resources since the country's independence. We describe the coverage of interventions for women's and children's health in Upper Nile and Unity states, and explore factors that affected service provision during a protracted conflict.

METHODS: We conducted a case study using a desk review of publicly available literature since 2013 and a secondary analysis of intervention coverage and conflict-related events from 2010 to 2017. During June through September 2018, we conducted 26 qualitative interviews with technical leads and 9 focus groups among health workers working in women and children's health in Juba, Malakal, and Bentiu.

RESULTS: Coverage for antenatal care, institutional delivery, and childhood vaccines were low prior to the escalation of conflict in 2013, and the limited data indicate that coverage remained low through 2017. Key factors that determined the delivery of services for women and children in our study sites were government leadership, coordination of development and humanitarian efforts, and human resource capacity. Participants felt that national and local health officials had a limited role in the delivery of services, and financial tracking data showed that funding stagnated or declined for humanitarian health and development programming during 2013-2014. Although health services were concentrated in camp settings, the availability of healthcare providers was negatively impacted by the protracted nature of the conflict and insecurity in the region.

CONCLUSIONS: Health care for women and children should be prioritized during acute and protracted periods of conflict by strengthening surveillance systems, coordinating short and long term activities among humanitarian and development organizations, and building the capacity of national and local government officials to ensure sustainability.

© The Author(s) 2020.

Keywords: Child health; Conflict; Displaced populations; Health system; Maternal health; South Sudan

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

References

  1. BMJ Open. 2015 Dec 23;5(12):e009296 - PubMed
  2. Emerg Infect Dis. 2017 Nov;23(13): - PubMed

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