A Community Health Worker examines a pregnant woman in a health clinic, South Kordofan State, Sudan. Photo credit: Save the Children

The outbreak of conflict in the South Kordofan region of Sudan in 2011 has had a huge impact on the state’s health facilities, especially in the rural areas. Facilities are operating under few number of skilled health staff and some areas are left with no permanent staff to be run by volunteers.

Save the Children has been helping to rebuild the health system in this region by supporting community health workers to treat childhood illnesses, provide immunisation and nutrition services, as well as disseminate health promotion messages.

To help train more health workers, Save the Children also started a rehabilitation programme in Al Fula Health Academy. The Academy lacked qualified tutors and a lot of the basic facilities. Due to the disrupted system the classes were overly occupied and exams were delayed.

Since the start of the programme, the Academy’s students have been frequently and passionately attending their classes and looking forward to the day of their graduation. According to 24-year old student El Haj “the situation was depressing, overcrowded class and infrequent lectures, I gave up and I thought I would never graduate and I was about to quit, but things changed now and for the better and positively impacted me and my colleagues”.
Between 250-350 students are now being admitted every year. In January 2013, 307 newly trained midwives, medical assistants, lab technicians, public health, nurses and pharmacists all graduated from AL Fula Health Academy and were immediately interviewed by the Ministry of Health to fill vacant posts.

Neonatal mortality rate  (per 1,000 live births) (2011) 31
Under-five mortality rate (per 1,000 live births) (2011) 86
Maternal mortality ratio (per 100,000 live births) (2010) 730
Number of doctors, nurses and midwives per 10,000 people (2010) 11.2
Births attended by skilled personnel (2011) n/a
Total expenditure on health as a percentage of gross domestic product (2011) 8.4%
General government expenditure on health as a percentage of total expenditure on health (2011) 28.4%

Although there is a National Insurance Scheme for public and formal sector employees in Sudan, user fees are charged for services, and out-of-pocket payments account for up to 70-80% of total health expenditure. Non-communicable diseases are the greatest health challenge at present, and there has been limited progress towards the health MDGs.

The availability of skilled health professionals is below the minimum international thresholds – but there is little data available on the accessibility and acceptability dimensions of the workforce. In terms of quality, there is evidence that, on the whole, mechanisms for accreditation of educational institutions and regulation and licensing of the workforce are in place and functioning. The recently developed HRH Plan (2012-2016) aims to address important aspects such as distribution, retention, quality and performance of the health workforce.

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