Health
Program Overview
The people of Southern Sudan and the Three Areas of Abyei, Blue Nile, and Southern Kordofan must overcome significant health challenges as the country recovers from decades of civil war and addresses historical underdevelopment. Childhood deaths due to infectious diseases are rampant. Maternal mortality rates are among the highest in the world due to a lack of access to skilled antenatal care. HIV/AIDS-already rampant in the region-has emerged as a significant threat due to high-risk practices and the dramatically increased flow of populations across Sudan's borders with nine neighboring countries.
As part of its effort to improve living conditions and broaden the benefits of peace under the 2005 Comprehensive Peace Agreement, USAID activities foster local capacity to sustainably address priority health threats, strengthen maternal and child health services, reduce the burden of infectious diseases and strengthen the systems that deliver health services. USAID efforts not only save lives, but also bolster public confidence in the ability of the Government of Southern Sudan (GOSS) at the regional, state and local levels.
Activities
Improving Maternal and Child Health
Southern Sudan has the highest maternal mortality ratio in the world-an estimated 1 in 50 live births. Infant mortality is also unacceptably high, at 1 in every 10 live births. This is largely attributable to low immunization rates for preventable diseases. USAID has expanded urgently needed services to nine county health zones, renovating health facilities and constructing boreholes and pit latrines. As a result, more than 2 million people in Southern Sudan have improved access to high-impact maternal, child, and family planning services.
Preventing and Controlling Infectious Disease
HIV/AIDS: The profile of HIV/AIDS in Southern Sudan exemplifies that of many countries in the region. With the end of the war, the population is more mobile, and truck drivers-among the groups most at risk from the virus-are again traversing Southern Sudan from and to neighboring countries. Internal commerce and cross-border trade have resumed. Many internally displaced persons are moving within Sudan to join their families or seek better economic opportunities. USAID and the Centers for Disease Control and Prevention collaborate to implement the President's Emergency Plan for AIDS Relief aimed at combating HIV/AIDS transmission and preventing the spread of a regional pandemic.
Tuberculosis: Tuberculosis (TB) is a major cause of morbidity and mortality in Southern Sudan. An estimated 18,500 people develop TB and 5,300 people die of the disease every year. USAID supports treatment of tuberculosis in more than 30 health facilities, with at least one unit in each of the 10 southern Sudanese states, and has achieved treatment success rates above 90 percent. In 2008, USAID supported the National TB Control Program to provide the most effective treatment-Directly Observed Treatment, Short-course (DOTS)-and with technical assistance for coordination, policy development, and lab renovation. USAID also supports other international partners, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
Malaria: Malaria is one of the leading causes of child and maternal death in Southern Sudan. As a key intervention, the GOSS, with support from USAID, established the National Malaria Control Program and developed a five-year National Roll Back Malaria strategic plan to reduce deaths from the disease by half within five years. The goal is to focus on high-risk groups, such as children, pregnant women, and internally displaced persons. USAID also helps combat malaria through a bed net distribution campaign, which successfully distributed approximately 200,000 nets in 2008. In USAID-supported health care facilities, malaria patients are assured proper diagnosis by trained clinicians and treatment with recommended artemisinin combination therapy. USAID technical assistance, including strengthening the GOSS malaria policy framework, helped the government secure a Global Fund grant of $74 million.
Polio: USAID supports polio eradication efforts and surveillance activities throughout Southern Sudan. In 2008, more than 2.8 million children were vaccinated against polio. USAID sponsors National Immunization Days across Southern Sudan, when children receive not only polio vaccine but also Vitamin A supplementation. This has resulted in over 90 percent coverage of children under the age of 5. USAID helped establish a polio surveillance system with field agents who have confirmed 56 cases of wild polio virus since June 2008.
Increasing Access to Clean Drinking Water and Sanitation
Just 48 percent of Southern Sudanese have access to potable water and only 7 percent have access to proper sanitation. The lack of clean water and sanitation coupled with poor hygiene practices continue to threaten the lives of Southern Sudanese, especially children, as well as livelihoods in both semi-urban and rural areas. In responding to the dire need for clean water in Southern Sudan's capital Juba, USAID has launched a fast-track intervention to market purification tablets, install water systems to prevent cholera outbreaks and promote better household hygiene. In four southern states and the Three Areas, USAID is working through partners to improve water supply and sanitation facilities through borehole drilling, hand pump repair and latrine construction along with hygiene promotion.
USAID works with government, local community-based organizations and the private sector to increase access to safe drinking water and sanitation with a special focus on promoting sustainability and ownership through community engagement. USAID funds community education and awareness programs to train water and sanitation community volunteers. USAID efforts over the next five years will increase access to potable water, sanitation and hygiene in Southern Sudan and the Three Areas, to help reduce death and disease.
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