IFGH 2012: Beyond a Human Resources Crisis: The Quality of Health Services in South Sudan

Authors:Lako RL.^1,2, Muja L.², Velerinio L.²

Author Affiliations:¹Field Epidemiology and Laboratory Training Program Alumni , ²Ministry of Health, Republic of Southern Sudan

Option 2– Lessons from the field; project and programme evaluations; and syntheses or analyses

Presented as – Oral Presentation

Aims:

South Sudan is an independent country since June 2011 and very little data is available on health services and their quality. With increasing demand for effective and high quality health care an assessment of the existing quality of health services was needed.

Methods:

A health facility survey was conducted in 10 states of South Sudan from February to May, 2011 by a team of health researchers from the Ministry of Health. Lots Quality Assurance Sampling methods were used to sample 156 facilities.

Results:

In general, the quality of health services available in the health facilities is low. Some of this can be attributed to the shortage of health workers in general (15% of facilities met the minimum standard for the number of qualified health workers), but other main contributors are:

• Infrastructural (e.g. 4% of facilities have adequate requirements for infection control and 33% had a working refrigerator).
• Inadequate information systems (e.g. 18% of facilities had complete registers for IMCI information).
• Poor utilization of available services (e.g. 16% of facilities see the number of ANC consultations appropriate for their catchment area).
• Skills and knowledge of the available health workers (23% of facilities had appropriate prescribing practices).

Efforts to improve the situation are ongoing. 72% of health workers receiving some training in the previous year in maternal or child health, and 83% being supervised in the previous 6 months.

Conclusions:

Despite regular drug deliveries, and high levels of training and supervision overall quality of health services in South Sudan remains poor. Short term solutions include supplying some low-cost equipment, guidelines, and improving record-keeping for registers and stock control. In-service IMCI training could also improve the existing health worker performance. However, the lack of human resources requires a longer term solution alongside more general health systems strengthening.