Increasing access to skilled birth attendance in the newest country of the world: The South Sudan experience


South Sudan has one the highest maternal mortality rates in the world, with more than 2,000 deaths per 100,000 live births.  Most women still give birth at home, and very few of those deliveries include skilled attendants. The lack of basic and emergency obstetric care is a major factor behind the high levels of maternal mortality and morbidity there.

But today, delivering a baby in Wau, South Sudan, is safer. Lokoloko Primary Health Care Clinic is one of the six primary health care centers in Wau County where JSI is working to improve access to obstetric care. It is part of the Basic Services Fund for Southern Sudan, a project funded by the UK Department for International Development (DFID). I visited in October, and was very pleased to see the dramatic advancements there.

Sumaya is having her second baby. The first one was delivered at a different health center. When we asked her permission to publish her picture, she said, “I would like all mothers to have their babies in clinics like this one.” The women around her are from left to right: the director of the center, community midwives, and the trained traditional birth attendant.

JSI launched the comprehensive maternal health intervention at Lokoloko in March. The work has allowed the clinic to be open 24 hours a day, while ensuring the staff are well-trained, that they provide client-friendly services, and that basic medical equipment, drugs, and contraceptives are available. In parallel, JSI worked with the village health committees around the clinic to educate them about the importance of women visiting the clinic for antenatal care, delivery, and postpartum services.

The clinic is now staffed with nurse midwives and community midwives who have been trained in Basic Emergency Obstetric Neonatal Care (BEmONC). Also, some of the traditional birth attendants (TBAs) from the nearby communities—the clinic’s catchment area—have been trained to promote healthy behaviors in their communities and encourage mothers to deliver at the clinic. In some cases, TBAs accompany women to the facility and assist clinic staff with the deliveries. Periodic supportive supervision visits and in-service refresher trainings ensure that quality is maintained and staff morale stays high. The new mothers stay with their babies at the clinic for 24 hours after delivery: The time is used to facilitate breastfeeding, help the new mother learn to care for her newborn, and to discuss healthy birth spacing options.

I am happy to say that the new service has been so well received that in the first six months of the program more than 200 women have chosen to give birth at the center, whereas none had delivered there before. Most of those mothers also had four or more antenatal visits at the clinic. The initiative is now being scaled-up to the 6 remaining clinics of the project catchment area where we are starting to see similarly encouraging results.

5 responses to “Increasing access to skilled birth attendance in the newest country of the world: The South Sudan experience”

  1. That is good news to hear Can you plan to do a presentation to the Reproductive Health Coordination Forum in Juba. Kindly get in touch so we can arrange the time and other details

  2. Hi Merce,
    It is amazing to make such a huge difference with a new initiative within a short period of time. Kudos to the Sudanese team and to all in JSI who made all the effort that resulted in this achievement.

  3. Hi Merce,
    Congratulations for such a wonderful job. I used to work in similar project in Bangladesh funded by Bill Gates foundation run by BRAC. I am so impressed by the positive outcome in such a short term implementation.

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