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IMPLEMENTATION OF NATIONAL DEVELOPMENT STRATEGIES; SUDAN PRESENTATION. بسم الله الرحمن الرحيم THE REPUBLIC OF SUDAN. ECOSOC MEETING, GENEVIA 6-10-2009. Outlines of the presentation. Sudan Background Key Features of HS in Sudan MDGs; indicators and efforts

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implementation of national development strategies sudan presentation

IMPLEMENTATION OF NATIONAL DEVELOPMENT STRATEGIES; SUDAN PRESENTATION

بسم الله الرحمن الرحيم

THE REPUBLIC OF SUDAN

ECOSOC MEETING, GENEVIA

6-10-2009

outlines of the presentation
Outlines of the presentation

Sudan Background

Key Features of HS in Sudan

MDGs; indicators and efforts

Main challenges and Recommendations

background
Background

Shares borders with

9 countries; free movement across most of these borders

Vast

country;

surface

area 2.5

million km²

background1
Background

40 millions population (2008 census), scattered scanty populated settings

Massive population movement and displacement (civil conflict, drought, desertification and major floods)

background2
Background

High adult illiteracy rate (mainly women)

Low population awareness on health issues

financing of the health system
Low public health spending;

13.5 US$/ capita (around 5% of government expenditure)

high out of pocket expenditure > 60%

Fragmentation (multiple providers e.g. MOH, Police, HI, ……………)

Financing of the health system
multiple actors partners
Multiple Actors/Partners
  • Heath Coordination Councils, at all levels of the health system, with adequate representation of all partners to oversee the development of health policies and strategies and monitor the implementation
human resources for health
Human resources for Health
  • 1.5 care providers/1000 population
  • Disproportional production of HRH (6 doctors to one nurse) with huge gap specially for AH W
  • High turnover (specially doctors)

source.; 10 year HRH Strategy

human resources for heath

Distribution of Doctors

Human resources for Heath
  • Marked inequality in distribution
coverage and accessibility to phc services
Wide disparities in geographic coverage with PHC unitsCoverage and accessibility to PHC services

Percentage of Pop. Living within 5 Km from the nearest functioning health facility, Mapping survey 2008

goal 1 eradicate extreme poverty and hunger
Goal 1:Eradicate Extreme Poverty and Hunger

Target 2: Reduce by half the proportion of people who suffer from hunger

Indicator 4: Prevalence of Underweight Children Under Five Years of Age (UNICEF)

goal 2 achieve universal primary education
Goal 2: Achieve Universal Primary Education

Target 3: Ensure that all boys and girls complete a full course of primary schooling

goal 3 promote gender equality and empower women
Goal 3:Promote Gender Equality and Empower Women

Target 4: Eliminate gender disparity in primary and secondary education preferably by 2005, and at all levels by 2015

Indicator 9: Ratio of Girls to Boys in Primary, Secondary, and Tertiary Education

goal 6 combat hiv aids malaria and other diseases
Goal 6. Combat HIV/AIDS, Malaria and Other Diseases

Target 8: Halt and begin to reverse the incidence of malaria and other major diseases

goal 7 ensure environmental sustainability
Goal 7: Ensure Environmental Sustainability

Target 10: Reduce by half the proportion of people without sustainable access to safe drinking water

goal 4 reduce child mortality
Goal 4:Reduce Child Mortality

Target 5: Reduce by two thirds the mortality rate among children under five

Indicators 13, 14: Infant &Under-Five Mortality Rate

goal 5 improve maternal health
Goal 5:Improve Maternal Health

Target 6: Reduce by three quarters the maternal mortality ratio

Indicators;

16: Maternal Mortality Ratio

17: Proportion of Births Attended by Skilled Health Personnel

19c: contraceptive prevalence

efforts and opportunities policies
Efforts and opportunities; Policies
  • National Health, RH and Child health policies
  • Making life-saving care free:
      • Declaration of free treatment for U5s, CSs and delivery care
  • Revision of the midwifery curriculum toward SBA
    • 2 pathways identified
      • Midwifery technician (2 years)
      • BSC midwifery curriculum (4 years
      • Gradual phasing out of old VMW curriculum in order not to affect coverage
efforts and opportunities plans and strategies
Efforts and opportunities; Plans and strategies
  • Road Map for Maternal and Child mortality reduction
    • Keys steps undertaken for operationalization -detailing, costing and implementing the Road Map
  • RH Communication strategy to guide all partners in implementing community interventions
efforts and opportunities plans and strategies1
Efforts and opportunities; Plans and strategies

Expanding access to effective child and maternity care

expanding access to effective child and maternity care
Expanding access to effective child and maternity care
  • ACSI Jump and pulse campaigns; Start in 15 States targeting 3.7 million U5s (Measles Vaccine, Polio Vaccine, Vitamin A, Iodine Tablets, De-worming, ITN and Health education massages
  • Introduction of Penta-vaccine (DPT+HepB+Hib vaccine)
rehabilitation of hospitals and hcs project

Expanding access to effective child and maternity care

Rehabilitation of Hospitals and HCs Project
  • Supporting 210 Hospitals and HCs with Furniture and essential equipment
expanding access to effective child and maternity care1
Expanding access to effective child and maternity care

Rehabilitation of Hospitals and HCs Project

expanding access to effective child and maternity care2
Expanding access to effective child and maternity care
  • Central ambulance project; phase 1 (115 ambulances)
slide45

Increasing Political Commitment to Maternal and Child Health-Higher Council for Child and Maternal Mortality Reduction

Ministerial decree

All partners in Health

State level councils -Wali decree (5 States)

attracting external resources
Attracting External Resources

UN agencies; WHO, UNFPA, UNICEF

GAVI Alliance

HMN

MDTF

GFATM

IDB

Bilateral relations; Chinese, Turkish and Japanese support

More coordination and focus on Health System issues is needed

improving quality of services through child and maternal death reviews
Improving Quality of Services through Child and maternal death reviews

Recommendation of the Maternal Mortality Reduction workshop – February 2007

slide49

Mg SO4 and Hydralazine for severe pre-eclampsia and eclampsia

Misoprostol for PPH

Improvements in Blood Bank Services

The use of thrombo-prophylaxis

Audit meetings and quality control

Measures Taken to Reduce MMR in OMH:

slide51

Effective interventions existThey need to reach more people…..

As we count down to 2015,

slide52

we need to strengthen health systems by unlocking the talent and resources that should be available to all mothers and children….

In this forum, you are that talent….

Use your talent & knowledge to improve the quality of care that mothers and children receive

By doing this, at the very least, you will honour those of Sudan who died earlier than they should have

thank you

Thank you

THE REPUBLIC OF SUDAN

ECOSOC MEETING, GENEVIA

6-10-2009

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