Article by Dr Humphrey Karamagi, WHO Representative to South Sudan
Juba – As we imprint World Successfully being Day 2025 under the theme “Healthy Beginnings, Hopeful Futures,” South Sudan stands at a defining moment in its pursuit of equitable health for all. Nowhere is the urgency extra evident than in the home of maternal and newborn health, where mortality rates live unacceptably high, and development is hindered by power procedure-level gaps.
The nation studies one among the best maternal mortality ratios globally, with 1,223 maternal deaths for every 100,000 live births. For newborns, the burden is equally extreme, with 40 deaths per 1,000 live births and a stillbirth price of 26 per 1,000. These outcomes are pushed by successfully-documented barriers equivalent to restricted gain correct of entry to to skilled care, low rates of facility-based entirely deliveries, insufficient emergency obstetric products and providers, and underutilization of reproductive health interventions.
No matter centered investments, skilled attendance at delivery stays low. Handiest 19 p.c of deliveries happen with a skilled scientific examiner, and excellent 3 p.c of amenities are equipped to set entire emergency obstetric and newborn care. Caesarean section coverage accounts for simplest 1 p.c of total anticipated births, which is a lot under the brink wished to take care of watch over problems and live maternal and neonatal deaths.
Though many females provoke care at some level of pregnancy, some distance fewer entire the entire continuum of well-known products and providers. In response to DHIS2 records from 2024, over 60 p.c of pregnant females attended a minimal of 1 antenatal care consult with, nonetheless not as a lot as half of executed four visits, and simplest 15 p.c reached the World Successfully being Organization-suggested eight contacts. This tumble-off continues along the maternal care pathway.
Fewer than half of of oldsters that started antenatal care delivered in health amenities, and excellent one in four moms and newborns got postnatal care inside two days. Alternatively, females who delivered in health amenities were a wonderful deal extra at risk of receive timely postnatal care, highlighting the protective set of institutional deliveries.
Encouragingly, antenatal attendance is strongly linked to early newborn interventions. Among infants born to females who accessed antenatal care, 97.6 p.c got the BCG vaccine. Starting up outcomes inside health amenities also replicate the affect of skilled care.
Are residing births accounted for 94 p.c of facility deliveries, and stillbirth and early neonatal mortality rates were substantially lower than national population estimates. Alternatively, preventable conditions equivalent to preterm delivery, neonatal sepsis, and delivery asphyxia live leading causes of problems. These are largely because of delayed or insufficient care, in particular in underserved rural areas.
These provider-level challenges are intently linked to broader health procedure constraints. Whereas coverage frameworks are in feature, implementation is often slowed by coordination complexities all over sectors. Successfully being financing continues to rely a wonderful deal on exterior enhance, highlighting the must enhance home useful resource mobilization. Gaps in the provision and distribution of skilled health group, in particular midwives and obstetricians, live a key deliver, alongside periodic stockouts of well-known maternal and newborn commodities. Furthermore, continued funding in health records techniques is wished to enhance timely decision-making and affords a clutch to records exercise all over all levels of care.
To tempo up development, the World Successfully being Organization calls for a renewed collective focal level on integrated maternal and newborn health.
Strengthening national ability for skilled delivery attendance, along side practising, deployment, and retention of midwives, improves coverage and supports safer deliveries. Expanding gain correct of entry to to entire emergency obstetric and neonatal care, alongside sensible referral techniques, will increase the flexibility to take care of watch over problems. Bettering the provision of maternal and newborn commodities and advancing the utilization of the health records procedure, in particular DHIS2, permits timely monitoring and extra intellectual planning. Institutionalizing the Maternal and Perinatal Death Surveillance and Response procedure enables for routine review of deaths and contributes to quality development. Further investments in maternal nutrition, training, and gender equity enhance long-timeframe outcomes. Increasing the provision and uptake of neatly-liked contraceptives helps lower unintended and high-risk pregnancies and improves reproductive health.
