Health Sector. Sudan. bulletin. WHO presents health and nutrition needs at Darfur Donor Conference

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1 DOHA DONOR CONFERENCE 1 January April 2013 Volume 2, Issue 1 HEALTH SECTOR REVIEW..2 UPDATE FROM JEBEL MOON 5 Sudan Health Sector bulletin A Q U A R T E R L Y B U L L E T I N O F S U D A N S H E A L T H S E C T O R WHO presents health and nutrition needs at Darfur Donor Conference Darfur needs 150 million US$ in next 2-3 years to ensure provision of health and nutrition services to 3.4 million affected people said World Health Organization at International Donor Conference for Darfur held in Doha. Rehabilitation of existing health facilities, increase and training of health workforce and improving supply systems are some of key priorities in this region of Sudan with poorest health indicators. Additional 105 US$ million will be needed to sustain health and nutrition coverage in next 15 years through improved surveillance and overall rebuilding of health system. Today low coverage, inadequate provision of the essential health care and limited accessibility characterize Darfur s health system. Most of the primary healthcare facilities lack the minimum appropriate medical equipment and adequate infrastructure The Doha conference brings together Darfur and Sudanese authorities and international donors and partners, to discuss needs for economic recovery, development and poverty eradication in the aftermath of the conflict in Darfur. WHO and health partners work in Darfur since the beginning of conflict to provide basic health services and supplies and to monitor and respond to epidemics and other public health emergencies.

2 Sudan health sector meets to review issues and challenges in 2012 Some 50 health partners in Sudan gathered on 6 and 7 February at Corinthia Hotel in Khartoum to share experiences in the implementation of health cluster approach, as well as identify weaknesses in operational framework at the national and state levels. The two-day review meeting was geared towards strengthening networks and partnerships among national and international organizations working in health, along with Sudan s Federal and State Ministries of Health. Issues affecting health service delivery such as coordination and information, needs assessment, strategy development and planning, capacity building, monitoring and reporting, as well as resource mobilization were discussed and reviewed, while recommendations were drafted to improve operations of the health sector at both country and state levels. Sudan s Federal Ministry of Health Undersecretary Dr Ismaeldin Mohamed Abdalla highlighted FMoH s satisfaction over the sector s performance in He emphasized the importance of coordination among organizations working on ground to ensure delivery of health services particularly to vulnerable communities. Dr Anshu Banerjee, the World Health Organization s Representative in Sudan said, Reviewing sector performance and functions at the national and state levels in both sudden onset and protracted crises is necessary to ensure that the sector is efficient, has effective coordination mechanisms, fulfilling core functions, meeting the needs of its members, and supporting delivery to affected people. Dr. Banerjee added that the transformative agenda also focuses on three key areas: leadership, coordination and accountability. The health sector approach has been in operation since 2005, and was rolled-out in Sudan only in It gives opportunity to enhance coordination, effectively mobilize resources, and share information among partners. 2

3 Sudan renews commitment in the fight against tuberculosis Thousands gathered on the 24 March 2013 at the Friendship Hall in Khartoum to celebrate World TB Day. Led by the Sudanese TB Patients' Association, 25 community-based organizations, including the women's union, youth organizations, student organizations, the scouts, and representatives from the Sudanese army and police, marched along Nile Street carrying flags and placards with TB-related messages while chanting and singing songs about TB. The Government of Sudan fully supports the fight against tuberculosis, Sudan's Vice- President AlHaj Adam said during the gathering. We recognize the importance of strong partnerships with various organizations and agencies, both in the public and private sectors, to achieve our goal of making Sudan TB-free, the Vice-President added. TB is not a shameful disease and everyone has to be reminded that it is curable, Dr Isameldin Mohammed Abdalla, Under-Secretary of the Federal Ministry of Health, said during the celebration and he called on each and every Sudanese person to take part in their own little way to stop the stigma. Social stigma has been one of the hurdles in TB prevention in Sudan. Dr Anshu Banerjee, WHO Representative in Sudan, emphasized the hard work, commitment and dedication of health workers, TB programme staff and their partners, from far-off villages in Darfur to the crowded city in Khartoum, saying In Sudan, innovative partnerships have been developed between the public and private sectors, as well as with civil society, TB-affected communities, donors, business and the media. This year s World TB Day is commemorated with the slogan Stop TB in My Lifetime. The message conveys both the urgency of the fight against TB, and the goal of reaching the 2015 target of the United Nations Millennium Development Goals and the targets set by the global Stop TB Partnership. 3

4 The Women s Empowerment and Development Conference organised by GOAL and Ministry of Welfare and Social Security from March with active engagement of National and International NGO s, Government Ministries, UN agencies, Research Institutions and the Micro-Finance Sector The conference brought together over 130 different actors, including the grassroots in the different States. They discussed and identified the main problems, needs and gaps in different sectors and made collective plans to address these, considering lessons learnt from the best practices identified. Critical Health Gaps in South Darfur The closure of two health facilities, supported by Saudi Red Crescent Authority, during first quarter in Elsalam and Ottash IDP camp in South Darfur have put additional burden on other existing health facilities in these camps. Only one health facilitiy run by International Medical Corps (IMC) is covering the needs of IDPs in Elsalam Camp and has doubled its caseload. Although the health clinic in Ottash camp is taken over by Sudanese Red Crescent Society, it needs additional resources to maintain quality of basic health care. The Johanniter International Assistance (JIA) have also withdrawn support to 66 health staff on secondment in 11 health facilities in Edulfarsan, Katilla and Kubum localities of South Darfur. The move will negatively affect the provision of basic health care. The health sector lead is coordinating with ministry of health and health partners to address the critical gaps. Maternal and Infants Health Care Network project The project, executed by Al Bir & Al Tawasul organization (BTO) and supported by the Chinese Foundation for Poverty Alleviation (CFPA), started in July and ended in December Executed in Abuashar hospital and 16 villages in the locality the project aimed to reduce risk of pregnancy and improve survival status, through establishment of a health care network, provision of qualified health services and increasing health awareness. In-site training was conducted in 16 villages and community schools are formed in the targeted villages. 20 village midwives have been trained and the health awareness of the pregnant women improved. An information system was built and reports were kept for the follow up of the pregnancy of the targeted women. 4

5 Concern Worldwide: Health Situation in Jabel Moon Access to basic health services continues to be one of the challenges for the conflict affected communities in West Darfur. Limited capacities in localities like jebel moon have left West-Darfur with low health care coverage compared to the other Darfur states. In localities such as Seleia, health care coverage has been reported to be 54%, when over 40% of the population live in camps where communities live in congested setup, poor sanitary and waste disposal practices. The reproductive health is particularly in a poor condition where in Seleia, reports between January and December 2012 indicated that 8% of total births are still births, while Sudan infant mortality rate was reported at deaths /1000 live births. The neonatal mortality rates in Concern s areas of operation in Seleia/ Kulbus are higher than the national average, due to the fact that most deliveries are conducted by unskilled birth attendants (48.5%) or women delivering on their own (51.5%), leaving both mothers and babies at risk of sepsis and increased mortality. MoH and Concern health programme in Jebel Moon locality provides basic services to 31,458 individuals 11,609 of whom are IDPs and 6,000 returnees. Due to the cost of seeking primary health care support, most communities seek help from traditional healers, which can provide some support for basic ailments but are not qualified to provide medical advice for more complicated illnesses. During periods of prolonged illness people revert to assets selling to help support their families. During this period, when they are unable to cultivate, highly needed resources are sold to pay traditional healers and pharmacists for medicine. Poor health seeking behavior by the communities in Seleia was also evidenced by the fact that of the children reported to have been ill (n=832), only 65% were taken to a health facility for treatment, respectively. The remaining 35% of sampled children did not receive any treatment. The most common of these are malaria and diarrhea and what those who were interviewed described as the cough covers a variety of respiratory disorders including bronchitis and pneumonia. Concern supported health activities in priority areas: Support the operation of mobile clinics at least once a week for three villages in Seleia area in collaboration with SMoH, using Seleia clinic as a base and Rongataz IDP camp in collaboration with our partner SOHA. Strengthen the outreach and community sensitization component of the programme through the delivery of health, nutrition and hygiene messages during home visits, in line with Concern s community mobilization strategy. Support five trained village midwives in the provision of basic reproductive health services at village level, through the provision of essential equipment and supplies. Provide support to SOHA (NNGO) through the payment of incentives to their staff working in Rongataz PHCU. Support the operation of mobile clinics at least once a week for three villages in Seleia area in collaboration with SMoH, using Seleia clinic as a base and Rongataz IDP camp in collaboration with our partner SOHA. Support routine immunization services within the clinic as well as supporting the state run campaigns. Organize focused refresher trainings for technical staff including IMCI, Management of STIs using the syndromic approach, EMOC, Drug and Supply Management and Safe motherhood. Concern s is applying an integrated program approaches to maximize the benefit for the extreme poor in the operational areas through focusing on Food, Income and markets, Health & Nutrition, Water, Sanitation and hygiene promotion services, working with IDPs, returnees, host and rural communities. 5

6 Reflecting and Learning, World Vision responds to Outbreak of Yellow Fever in South Darfur state World Vision Sudan in collaboration with Ministry of Health (MoH), World Health Organization (WHO), Humanitarian Affairs Commission (HAC) and other partners responded to outbreak of Yellow Fever in Darfur which started in September The overall goal of the response was to contribute to reduction of excess morbidity and mortality related to the outbreak of hemorrhagic fever caused by Yellow Fever virus. With support from World Vision International and the Government of Germany, a total of 338,861 vulnerable population in Mershing, Nyala North Alwehda, Nitega and Ed Al Fursan localities were reached with vector control interventions and health education messaging while 330,388 Internally Displaced Persons (29% of whom were children aged below 15 years) in Otash, Derage, Al salaam, Al Sereif and Kalma camps were vaccinated against yellow fever during the phase II vaccination campaign. World Vision staff, being a valuable asset to the organization, their safety was also a key component of the response. A total of 531 staff benefited from a staff care package inclusive of fact sharing staff sessions on yellow fever, emergency vaccination, vector control at WV premises and staff capacity building including Psychological First Aid (PFA) skills. Five months into the response, World Vision Sudan as a learning organization has undertaken a Lessons Learned process to reflect on the project outcomes as well as how the Humanitarian Accountability Principles were mainstreamed during the Yellow Fever response in South Darfur. Feedback was sourced internally from World Vision staff as well as externally from key partners including MoH, WHO, HAC and the targeted community members (specifically women, men, girls and boys aged 8 15 years). only men and sheikhs of the community met and discussed with WV and they did not share any information with us women but we are the most vulnerable. in community sensitization during the initial period of the outbreak. Some of the key lessons observed during the reflection process include the need to strengthen preparedness and early warning systems as well as work with communities to establish community based Disaster Risk Reduction. Accountability towards the community should be strengthened by involving women and children more, in the process of information sharing and consultation. Delay in the acquisition of the vaccines which resulted in panic, anxiety and fear among both WV staff and communities. I am so pleased with WV s work performance and the support that was given to SMOH Darfur, Partner Key good practices highlighted during the reflection process include timeliness and management of the response ( WV responded as soon as they received the SMoH plan to respond ), good collaboration with partners, WV s competence and organization during the response, comprehensive care for WV staff, community information dissemination through mass media and awareness campaigns; the community s reliance on health educators trained by various NGOs The good practices and lessons observed from this Yellow fever response will be intentionally utilized to improve future humanitarian responses as well as enforce World Vision s accountability to key partners and beneficiaries we serve. 8 year old Mohammed from Otash camp in South Darfur illustrates his experience with Yellow Fever during Focus Group Discussion, March

7 UNFPA Needs Assessment Mission to East Darfur During the period from 24 th through 31 st of March, UNFPA conducted a mission to Eldain of East Darfur with the purpose of identifying the needs and figuring the gaps in the area of reproductive health and gender based violence. The mission met with HAC, DG of the state ministry of health and the reproductive health coordinator. The major recommendations made by the mission as per the findings were: 1. Strengthening the health information system by training RH staff on health information system management and provision of IT equipment and supplies. 2. Conduct a TOT training on CMR for assistant health visitors, to meet the need for ongoing capacity building for health care providers in the state. 3. Assist the RH department and Aldaein teaching hospital to establish a confidential area within Aldaein teaching hospital. 4. To support reproductive health coordination meeting. 5. Expand the capacity of Aldaein hospital to accommodate more students (rehabilitate 2 more rooms) 6. Establishment of training & meeting room within Aldaein midwifery school to be used for trainings and coordination meeting. 7. Rehabilitate two rooms in Aldaein midwifery school to secure all training chances provided by Federal MOH and partners. 8. Support the RH department in East Darfur state to celebrate the international midwifery day. 9. Provision of IEC materials and awareness raising activities on RH/HIV issues.. Management of Projects in Emergency Training for HWP 2013 NGOs Feb & March, The health sector organized a training course on Management of projects in emergency settings, targeting 25 participants representing the sector partners, National and International organizations. During HWP planning cycle, the sector identified the need to support sector partners in proposal writing, programmatic and financial reporting, particularly concerning the Common Humanitarian Fund (CHF). Therefore, the training has been specifically tailored to cover CHF funding cycle, from needs analysis through grant writing and reporting. National organizations were the main focus of the training. However, few International actors have also participated with the aim to facilitate experience sharing and strengthen networking among partners. Sudan Health Sector Khartoum, Sudan Dr Jamshed Tanoli Sudan Health Sector Coordinator tanolij@sud.emro.who.int health@sud.emro.who.int 7