South Sudan

Improving maternal health in Jonglei State: new maternity ward established

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7 February 2013, South Sudan – Nine months after starting work on Bor State hospital, WHO has handed over a fully equipped maternity ward to Jonglei State health authorities. The new ward, built by WHO with funds from the Canadian International Development Agency (CIDA), is a 40-bed health facility with modern maternity equipment.

The ward comprises two operating theatres, labour suite, procedure room, emergency room, neonatal unit and eight cubicles each with four beds. Other facilities inside the ward include: a recovery room, sluice rooms, waste room, consultation rooms, doctor’s room, sterile equipment room, reception and nine wash rooms.

Comprehensive emergency, obstetric and neonatal care programme (CEmONC)

While handing over the maternity ward, WHO Representative for South Sudan Dr Abdi Aden Mohamed thanked CIDA for supporting the CEmONC programme in South Sudan. He informed the Jonglei state and Ministry of Health officials of WHO’s plans to construct similar maternity wards in seven other states. This means that women with obstetric complications would have increased access and utilization to CEmONC services. Dr Abdi thanked the government of Jonglei state for their support during the construction of the ward and further commended the Minister of Health Dr Michael Milly Hussein and the Under Secretary Dr Makur Kariom for their support and commitment towards the project from the time of its conception until the day of the handover. He congratulated the people of Jonglei state for acquiring the maternity ward and asked them to use the ward for its intended purpose and maintain it well.

CIDA support

He said that the ward would contribute to the reduction of maternal mortality indicators in the state and that WHO would support the state to construct a warehouse for the hospital. “In addition to the maternity ward, we have also secured support from CIDA to support professional development, as such, we have already sponsored two medical doctors for training specializing on gynaecology and obstetrics in Khartoum and Uganda,” said Dr Abdi, these will come back and support the ongoing programme in the State. WHO has also deployed three international staff members to mentor the national staff at the hospital, which include one obstetrics and gynaecologist, an anaesthesiologist and two UNV midwives.

His Excellency Mr Nick Coghan, the Canadian Ambassador, said that the Canadian Government had identified maternal and child health as a top priority and would focus on supporting South Sudan. He said that 75% of all maternal deaths are due to obstetric complications caused by five preventable causes. He, however, said that simple solutions could make a big difference and that many hospitals in South Sudan were ill prepared but with hard work and determination, South Sudan could make tremendous progress. Mr Coghan advised the state Ministry of Health and WHO to strengthen the project with outreach activities to communities and to provide information to women on the available services if the programme was to succeed.

While receiving the maternity ward, the State Minister of Health, H.E. Jehan Michak Deng, thanked CIDA for the financial support towards the construction of the ward. She also thanked the Ministry of Health for selecting Jonglei state to benefit from the CEmONC programme as this reflected on the vision for building the new South Sudan. She further thanked WHO for completing the construction of the ward and supporting the state hospital through building capacity of health professionals in Jonglei state, especially those working to save the lives of mothers and children.

Health workers praised

The Governor of Jonglei state, His Excellency Kuol Mayang Juuk, said that although the people of South Sudan had been politically liberated they had not been liberated from diseases. He commended the medical staff of Jonglei State Hospital for a job well done under difficult conditions. He thanked the Ministry of Health for supporting the state with capacity-building of medical staff and international development partners for supporting the construction of the maternity wing. “With this health facility, people of Jonglei will not send their wives to Uganda and Kenya for medical obstetric emergencies, we have qualified doctors and what we lacked were the facilities, now we have them,” said the Governor.

“This project started nine month ago. When I was invited to lay the foundation stone, I was hesitant but today, a few months later I am standing here launching and attending the handover of this ward that is also fully equipped”, said Dr Michael Hussein Milly, the Minister of Health. He added that the newly constructed maternity ward is the first state-of-the-art one in South Sudan. “This is the first of its kind and it’s in line with the health policy of South Sudan,” said Dr Michael. He further said that South Sudan wanted to be part of the global slogan that says “No woman should die while giving birth to life”. He advised health workers to ensure that the maternity ward was maintained, kept open and functional at all times. The Minister also advised health workers to create awareness among mothers as a way of encouraging them to come to the hospital instead of seeking services from traditional birth attendants. The CEmONC programme is being undertaken by WHO and the Ministry of Health to ensure the delivery and utilization of quality comprehensive emergency obstetrics and newborn care services in hospitals in South Sudan, a vital intervention towards accelerating maternal mortality reduction in the country. In 2010 alone, Bor hospital received between 60 to 70 pregnant women, who were admitted on a monthly basis due to obstetrics and pregnancy complications. About 52% were post-abortion cases while obstructed labour accounted for another 42%.

Caesarean section rates

WHO is supporting the programme because universally the accepted standard indicator of quantity of critical services as well a proxy indicator on accessibility is the caesarean section rate, where the acceptable threshold is that not less than 5% and not more than 15%, as a proportion of all births in the population are by caesarean section. In Jonglei state, the State Ministry of Health was supported by two international nongovernmental organizations (IMC for Akobo hospital and Merlin for Boma Hospital), before WHO started with the programme, 0 to 2 C-sections were performed per month in each health facility, according to information provided by an international nongovernmental organizations.

Bor hospital

To address delays that cause maternal and neonatal deaths, WHO has constructed a maternal waiting home, and equipped Bor hospital with technical, operational and organizational capacity to be fully prepared to receive and treat women with critical obstetrics complications. Bor hospital is now upgraded to fully function as a CEmONC centre so that emergency cases relating to pregnancy/delivery and child birth will be promptly and adequately attended to.

Bor hospital is a state referral hospital in Jongei state and serves over 1.3 million people within the state. The hospital offers both curative and preventive medical services and has a total of 7 Medical Officers and limited number of health workers. The state has no source of revenue and depends entirely on government (100%) for their budgetary needs. With the support from WHO, it is envisaged that reduction in the Maternal Mortality Rate will contribute to Millennium development Goals 4 and 5 which seeks to reduce child mortality rates and Improve maternal health respectively.