The Republic of South Sudan: The Sudan Household Health Survey 2010
This household and health survey studies the general well being of women and children in South Sudan. It aims to collect health and related indicators essential to identifying women and children’s health needs and for establishing priorities for evidence-based planning, decision-making and reporting. The sample, based on MICS4 (Multiple Indicator Cluster Survey 4) methodology, provides seemingly robust estimates of the selected health and social development indicators required for effective planning and management purposes.
The current report and the case it advances provides an overview of the information collected, which highlights the major health concerns and needs of women and children in South Sudan. This information is of profound importance in the setting of health service priorities designed to efficiently and effectively respond to the underlying population needs.
Due to paradigmatic shift in the 2010 study, findings from prior analyses may not be utilized as benchmark for assessing more recent health conditions of women and children in the area. Notably, South Sudan is just starting out on the long road towards building a functional health system following the decades of war. Progress will presumably come slowly, building on better systems of planning, measuring and monitoring, but also in the provision of quality health services, properly staffed, equipped and served with regular medication and supplies.
Present results are critically informative. The health services that people need are very limited. Based on the results, the health status of children is low; death rates among children and infants in South Sudan remain high by international standards. Malaria, pneumonia, and diarrheal diseases are prominent killers among children under the age of five. Malnutrition of children under-five years of age, in all its three manifestations (underweight, wasting and stunting) remains a major and serious challenge. Immunization coverage for under-five children is relatively low, with protection of women against tetanus remaining quite modest as well. Malaria, pneumonia, and diarrheal diseases are still prominent killers among children under the age of five.
Results confirm the urgent need to address the water and sanitation problems. Access to safe drinking water is still far from being universal, with very few households having water on their premises. A considerable proportion of the country’s households have to travel more than 30 minutes to get to the nearest site for safe drinking water. Besides, use of sanitary facilities is still very limited with a large proportion of household population using open air spaces to dispose of human wastes.
Women’s health is also a major cause for concern. Women of reproductive ages in South Sudan are exposed to high birth rates, raising concerns over maternal health. Early marriage, which is common in South Sudan, puts many young women at an elevated risk of maternal death. Contraceptive use is practically non-existent and majority of women have very limited access to basic healthcare services needed during pregnancy and after birth. More than 80 percent of deliveries occur at home and mostly at the hands of traditional birth attendants.
A significant number of women in South Sudan are in polygamous marriages, putting them at an increased risk of contracting sexually transmitted diseases. Fewer than 10 percent of those in polygamous marriages/unions model safe sex practices, including condom use. There is little knowledge of HIV/AIDS transmission among South Sudanese women, another key factor that may lead to risky sexual behaviors in the population.
The general level of education is low, with a literacy rate for men higher than for women. Primary school attendance remains very poor. Although people living in urban areas fare much better on most of the indicators than those living in rural areas, and wealthier families fare better than poorer families, overall, most indicators are generally poor. Moreover, gender and geographical disparities are evident, clearly demonstrating the importance of social and spatial phenomena in access to services in the nation.
Violence affects women worldwide and more so in South Sudan. A significant proportion or 79 percent of the respondents in this study expressed that it is right for husbands to beat their wives or partners for whatever reason deemed appropriate. Unlike children of living parents, orphaned children are least advantaged in access to health and educational services.
Overall, most indicators are generally poor. People living in urban areas fare much better on most of the indicators than those living in rural areas, and wealthier families fare better than poorer families, Moreover, gender and geographical disparities are evident, clearly demonstrating the importance of social and spatial phenomena in access to basic services in the nation.
Finally, although the study serves as an essential blueprint for future health and household studies in South Sudan, there remains a serious conundrum in a number of results. Some results seem to be inconsistent. This could presumably be associated with data quality. Future work should investigate this and related problems in the dataset in order to improve future related studies.