Sudan

Towards a baseline: Best estimates of social indicators for southern Sudan

Attachments

NEW SUDAN CENTRE FOR STATISTICS AND EVALUATION
IN ASSOCIATION WITH UNICEF
MAY 2004
NSCSE SERIES PAPER 1/2004

FOREWORD

On the threshold of peace, the people of the Sudan, particularly the war-affected communities, face formidable social problems but tremendous opportunities. The real test in the post-conflict period is how to devote our efforts to address these social problems as one of our commitments that we have set for ourselves during the liberation struggle and to join the international community in its war against poverty and deprivation.

An accurate description of the scale of these social problems - and the resources needed to tackle them - is a prerequisite for managing expectations and development in the post-conflict Sudan. Until now, we only knew we had a mountain to climb. This publication produced by the New Sudan Centre for Statistics and Evaluation, which I am delighted to recommend to you, gives us for the first time, a map of that mountain. Some of the statistics provided in this publication are appalling. Others merely confirm what we already suspected.

Children are always ill, with malaria and diarrhoea as their biggest killers. One out of every four newborns will die before reaching age five. Alarmingly one out of every five children suffers from moderate or severe wasting. More than one million kids, particularly girls, are out of school and only one out of every 50 children attending school finishes primary education, and this is even worse among girls. The chance of a woman dying in pregnancy or childbirth is one in nine.

These statistics clearly highlight the enormous social problems faced by the war-affected communities and pose real and strenuous challenges. Armed with credible and well-presented statistics and analysis, the SPLM and its partners in development look forward to an era of unprecedented progress and development for a brighter future. In addition we will scale up our support for capacity building in statistics in order to assess our efforts and commitments in addressing these social problems as well as knowing how far we have come and how far we have to go to meet the Millennium Development Goals.

Dr John Garang de Mabior
Chairman and C-in-C, SPLM/A

PREFACE

The New Sudan Centre for Statistics and Evaluation (NSCSE) was established by the SPLM in early 2003 with a mandate to develop the necessary capacity to become the professional source and effective provider of official statistical information for the SPLM-controlled areas. Its main aim is to facilitate the evidence-based decision making process in public and private sectors. With the positive momentum of the Sudan peace process, the demand for reliable baseline social indicators becomes increasingly important for the future government of Southern Sudan, government of National Unity, development partners, donors and civil society.

In the light of this potential demand for reliable baseline social indicators, the NSCSE with support from UNICEF Operation Lifeline Sudan undertook in October 2003 to review, evaluate and compile all existing data in order to refine baseline data on basic social indicators. This endeavor was also undertaken to clearly understand the situation we seek to address not only in post-conflict Southern Sudan but also in Sudan as a whole. The resulting data provided in this publication presents our best estimates and represent as well a statistical starting point for post-conflict Sudan, particularly Southern Sudan.

The objective of this publication is to present and evaluate existing information and data on as many social indicators as possible and if necessary, to make model-based assumptions about important missing indicators. Because many deductive estimates were necessary, this publication can be considered a scenario-based set of estimates. In cases where conflicting data exists, the reasons behind the choice of the preferred data are explained and discussed.

In addition to serving as a baseline for future planning and prioritizing, the data presented in this publication has been presented in such a way that it can also be used to evaluate the impact of one of the largest and longest ever humanitarian aid operations: Operation Lifeline Sudan (OLS). It also provides for the first time comparable estimates of social indicators for various regions of Sudan. It undoubtedly provides a basis for monitoring and setting realistic targets for achieving the Millennium Development Goals.

This publication reflects the cumulative and rich data collected by many organisations operating in Sudan and we have tried to acknowledge these sources throughout the document. As our potential client and future user of our products, it is to our best interest to serve you and we hope this publication goes some way toward satisfying your needs.

Dr Luka Biong Deng
Executive Director
New Sudan Centre for Statistics and Evaluation

EXECUTIVE SUMMARY

General Context:

1. Southern Sudan covers an area of about 640,000 square kilometers and includes stretches of tropical and equatorial forests, wetlands including the Sudd swamps, savannah and mountains. It is entirely within the Nile basin and shares borders with four countries. Southern Sudan is culturally, geographically and religiously diverse and well endowed with natural resources, including water, wildlife, forest, oil and minerals.

2. Since the independence of Sudan in 1956, southern Sudan has been a battleground for two civil wars (1955-1972, 1982-now) that resulted in egregious suffering, loss of life and opportunities, widespread poverty and food insecurity. This publication is the first attempt to assess in terms of social indicators the costs of civil war in the Sudan, particularly in southern Sudan, the most affected region of the country. The term SOSUS (Southern Sudan SPLM areas) is used in this document to refer to the part of southern Sudan controlled by the SPLM/A, excluding the three areas of Abyei, Nuba mountains and southern Blue Nile. The term SOSUS does not include data for Government of Sudan (GoS)-held areas in the south, particularly the "garrison towns". Use of the labels "northern Sudan" or "southern Sudan" as well as any other labels or boundaries do not imply acceptance or endorsement of any political position but simply reflect how the data were collected and organized for this exercise.

Population:

3. The population of SOSUS is estimated to be 7.5 million in 2003. This population is expected to grow by as much as 4.5 million in the next six years as a result of returnees coming back (both refugees and internally displaced people) and the high natural population growth (almost 3% a year). This will cause a major drain on resources.

4. The SOSUS population is the youngest in the world. At 21%, SOSUS equals the highest proportion of under fives of any country. SOSUS has a high fertility rate (the total fertility rate is at 6.7) and a high crude birth rate (50.5 per 1,000 people). However, SOSUS has a low proportion of adults in the population as a result of the civil war and famine.

Primary Education:

5. SOSUS children have the least access to primary education in the world. Its net enrolment ratio in primary school (20%) is the worst in the world and second to the latest official figures for Afghanistan in terms of gross enrolment ratio in primary school (23%). Equally SOSUS has the lowest ratio of female to male enrolment (35%). In other words, only one out of every five children of school age is in class and around three times more boys than girls are at school. .

6. In terms of primary school completion, SOSUS has the lowest rate worldwide (2%) while only Afghanistan under the Taliban performed worse in terms of female primary completion rate (0.8%) compared with male primary completion rate (3%). This suggests that only one out of every 50 children finishes primary school. With a population of 7.5 million, only 500 girls finish primary school each year while 2,000 boys finish. The share of cohort reaching grade 5 (28%) is the least in the world.

7. SOSUS is second only to Niger in terms of adult literacy rate (24%), adult female illiteracy rate (88%) and youth literacy rate (31%). This suggests that at least three out of every four adults are illiterate and about one of every ten female adults is literate.

8. The teacher-pupil ratio (one teacher for every 33 pupils) is better than other countries in the region but far less than that of the rest of Sudan. However, only 7% of the teachers are trained in the sense of having received at least one year of pre-service training. Of the 93% of teachers having received less than a year of training, half (50%) of teachers had no training at all and the other half have received from two weeks to a few months of in-service training. So the "teacher"-pupil ratio does not reflect this reality and may be misleading. To underscore discrimination against women, only 7% of the teachers are female.

9. Massive investment in the education system is needed in Southern Sudan. Only 1,600 schools exist for the 1.6 million children of school age, only 10% of the classrooms are in permanent buildings, 80% of the children have no bench to sit on and only one third of the schools have access to latrines and half have access to safe clean water.

Child and Maternal Mortality:

10. SOSUS has high rates of infant mortality (150 per 1000 live births), under five mortality (250 per 1,000) and under five deaths as a percentage of total deaths (57%). This means that one out of every four newborns will die in SOSUS before reaching the age of five. Children in SOSUS are three times more likely to die than those in the rest of the Sudan. However, these figures and many others in this publication would undoubtedly be even worse if it were not for the efforts of humanitarian agencies and particularly, the Operation Lifeline Sudan consortium.

11. The maternal mortality ratio in SOSUS (1,700) is almost three times that of the rest Sudan and the lifetime risk of dying in pregnancy or childbirth (one in nine) is among almost four times that of the rest of Sudan. This is a result of poor women's health coverage combined with high fertility. Contrary to demographic expectations and despite the impact of war on the male population, SOSUS is paradoxically witnessing a novel demographic phenomenon with more elderly men than women.

Child and Women's Health:

12. The prevalence of diarrhea among under fives in SOSUS (45%) is exceptionally high and the prevalence of acute respiratory infection (ARI) (30%) and fever (malaria) (61%) are the highest rates among the peer countries. Also the prevalence of malaria in SOSUS is almost four times higher than the level in the rest of Sudan. Children are always getting sick.

13. The percentage of pregnant women immunized against tetanus in SOSUS (16%) is the lowest in the world as is the proportion of one-year-old children immunized against DPT (18%) and TB (21%). The level of immunization against measles in SOSUS (25%) is among the lowest rates in the world and less than half of the level in the rest of Sudan (67%).

14. The proportion of births attended by skilled health staff in SOSUS (5%) is not only the lowest in the world but it is almost thirteen times less than the level in the rest of Sudan. Also the antenatal care coverage (16%) and contraceptive prevalence rate (<1%) in SOSUS are the lowest in the world. The maternal mortality rate is very high as a result. The limited access to health services is highlighted by the fact that there is one medical doctor for every 100,000 persons in SOSUS. Despite the absence of any public sector social programmes, Operation Lifeline Sudan (OLS) has booked successes in guaranteeing a minimum level of health services and the annual polio campaigns have produced very good coverage.

Water and Sanitation:

15. The level of access to an improved water source (27%) and sanitation facilities (16%) in SOSUS are low compared to the peer country groups and are respectively more than three and four times lower than the level of access in the rest of Sudan.

Nutrition:

16. The level of under five children suffering from wasting in SOSUS (21.5%) is the highest in the world and suggests that one out of every five children suffers from moderate or severe wasting. The prevalence of general malnutrition (48%) and severe malnutrition (21%) among the under-five children in SOSUS is almost three times higher than in the rest of Sudan.

17. About one third of the population does not even use salt at all, however of those who do, most use iodized salt, thanks to OLS. The overall level of consumption of iodized salt in SOSUS (40% of households) is still lower than in the surrounding countries, except Sudan.

18. The level of Vitamin A supplementation among children in SOSUS (16%) was amongst the worst in the world and almost six times lower than the level in the rest of Sudan. However, the inclusion of Vitamin A in the polio campaigns has improved the rate significantly.

Child Rights:

19. The proportion of children who work in their households in SOSUS (58%) is higher than in the neighboring countries and four times higher than the level in the rest of Sudan.

20. There is virtually no birth registration in SOSUS, this being just one example of the wholesale neglect of children's rights.

Economy:

21. The Gross National Income per capita in SOSUS is estimated to be less than $90 US per year and makes SOSUS alongside the poorest countries in the world. SOSUS income is about four times lower than the level of the rest of Sudan.

22. The proportion of the population earning less than one dollar a day in SOSUS is around 90%, putting SOSUS among the poorest regions in the world.

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