Healthcare in South Sudan: A Fractured System

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SEATTLE, Washington — South Sudan is Africa’s youngest country and gained independence in 2011. Since gaining independence, South Sudan’s healthcare system has faced major challenges, ranging from adjusting to a new government to functioning through a time of civil conflict. The conflict has caused over four million people to be displaced from their homes, creating even more obstacles in providing healthcare to South Sudan’s population of 11 million. Healthcare in South Sudan continues to be a growing concern.

South Sudan’s Healthcare System

The World Bank reported that in 2017, South Sudan had healthcare expenditure of $22.8 (USD) per capita. This is far lower than its neighboring countries of Sudan and Kenya that spend $193.7 and $76.6 (USD) respectively on healthcare per capita. South Sudan has one of the lowest healthcare budgets in the world. The World Bank attributes the low investment in crucial sectors like healthcare to the fact that much of the governmental funds go toward security and defense sectors.

Due to the lack of financial support from the South Sudanese government, international organizations have become the major providers of healthcare in South Sudan. Only 20% of healthcare in South Sudan is run by local providers.

The South Sudanese population has very limited access to healthcare facilities, with only 44% of the population living within a one-hour walk of a medical center. This adds an extra burden on those in need of medical attention as the majority of the population has to walk for an extended time to reach a medical center. During a time of civil unrest, traveling for an extended period comes with increased exposure to the risk of ambushes and looting.

Another major challenge outlined by the United Nations Children Fund (UNICEF) is that South Sudan has poor road infrastructure, resulting in the need for costly charter flights to transport medical supplies to many areas of the country.

The U.N. emergency aid coordination body, OCHA, reports that South Sudan has 1,900 medical centers as of 2017. However, only 400 of these centers are fully operational. Many of the healthcare facilities throughout South Sudan experience shortages in trained staff and supplies, making it difficult to provide treatment to the patients that make it to the facility.

The Health Challenges in South Sudan

The limited access to healthcare facilities and medical supplies in South Sudan results in a high number of preventable deaths. Among the top causes of preventable deaths are severe malnutrition and maternal mortality. Additionally, there are high rates of tuberculosis, HIV/AIDS, malaria and diarrheal diseases in the country.

Access to maternal healthcare is very low for South Sudanese women. UNICEF reports that more than 92% of births occur without the presence of a skilled professional. This contributes to South Sudan having the fifth highest maternal mortality in the world. In 2015, South Sudan’s mortality rate was reported to be 759 deaths per 100,000 births. Preventable diseases like malaria, pneumonia and diarrhea cause 75% of child deaths.

South Sudan has faced serious malaria outbreaks over recent years. In 2017, the World Health Organization estimated there were 1.3 million cases of malaria in South Sudan. The World Health Organization also cited that those displaced due to the civil unrest were among those most likely to be infected.  Between 2016 and 2017, 20,000 reported cases of cholera added additional strain to South Sudan’s already fractured healthcare system.

Improvements in South Sudan’s Healthcare

International organizations have intervened to provide healthcare to the South Sudanese population. In the early months of 2020, UNICEF provided health consultations to over 285,000 people. During these consultations, UNICEF healthcare workers were able to provide treatment for many malaria, diarrhea and respiratory infection cases. UNICEF also provided over 7,000 families with mosquito nets to help protect the population against malaria infections.

From 2007 to 2017, there has been a decrease in South Sudan’s mortality rate according to the World Bank. Over the 10 years, the mortality rate per 100,00 births decreased from 1,330 to 1,150. Although improvement has been slow, it shows that healthcare is improving in South Sudan.

It is important to highlight how dependent on foreign aid war-torn countries like South Sudan are. Without the intervention of international organizations, South Sudan would only have 380 medical facilities for a population of 11 million people spanning across 249 square miles. Currently, the U.S. uses less than 1% of its annual budget for foreign aid. It is imperative to promote foreign aid to improve healthcare in South Sudan and other countries in similar positions.

– Laura Embry

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