Ministry of Health, - UNICEF

1 Ministry of health , Government of Southern SudanBasic Package of health and Nutrition ServicesFor Southern SudanFinal Draft January 2009 ACKNOWLEDGMENTThe review of Basic Package of health Services (BPHS) for Southern Sudan has been made possible through the combined efforts of many organizations and individuals. First and foremost, financial and technical assistance provided by International Bank for Reconstruction and Development the World Bank (WB). Let me take this early opportunity to express profound gratitude to the Dr. Nathan Atem, the Director General Primary health Care and his entire team for leading the review process that reqired much patience and concentration. Special thanks go Dr. Makur Kariom, the director Reproductive health (RH-PHC), Dr. Antony Lako, the Director Community Base health Care (CBHC-PHC), Dr.

2 Lueth Garang, the Director health Education and Promotion (HEP-PHC) for devoting time to make technical input in the document. I wish to specially mention Ms. Janet Michael, the Director General Nursing Services for her committed advocacy for maternal services within the BPHS, given the challenge of maternal mortality in Southern Sudan. Let me also take the opportunity to specially thank Dr. John Rumunu, the Director General, Preventive health and his entire team in setting the pace in linking the BPHS to the strategies for the common endemic infection programs and with him, Dr Thabo Othwonh, the Manager Malaria Program, Dr. Rober Azairwe, the Team Leader MSH and advisor Malaria Program, to the different directorates entire Southern Sudan health fraternity for the Nutrition and the Reproductive health Technical Working Groups their tireless efforts in reviewing and making most valuable technical contributions to the editing of this document.

3 The Ministry also recognizes contributions from Dr. Olivia Lomoro, the DG health Research, Policy, Planning and systems development, Dr. Richard Lagu, Dr. George Rae and the entire staff of the directorate. Other significant contributions came from Ms. Victoria Jaba Eluzai, Dr. Ayat Jervas, Mr, Samwel Makoy, Mr. Ali Ngor, Dr. Yatta Lugor and Dr. Stanley Ambajoro, MS. Bibian Alex Lotio, Catherine Jurua Otto and Rebbecca Alum WilliamSpecial thanks go to Dr. John Alwar for ensuring comprehensiveness and sound technical edit of the final version of this the document and to Dr. Chris Lewis, Tearfund, Ms. Marcie Cook, PSI and Dr. Tessa Matholie, Malaria Consortium who assisted with editing the second draft of the document. The Staff of Southern Sudan Offices of United Nations Fund for Population Activities (UNFPA), World health Organization (WHO), and the International Committee of the Red Cross (ICRC), Sudan health Transformation (SHTP), Management Sciences for health (MSH) and Help Age International, made specific inputs to ensure the document is in line with the Interim health Policy of Sothern Sudan and international state of the art practices in Primary health Care.

4 Thank you all. Dr. Majok Yak MajokThe Under Secretary, Ministry of health , Government of Southern Sudan2 ForewordFollowing the signing of the Comprehensive Peace Agreement (CPA) on January 9th, 2005, the SPLA/SPLM committed itself to establishing a right based approach to development facilitation. The interim Constitution Guarantees every Southern Sudanese the right optimal health . The Government of South Sudan (GoSS) has therefore developed a health policy founded on the Primary health Care (PHC) as the strategy to make quality health care universally accessible. This policy will form an integral part of the country's development program to ensure rapid improvement of health of the Southern Sudanese. The PHC approach considers full community involvement in decision making as the key to successful provision of health services.

5 This in turn requires a gender balanced representation in the structure for health services governance from the grass root to the GoSS health sector reforms is adapting of priority actions and interventions which will most efficiently and effectively reduce mortality, disability and morbidity. The interventions will be made equitably available and accessible at costs that are affordable to the government and the communities and families. Whereas low cost health interventions that can be delivered with very humble technology have been developed, they require efficient managerial systems for their impact to be realized. The current development of the health system takes a two tier approach. The first is the development of sound systems for planning, management, monitoring and evaluation.

6 The second is the concurrent delivery of priority services that address the priority health document provides guidelines, which will help health service managers, and providers at different levels, the village, the primary health care units (PHCU), the primary health care centers (PHCCs), the county health department (CHD) and the state Ministries of health (SMoH) in implementing various components of the Basic Package of health Services (BPHS). The SMoHs and CHDs have the responsibility of ensuring the implementers of health programs are trained in and use this package in evidence based planning and realistic budgeting for effective health service delivery. The objective of having a package is to offer services, which maximize value for money by achieving greater health improvements.

7 It is my hope and conviction that the implementation of BPHS will increase access to quality essential health services and expedite progress towards the attainment of the MDGs in Southern Sudan. To ensure equity of quality care the establishment of levels of services, with their packages especially in Maternal and child health have taken into consideration the unique geographical, climatic and spatial population distribution features of Southern Sudan. Dr. Joseph Manytuil WejangMinister of health Government of Southern Sudan3 TABLE OF OF AND COUNTRY Land and State of health and health Services in Southern BASIC PACKAGE OF health SERVICES (BPHS).. The Purpose of The Values and COMPONENTS OF THE BASIC PACKAGE OF health Integrated Reproductive health Services (IRHS).

8 Essential Obstetric Care (EOC) .. Family Planning and Women s health (FP/WH).. Adolescent Sexual Reproductive health Services (ASRHS) .. Men s Reproductive health Services (MRHS).. Integrated Essential Child health Care (IECHC) .. Community Based Child Survival Program (CBCSP).. Expanded Program on Immunization (EPI).. Essential Nutrition Action (ENA).. Home treatment of Malaria, Diarrhoea and Management of endemic Common Endemic Diseases (MCED).. Diarrhea, enteric infections and Acute Respiratory Infection (ARI).. Neglected Tropical Diseases (NTD).. Primary Eye Care and Visual Oral Mental health .. Community based prevention and care for common injuries and rehabilitation .. Integrated Disease Surveillance and Response (IDSR) .. health Education and Promotion.

9 The Promotion of health seeking behavior - targeting epidemiological Basic package of health and nutrition for Community based nutrition and food security program (CBNFSP).. Community management of environmental health and hygiene (CMEH) ..27At work place, CMEH will develop Healthy Workplaces activities to promote and protect the health and safety of people at work by preventing workplace-related fatalities, illnesses, injuries, and personal health risks. These will include gender relationships and perspectives at work place using STI and HIV/AIDS as entry points. Training in prevention and first aid for physical injuries and snake-bite are highly relevant to the situation in Southern Sudan. Other work place interventions will target lifestyle related diseases including obesity, high blood pressure and diabetes.

10 Healthy healthcare settings are absolutely essential to successful health promotion programs. Again, HIV/AIDS as one of the health workplace programs will be useful entry Monitoring and evaluation .. health Management Information System (HMIS) .. Periodic M/E .. Operational research ..29 The bulk of health problems and health systems challenges in developing countries lie at the primary level. A significant number of these require operational research to establish causalities and consequences. Much operational research currently takes place in Southern Sudan, both initiated from within the country and from outside. However, there is no existing mechanism for quality control to ensure reliable evidence and no existing forum for disseminating findings and for ensuring that findings filter through into improved policy and practice.