Safe Motherhood in South Sudan
South Sudan has registered significant improvements in its health indicators in the past 17 years. Mortality among mothers dropped from 2,054 per 100,000 live births in 2000 to 789 per 100,000 live births in 2017 according to the 2017 UN Maternal Mortality Inter-Agency Group estimates. The country had fewer than eight trained midwives in 2011 (SSHHS, 2011); today, it has over 1,436 trained midwives (765 nurses and 671 midwives), according to the South Sudan Ministry of Health 2018 SMS project II tracking report. As the gender mainstreaming effort in health education continues, more males are registering as midwives and nurses. As a result, some communities do not have sufficient professional female midwives available during deployment, resulting in women and mothers having to rely on male midwives for care.
Six pillars of family planning, antenatal, obstetric, post-natal, abortion, and STI/HIV/AIDS prevention and control compose safe motherhood. Every woman who has reached reproductive age will, at some point, require one of these services. For instance, when she becomes pregnant, she will require antenatal care and, during delivery, obstetric care. In the event of an abortion, she will need post-abortion care, and she will need protection against sexually transmitted diseases. Therefore, a break or alteration in this link can put a woman’s life at risk.
The World Health Organization launched the Safe Motherhood Initiative (SMI) in 1987 as a way of improving maternal health and reducing maternal deaths by half by the year 2000. This would be achieved by improving the health of mothers through a comprehensive strategy of providing, preventing, promoting, curative, and rehabilitative health care.
Addressing Cultural Sensitivities
The South Sudan Nurses and Midwives Association (SSNAMA) piloted the “Safe motherhood campaign” for community engagement including an open maternity day dialogue at Aweil hospital. This was in recognition of the community’s strong resistance to male midwives providing reproductive and maternal health care to women and young girls in Maper Village. SSNAMA carried out the interventions in partnership with the Reproductive Health Association of South Sudan, Amref Health Africa, and UNFPA.