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MINISTRY OF HEALTH PRESENTATION 21/03/2007. MINISTRY OF HEALTH PRESENTATION. CURRENT SITUATION LOW COVERAGE (1) Low clinical services coverage at all levels Inadequate number of Health facilities Inadequate referral centers Hospital are ill equipped to manage life
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MINISTRY OF HEALTH PRESENTATION 21/03/2007
MINISTRY OF HEALTH PRESENTATION • CURRENT SITUATION • LOW COVERAGE • (1) Low clinical services coverage at all levels • Inadequate number of Health facilities • Inadequate referral centers • Hospital are ill equipped to manage life saving emergencies e.g. lack of oxygen etc.
MINISTRY OF HEALTH PRESENTATION • Referral system is non – existence from rural areas. The available referral facilities only favour civil servant who could be assisted by Government funds and private citizens who can afford.
MINISTRY OF HEALTH PRESENTATION • (2) Low EPI Coverage • EPI Services are only available to less than 30% of the population. • Limited fixed vaccination Centers. • Almost non – existent out reach services. • Inadequate transport and communication support
MINISTRY OF HEALTH PRESENTATION • (3) Low Maternal and lack of obstetricalemergency services • Inadequate qualified maternal workers. • Lack of obstetrical emergency services • Low institutional capacity • Serious shortage of manpower at all levels i.e. State, County and Payams in all the cadres. • Inadequate system of monitoring and evaluation, incentive award and career progress.
MINISTRY OF HEALTH PRESENTATION • Inadequate funding • The need and demand is so high that there is high competition for meager resources. • Delays in disbursement of funds. • (6)Low Motivation • The public Sector is now losing the few qualified staff to the private sector due to greener pastures. • Loss of qualified staff is also due to inadequate managerial or administrative support with appropriate incentives. • (7) Inadequate training facilities • Available training facilities are limited both in number, their intake and quality.
MINISTRY OF HEALTH PRESENTATION • (8) Inadequate logistical services at all levels • Inexperienced staff • Limited qualified staff • (9) Poor sanitation, inadequate surveillance and outbreak response • Almost non – existent garbage and human waste disposal • Lack of toilet facilities and hence open free defecation within residential areas especially from 7.00pm. • Safe drinking water is a rare commodity • Open recreational facilities are being choked by garbage and being occupied by buildings • Menace of disposable plastics materials
MINISTRY OF HEALTH PRESENTATION • (10) Poor physical infrastructure of health facilities; • The physical infrastructure are not adequate and in dilapidated state. For example JTH was originally a barracks for Kings African Rifles of the British Empire which was converted into a hospital. • All others are in bad shape.
MINISTRY OF HEALTH PRESENTATION • Progress and the next steps • Low coverage is being addressed through • Contracting International Companies to run the tertiary hospitals of Juba, Wau and Malakal • In the short and medium term contracting Lead Agencies to take care of each of the 10 States. This includes state County, Rural and Primary Health Centers and Primary Health Care Units. • In the longer term build publicly run and managed primary health care system, following the Government’s decentralized health service delivery system
MINISTRY OF HEALTH PRESENTATION • An International Company has already been identified to monitor all the contracted companies / firm / agency / organization on behalf of the Ministry of Health. All these activities will be in place before end of April 2007.
MINISTRY OF HEALTH PRESENTATION • Low Institutional Capacity • This is tackled in 2 ways • Immediate recruitment of manpower of all cadres needed from the sisterly countries to cover the gap temporarily. This will be done on annual basis according to needs. • All Director Generals at GOSS level as well as state levels will have qualified and competent persons attached to them. It is hoped the Director Generals will get this necessary support at this crucial stage of setting up systems in various departments.
MINISTRY OF HEALTH PRESENTATION • Policies, Protocols and Guidelines in the health sector have been developed and therefore being disseminated to the States. • Training component is being undertaken to tap Sudanese nationals to take over eventually. • This is a process and hence take time to implement.
MINISTRY OF HEALTH PRESENTATION • Inadequate Funding • Increase in funding will go a long way to improve the health service sector. • We ask for more support from our partners for mid level training which is greatly needed, however the higher level component is being considered. • Speedy flow of obligated funds be effected as expected. • Motivation of Health workers especially in remuneration will attract more health workers to the public sector.
MINISTRY OF HEALTH PRESENTATION • Inadequate Training Facilities • Immediate establishment of multi-purpose training institute complex. Once established the training needs will be geared towards local needs and ensuring quality. • Inadequate Logistical Services • Protocols and Guidelines are being developed. An experienced agency is being engaged to train Southern Sudanese in this field.
MINISTRY OF HEALTH PRESENTATION • Poor Sanitation, inadequate surveillance and outbreak response • The management of this does not rest with the Ministry of Health only. It is a cross cutting issue and hence collaboration with States, Counties and Payams is a must. • Other Government Departments such as Ministry of Works and Public Utilities, Water Works, Public Health Institutions, Town Councils, Ministry of Environment all come into play. • Establishment of surveillance centers coupled with training to be stepped up in all parts of South Sudan.
MINISTRY OF HEALTH PRESENTATION • Results of all the above conditions • Low quality of health services • High morbidity • Outbreaks are common • Poor quality of life • NB – Health as dividend for peace is under pressure!!!
MINISTRY OF HEALTH PRESENTATION • What are the strategic interventions needed to improve basic service delivery? • How can we improve the availability and accessibility of basic service facilities with special attention to the rural areas? • What are the key actions for improving quality of basic service delivery? • How do we set and ensure minimum standards for basic service delivery?
MINISTRY OF HEALTH PRESENTATION • How can we take full advantage of decentralization to improve basic service delivery? • How can we promote greater collaboration and linkages between basic services sectors? • How can we introduce more transparency in the priotization of needs, formulation and implementation of local government plans, budget, and timely payment and reports? NB: These are the problems we need to find answers to for us to speed up our health delivery system.