2 nd South Sudan Health Sector Summit

1. 2nd South Sudan Health Sector Summit “Towards Better Healthcare Service that Meets People’s Expectations” Day-Two Recap 2nd South Sudan Health Sector Summit

2. State Presentations – Central and Western Equatoria • Central Equatoria, Western Equatoria, Jonglei and Upper Nile State Ministries of Health presented with Honourable Jehan Deng, Minister of Health for Jonglei chairing • Central and Western Equatoria both reported very high rates of utilisation of HRIS, and good progress on budgets for Counties although these have not been finalised yet • The issue of job titles, qualifications and cadres was raised by Western Equatoria, this is an issue which affects the entire health workforce • Lack of drugs experienced in other States was reiterated, with Counties relying on other partners to fill gaps in national procurement 2nd South Sudan Health Sector Summit

3. State Presentations – Upper Nile and Jonglei • Jonglei was unable to report on any indicators because there is no M&E officer in the SMoH • Despite its large population Bor has few health facilities • There are problems with the health cadres, which were similar to those faced elsewhere – inadequate information and many unclassified staff • Both Jonglei and Upper Nile reported severe difficulties in travelling to the Counties, or in transporting patients • County Partners in Upper Nile are not budgeting with the County Health Departments and some have not even conducted budget trainings • Drugs are also a problem, with IMA supplying emergency supplies 2nd South Sudan Health Sector Summit

4. Discussions • There was a discussion about the use of data and the inadequacy of much reporting. Dr Richard Lako re-iterated Ministry of Health Policy that all partners must report to CHDs and SMoHs, not just to donors. • The HMIS needs to be expanded to cover hospitals and private sector. The expansion to include secondary and tertiary care • There was a further discussion about the role of States vis-à-vis national institutions operating within their state. It was advocated that roles and responsibilities be clarified and lines of communication improved. • Western Bahr el Ghazal reiterated its commitment to working closely to support Wau Teaching Hospital 2nd South Sudan Health Sector Summit

5. Pharmaceuticals • Presentations were given by the Dr Moses Malual DG of Pharmaceuticals and Medical Supplies • Dr Moses addressed the issue of drug shortages and assured that over the coming year there would be supplies available as two streams are coming in • He also discussed the need to transition to the pull system, and what this requires from the States and Counties in terms of reporting • The Directorate has suffered from inadequate funding to meet either regular or emergency needs, and funds have been disbursed late from MoFCIEP meaning contractors are paid late 2nd South Sudan Health Sector Summit

6. DFCA and CMS • Two semi-autonomous bodies have been created in the pharmaceuticals sector, the Drug and Food Control Authority and the Central Medical Supplies • Dr BortelOhisa, DG of Licensing, DFCA presented on the activities of the DFCA. Need for SMoHs to create a list of retail pharmacies and report to DFCA • Dr MohammedeenMohammedeen presented on the establishment of the CMS, with the draft bill currently undergoing final review by the Ministry of Justice before being sent for approval • He announced the CMS’ plans to spend 2,500,000 SSP expanding and refurbishing the main warehouses and 500,000 SSP on the operations and implementation of the pull-system this year 2nd South Sudan Health Sector Summit

7. Medical Services & National Reference Laboratory • Dr LoiThuou, DG of Medical Services, discussed some of the plans of the Ministry in terms of caital projects. • This includes a pledge to ensure there are at least 4 primary and 1 secondary hospital in every State, along with 5 tertiary hospitals nationwide • There have been some renovations of the Teaching Hospitals, construction of the KiirMayardit Women’s Hospital in Rumbek and developments of the curriculum and strategic plan for nursing • Planned construction of oxygen plant, dialysis units, completion of Kwajok Referral Hospital, John Lee Memorial Hospital, Indian Maternity Hospital and 100 PHCCs • Dr LulLojok Director of the National Reference Laboratory discussed the progress in the national public health and diagnostics centres and explained the wide range of services that would become available in South Sudan 2nd South Sudan Health Sector Summit

8. Primary and Preventive Healthcare • Dr Samson Baba, DG of Primary Healthcare reiterated the points made by the States regarding the poor state of PHCUs/PHCCs, lack of medicines, and vehicles. • He also discussed some of the malpractices that contribute to these, such as appropriation of vehicles for personal use • The Expanded Programme of Immunisation and the introduction of the new pentavalent vaccines with support from GAVI are going to significantly improve the situation of child health, however the use fund manager selected for implementation may need review • Dr PinyiNyimol, DG of Preventive Health Services reported the progress made on eliminating Guinea worm, the development of Medical Waste Guidelines and the distribution of mosquito nets. • We learnt about surveys on malaria, nodding syndrome and trachoma which will further our understaning of these in RSS 2nd South Sudan Health Sector Summit

9. Reproductive Health and HRH • Dr Alex Dimiti, DG Reproductive Health presented some of the results of the recent EmONC assessment, which found that only 24 facilities in South Sudan offering these services • The directorate is trying to improve matters with task-shifting training, new policy documents and recruitment of midwives • Eight hospitals are having maternity wards constructed or refurbished and maternity waiting homes constructed • Dr MayenMachutAchiek gave a very inspiring speech with a plan to dramatically increase salaries and training at a cost of just under $1 billion US dollars over 3 years. The recommendations and calculations he made need to be studied closely for improving our workforce 2nd South Sudan Health Sector Summit

10. Fund Managers • Dr MounirLado of the Rapid Results for Health Project discussed the work they have done supporting Counties in Upper Nile and Jonglei. Their main challenges have been insecurity and inaccessibility, and the difficulty of retaining staff in rural areas • Cat McKaig and Dr WasunnaOwino presented on the Integrated Service Delivery Project/Health Systems Strengthening Project in Central and Western Equatoria. There have been very encouraging early results in healthcare delivery and Abt Associates is rolling out management training and capacity building to all CHDs • Dr DamianosOdehof the Health Fooled Pund explained the design and initial stages of the programme, and the support being provided at national level to the HRIS development, and planned SMoH support 2nd South Sudan Health Sector Summit