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Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan
BACKGROUND: Decades of war left the Republic of South Sudan with a fragile health system that has remained deprived of resources since the country’s independence. We describe the coverage of interventions for women’s and children’s health in Upper Nile and Unity states, and explore factors that affe...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254670/ https://www.ncbi.nlm.nih.gov/pubmed/32514299 http://dx.doi.org/10.1186/s13031-020-00272-2 |
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author | Sami, Samira Mayai, Augustino Sheehy, Grace Lightman, Nicole Boerma, Ties Wild, Hannah Tappis, Hannah Ochan, Wilfred Wanyama, James Spiegel, Paul |
author_facet | Sami, Samira Mayai, Augustino Sheehy, Grace Lightman, Nicole Boerma, Ties Wild, Hannah Tappis, Hannah Ochan, Wilfred Wanyama, James Spiegel, Paul |
author_sort | Sami, Samira |
collection | PubMed |
description | BACKGROUND: Decades of war left the Republic of South Sudan with a fragile health system that has remained deprived of resources since the country’s independence. We describe the coverage of interventions for women’s and children’s health in Upper Nile and Unity states, and explore factors that affected service provision during a protracted conflict. METHODS: We conducted a case study using a desk review of publicly available literature since 2013 and a secondary analysis of intervention coverage and conflict-related events from 2010 to 2017. During June through September 2018, we conducted 26 qualitative interviews with technical leads and 9 focus groups among health workers working in women and children’s health in Juba, Malakal, and Bentiu. RESULTS: Coverage for antenatal care, institutional delivery, and childhood vaccines were low prior to the escalation of conflict in 2013, and the limited data indicate that coverage remained low through 2017. Key factors that determined the delivery of services for women and children in our study sites were government leadership, coordination of development and humanitarian efforts, and human resource capacity. Participants felt that national and local health officials had a limited role in the delivery of services, and financial tracking data showed that funding stagnated or declined for humanitarian health and development programming during 2013–2014. Although health services were concentrated in camp settings, the availability of healthcare providers was negatively impacted by the protracted nature of the conflict and insecurity in the region. CONCLUSIONS: Health care for women and children should be prioritized during acute and protracted periods of conflict by strengthening surveillance systems, coordinating short and long term activities among humanitarian and development organizations, and building the capacity of national and local government officials to ensure sustainability. |
format | Online Article Text |
id | pubmed-7254670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72546702020-06-07 Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan Sami, Samira Mayai, Augustino Sheehy, Grace Lightman, Nicole Boerma, Ties Wild, Hannah Tappis, Hannah Ochan, Wilfred Wanyama, James Spiegel, Paul Confl Health Research BACKGROUND: Decades of war left the Republic of South Sudan with a fragile health system that has remained deprived of resources since the country’s independence. We describe the coverage of interventions for women’s and children’s health in Upper Nile and Unity states, and explore factors that affected service provision during a protracted conflict. METHODS: We conducted a case study using a desk review of publicly available literature since 2013 and a secondary analysis of intervention coverage and conflict-related events from 2010 to 2017. During June through September 2018, we conducted 26 qualitative interviews with technical leads and 9 focus groups among health workers working in women and children’s health in Juba, Malakal, and Bentiu. RESULTS: Coverage for antenatal care, institutional delivery, and childhood vaccines were low prior to the escalation of conflict in 2013, and the limited data indicate that coverage remained low through 2017. Key factors that determined the delivery of services for women and children in our study sites were government leadership, coordination of development and humanitarian efforts, and human resource capacity. Participants felt that national and local health officials had a limited role in the delivery of services, and financial tracking data showed that funding stagnated or declined for humanitarian health and development programming during 2013–2014. Although health services were concentrated in camp settings, the availability of healthcare providers was negatively impacted by the protracted nature of the conflict and insecurity in the region. CONCLUSIONS: Health care for women and children should be prioritized during acute and protracted periods of conflict by strengthening surveillance systems, coordinating short and long term activities among humanitarian and development organizations, and building the capacity of national and local government officials to ensure sustainability. BioMed Central 2020-05-27 /pmc/articles/PMC7254670/ /pubmed/32514299 http://dx.doi.org/10.1186/s13031-020-00272-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Sami, Samira Mayai, Augustino Sheehy, Grace Lightman, Nicole Boerma, Ties Wild, Hannah Tappis, Hannah Ochan, Wilfred Wanyama, James Spiegel, Paul Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title | Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title_full | Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title_fullStr | Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title_full_unstemmed | Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title_short | Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan |
title_sort | maternal and child health service delivery in conflict-affected settings: a case study example from upper nile and unity states, south sudan |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254670/ https://www.ncbi.nlm.nih.gov/pubmed/32514299 http://dx.doi.org/10.1186/s13031-020-00272-2 |
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