Southern Sudan Nutrition Health Convention

Author(s):

The Government of Southern Sudan (GOSS), Ministry of Health (MOH) Directorate of Nutrition (DN) hosted a Nutrition Health Convention in April 2009 in Juba. One hundred thirty-four participants attended, including representatives from the MOHs of nine states, teaching hospitals, UN agencies, NGOs and nutritionists from outside South Sudan. Its aims were to raise awareness of nutrition to health outcomes, and to be a launch pad for developing a Nutrition Health Policy, which will lead to integrating direct nutrition interventions into primary health care services.

Rates of malnutrition and food insecurity in Southern Sudan are extremely high:

  • The Global Acute Malnutrition Rate (GAM) among 6-59 month old children is around 22%, significantly higher than the WHO 15% threshold for nutritional emergencies.
  • Although data are lacking, micronutrient deficiencies (especially iron, vitamin A, zinc, iodine and folic acid) are almost certainly widespread.
  • The number of people who are food-insecure is expected to reach one million by mid-2009.

Several speakers outlined the many causes of malnutrition. These included:

  • Destroyed infrastructure due to the war, leading to problems with access, and making it difficult to detect and treat people suffering from malnutrition. 
  • Poor water supplies and sanitation conditions.
  • Practices and beliefs related to child feeding, hygiene practices, and health-seeking behaviours.
  • Lack of knowledge and illiteracy of caregivers, and cultural issues leading to proscriptions of healthy foods for pregnant women and children.
  • Climate conditions such as frequent drought and flooding that reduce crop production; cattle raids; and inter-ethnic violence.
  • High levels of poverty.

There is lack of capacity at national and state MOH levels because of:

  • Budgetary constraints.
  • Nutrition services having collapsed or never having developed sufficiently.
  • Infrastructure, human skills, workspace, equipment, supplies and supervision mechanisms being inadequate or non-existent.
  • Lack of instruction and training.
  • Poor communications and logistics.
  • Most health professionals being male while nutrition is still perceived as the domain of female health professionals.
  • Most NGOs implementing nutrition interventions following an emergency model rather than addressing underlying developmental factors.

In order to reach the GOSS MOH/DN’s goal of integrating direct nutrition interventions into primary health care and to mainstream nutrition into the health system, participants agreed that there is a need to:

  • Improve human resources capacity (defining staff roles and strengthening nutrition-related skills).
  • Improve staffing levels and training.
  • Develop a nutrition policy, protocols and guidelines.
  • Improve coordination between the GOSS MOH and state MOHs.
  • Improve linkages with other sectors, especially food security.
  • Conduct a mapping of nutrition programs.
  • Increase emphasis on non-emergency interventions.

During the Convention the following topics were presented and discussed. We hope to bring more details of these in a future issue of this Bulletin.

  • 2006 WHO growth standards.
  • Nutrition surveys and surveillance.
  • Infant and Young Child Feeding.
  • Micronutrients.
  • Management of acute malnutrition and the community-based management of acute malnutrition (CMAM) approach.
  • Nutrition and HIV.
  • Food Security.

At the end of Convention, the state representatives affirmed their commitment to working in partnership with the MOH/DN in the future. They said that they were now more aware of the importance of developing nutrition departments at state and county levels, and had a new appreciation for the significance of good nutrition to the wellbeing of the people of Southern Sudan. They asked for MOH/DN assistance for staff recruitment, capacity building and training, and equipping the nutrition departments. The states expressed their desire to establish formal coordination mechanisms at all levels, standard reporting formats and internet-based communications.

Thanks to Diane De Bernardo for supplying the data on which this summary is based and Victoria Eluzai for approving the summary.