Annual health dialogue report in Kigile Payam, Maiwut County, Upper Nile State, South Sudan
Introduction
The Nile Initiative Development Organization (NIDO) in consortium with Relief International (RI) are currently implementing South Sudan Covid-19 Emergency Response Health System Strengthening Programme (CERHSP) funded by the World Bank through UNICEF. The project is currently supporting 25 health facilities in Longechuk and Maiwut Counties under Lot 4, of which 15 health facilities are in Longechuk and 10 health facilities in Maiwut.
In Longechuk, RI is supporting 10 health facilities including Mathiang, Watber, Udier PHCCs, Belwang, Jangok Warweng, Majiok, Malow, Pamach and Malual PHCUs. While NIDO is supporting five health facilities including Chotbora PHCC, Dajo, Guelguk, Wichlita and Chotlual PHCUs. RI is supporting three Bomas for its Community Health activities (Tochwengthok, Palguop and Mabor), while NIDO is supporting Mangok Boma for its Community Health activities.
In Maiwut, RI is supporting five health facilities namely Wunkir PHCC, Jotome, Malek, Jekow and Uleng PHCUs. Similarly, NIDO is supporting five health facilities including Pagak PHCC, Pinythor, Nyatok, Turu and Kigile PHCUs. RI is also supporting two Bomas (Palang and Woor) for its Community Health activities while NIDO is supporting Abajabe Boma for its Community Health activities.
This project intends to reach 228,526 people with 110,445 people in Longechuk and 118,081 people in Maiwut.
One of the key activities is to carry out community engagement activities to ensure that local communities are well informed and regularly updated about the project.
So, NIDO, and its consortium implementing partners, have undertaken community engagement activities, that are achieved through community meetings; this Annual Health Dialogue is an example.
Implementing partners for this project are required by the donors (World Bank and UNICEF) to carry out an Annual Health Dialogue every year but this is rarely done; therefore, this report could serve as a reference for any implementing partner interested in carrying out this event.
The general objective of the exercise was to review and discuss the BHI programme performance and to carry out health planning for the year 2024. The specific objectives were to:
- Review BHI programme performance for the years 2020 to 2023,
- Discuss BHI programme implementation challenges and come up with the way forward,
- Conduct annual health planning for the year 2024, and
- Open the newly constructed health facility building for Kigile PHCU.
Structure of the Dialogue
The Annual Health Dialogue involved: presentation by facilitators, questions and answers, group discussions, group planning, and key note speeches from County authorities. The tools used were flip charts, ball pens, note books, pens, soft papers, decoration papers, flowers, megaphones and batteries, chairs and tables.
The event included: Opening prayer, welcoming and opening remarks, review of BHI programme performances for the previous years, discussion on key challenges affecting the BHI programme operation in the County, annual health planning for the year 2024, speeches from various County authorities and opening of the newly constructed health facility building. See Figures 1 and 2.
The total budget for the event was 427 USD, which was used for refreshments such as: water, sodas, tea, coffee, lunch, and transportation.
Figure 1. Chief Guest delivering a key note speech during the event
Figure 2. Chief Guest cutting the ribbon during the inauguration of the new health facility in Kigile
Outcomes of the Dialogue
The dignitaries who participated during the event were:
County Health Department Director (Chief Guest), County SPLM party Secretary, County, Land and Survey, County Trade and Commerce, County Gender and Social Welfare Directors, Kigile Payam and Woldessa Payam Administrators, Head and Sub Chiefs for Kigile, Woldessa, Ras koor and Maiwut 2, Relief International (RI)/Lot 4 Lead Consortium partner, Access for Humanity (AFH) and Nile Initiative Development Organization (NIDO)/Lot 4 consortium member representatives.
Accomplishments
A total of 154 people participated in the event; 128 adults (100 male and 28 female) and 26 children (12 male and 14 female). It was conducted for one day on 07/12/2023 from 9:30 am – 3:05 pm, at Kigile PHCU where the newly constructed health facility building was officially opened.
NIDO BHI programme achievements between January 2020 and November 2023
Operationalization of BHI programme in Kigile Payam’s Abajabe Boma since January 2020, where a total of 19 Boma Health Workers (BHWs) were recruited, trained, and deployed across various villages in Kigile Payam to ensure that Community Health activities (BHI) are undertaken.
Since the inception of the BHI programme in January 2020 to Nov 2023, 54,989 under-five year old children were treated for the three common causes of morbidity and mortality (malaria, pneumonia, and diarrhoea), and 3,984 were referred for further care and support.
Kigile PHCU was reopened at the beginning of 2023 after nearly 10 years when it was closed due to conflict. A total of 15 health care workers were deployed to support the health facility. A new semi-permanent structure with 3 rooms was constructed by Kigile community with support from NIDO. To improve the quality of services delivery, health facility staff were supported with on job training, mentorship, and refresher trainings to ensure that their knowledge and skills are empowered. In June 2023, supplies were received from UNICEF and last mile delivery was completed. The new health facility received furniture to support its operation.
Key discussions/recommendations during the event
During the event, the following key points were underlined by the invited dignitaries:
Lack of enough health services for far Bomas like Woldessa, Raskoor, Phil and Katenbuoy; difficulty of referring sick patients due to poor road condition; need to upgrade Kigile PHCU into a PHCC, since PHCU services are not enough for the served population and lack of nearby referral point with advanced services where critically sick patients could be referred to; promotion of peace, unity and co-existence among the communities across the County; need for extensive community sensitization especially on promotion of utilization of existing health services in the County, this is especially importance mainly for MCH services like ANC, health facility delivery, post-natal care, family planning, immunization and early seeking of health care when someone is sick especially under-five year old children and pregnant women; equity in distribution of resources across different Payams in the County; need to consider Kigile Payam for nutrition services like: Outpatient Therapeutic Feeding Programme (OTP) and Targeted Supplementary Feeding Programme (TSFP); improvement of cooperation between the local chiefs and the County government; need for more cooperation between the County Health Department (CHD) and the health implementing partners in the County.
Payam and County authorities should ensure that the supported health facilities are properly equipped with qualified health workers and supported/monitored to ensure that they are carrying out their roles and responsibilities in a professional way.
Plans for 2024
During the event, the following points were underlined as plans for 2024:
- Installation of EPI fridges at Kigile PHCU and other health facilities like Nyetok and Jekow PHCUs to improve the delivery of EPI services among the Bomas in the County;
- Extension of health services to far distant Bomas through static and community health services (expansion of BHI activities);
- Initiation of nutrition services (OTP and TSFP) in Kigile and other payams;
- Provision of medical equipment, for example, patient beds, delivery couch, examination bed;
- Continuous engagement with State Ministry of Health/National Ministry of Health/and donors to improve the supply of medical supplies;
- Construction of woman friendly space in Kigile and other payams in the county;
- Mass measles and polio vaccination campaigns in Kigile and other payams in the county;
- Health facility staff screening to ensure that qualified staff are in place;
- Revision of harmonized incentive policy; and capacity building for health workers, with on job and refresher trainings, to empower them with necessary knowledge, experiences and skills that would enable them to carry out their work diligently, and continue to support and expand the existing health services in the county.
Challenges faced during the event
Most of the event participants were from Kigile and Maiwut 2, lack of sufficient budget limited the number of participants, and accessibility to Kigile was difficult as some parts of the road were flooded.
References
- 2023 Annual Ghana Health Policy Dialogue 24th – 27th Sept. 2023 https://www.moh.gov.gh/health-policy-dialogue/
- Kier PPD, Dai YC. Mothers’, knowledge, attitudes and practice on preventing diarrhoea in Juba, South Sudan. South Sudan Medical Journal 2018, 11(3):60-65 https://www.ajol.info/index.php/ssmj/article/download/177062/166423
- Kier PPD. How training is encouraging women to deliver in health facilities in Ulang, South Sudan. South Sudan Medical Journal 2021;14(4):135-137. https://www.ajol.info/index.php/ssmj/article/view/222102/209586
- The Republic of South Sudan: The Sudan Household Survey 2010. https://reliefweb.int/report/south-sudan-republic/republic-south-sudan-sudan-household-health-survey-2010
- Republic of South Sudan National Health Policy 2016-2026. https://www.socialscienceinaction.org/resources/republic-of-south-sudan-national-health-policy-2016-2026/
