Article by Dr Humphrey Karamagi, WHO Consultant to South Sudan
Juba – As we mark World Well being Day 2025 below the theme “Wholesome Beginnings, Hopeful Futures,” South Sudan stands at a defining second in its pursuit of equitable well being for all. Nowhere is the urgency extra evident than within the space of maternal and new child well being, the place mortality charges stay unacceptably excessive, and progress is hindered by persistent system-level gaps.

The nation studies one of many highest maternal mortality ratios globally, with 1,223 maternal deaths for each 100,000 reside births. For newborns, the burden is equally extreme, with 40 deaths per 1,000 reside births and a stillbirth fee of 26 per 1,000. These outcomes are pushed by well-documented limitations similar to restricted entry to expert care, low charges of facility-based deliveries, inadequate emergency obstetric companies, and underutilization of reproductive well being interventions.

Regardless of focused investments, expert attendance at start stays low. Solely 19 p.c of deliveries happen with a skilled well being employee, and simply 3 p.c of services are geared up to supply complete emergency obstetric and new child care. Caesarean part protection accounts for only one p.c of whole anticipated births, which is much beneath the brink wanted to handle problems and forestall maternal and neonatal deaths.

Though many ladies provoke care throughout being pregnant, far fewer full the complete continuum of important companies. In accordance with DHIS2 knowledge from 2024, over 60 p.c of pregnant girls attended a minimum of one antenatal care go to, however lower than half accomplished 4 visits, and solely 15 p.c reached the World Well being Group-recommended eight contacts. This drop-off continues alongside the maternal care pathway.

Fewer than half of those that began antenatal care delivered in well being services, and only one in 4 moms and newborns obtained postnatal care inside two days. Nevertheless, girls who delivered in well being services had been considerably extra more likely to obtain well timed postnatal care, highlighting the protecting impact of institutional deliveries.

Encouragingly, antenatal attendance is strongly related to early new child interventions. Amongst infants born to girls who accessed antenatal care, 97.6 p.c obtained the BCG vaccine. Delivery outcomes inside well being services additionally replicate the impression of expert care.

Dwell births accounted for 94 p.c of facility deliveries, and stillbirth and early neonatal mortality charges had been considerably decrease than nationwide inhabitants estimates. Nonetheless, preventable circumstances similar to preterm start, neonatal sepsis, and start asphyxia stay main causes of problems. These are largely attributable to delayed or insufficient care, significantly in underserved rural areas.

These service-level challenges are carefully linked to broader well being system constraints. Whereas coverage frameworks are in place, implementation is typically slowed by coordination complexities throughout sectors. Well being financing continues to rely considerably on exterior assist, highlighting the necessity to strengthen home useful resource mobilization. Gaps within the availability and distribution of expert well being staff, significantly midwives and obstetricians, stay a key concern, alongside periodic stockouts of important maternal and new child commodities. Moreover, continued funding in well being data techniques is required to assist well timed decision-making and improve knowledge use throughout all ranges of care.

To speed up progress, the World Well being Group requires a renewed collective give attention to built-in maternal and new child well being.

Strengthening nationwide capability for expert start attendance, together with coaching, deployment, and retention of midwives, improves protection and helps safer deliveries. Increasing entry to complete emergency obstetric and neonatal care, alongside useful referral techniques, will increase the power to handle problems. Enhancing the supply of maternal and new child commodities and advancing the usage of the well being data system, significantly DHIS2, permits well timed monitoring and more practical planning. Institutionalizing the Maternal and Perinatal Loss of life Surveillance and Response system permits for routine assessment of deaths and contributes to high quality enchancment. Extra investments in maternal diet, training, and gender fairness assist long-term outcomes. Rising the supply and uptake of recent contraceptives helps scale back unintended and high-risk pregnancies and improves reproductive well being.