Integrated Service Delivery Project (ISDP)
Start and end dates: June 2012 to March 2016
MCHIP Partners Involved
Jhpiego leads a consortium partnership, including Save the Children, John Snow, Inc., and Population Services International
Key Partners in Country
Ministry of Health (MOH), Adventist Development and Relief Agency, South Sudan Health Association, Mundri Relief Development Association, Catholic Medical Mission Board, Action Africa Help International, Johanniter International Assistance, International Medical Corps, American Refugee Committee, World Vision
Description of work
MCHIP is supporting the Government of the Republic of South Sudan in the provision of the minimum package of integrated primary health care services. The project operates in South Sudan’s two most populous states: Central Equatoria (CES) and Western Equatoria (WES). By the end of the ISDP, MCHIP will, in collaboration with Government of the Republic of South Sudan and USAID, ensure the presence of standardized, equipped, staffed and functional health facilities that are able to provide the minimum package of high-quality primary health care services and increase community access to information and services.
- Child health
- Family planning
- Maternal and newborn health
- WASH (Water, Sanitation and Hygiene)
Geographic Focus: ISDP covers all 16 counties in CES and WES, representing a population of approximately 2 million. ISDP supports a total of 364 health facilities, consisting of 81 primary health care centers (PHCCs) and 283 primary health care units (PHCUs).This represents approximately 90% of the PHC facilities in the two states, as the remainder are supported by faith-based organizations or the MOH alone. Through its County Implementing Partners (CIPs) in 16 counties, ISDP supports 70% of the PHC staff in WES and 30% in CES.
National Scale: At the national level, ISDP supports two long-term technical advisors embedded within the MOH: FP/reproductive health (RH) and HIV/AIDS monitoring & evaluation. While their primary purpose is to contribute to building capacity at the national level, they also contribute to selected ISDP activities. In addition, ISDP participates in a number of technical working groups contributing to the development of policies, guidelines, and data collection tools.
- Maintained delivery of PHC services within all 16 counties in CES and WES.
- Services continued during the period of conflict that commenced in December 2013.
- Trained 1,145 health personnel in FY14 in various technical areas, ranging from basic emergency obstetric and neonatal care (BEmONC) to integrated management of childhood illness.
- Formalized Standards-Based Management and Recognition (SBM-R®) as a quality improvement approach used by the MOH.
- Quality and performance standards were developed in infection prevention, focused antenatal care, normal labor, delivery and postpartum care, and BEmONC, and approved for nationwide use.
- Supported provider-initiated testing and counseling (PITC) and prevention of mother-to-child-transmission (PMTCT) of HIV in 15 PHCCs.
- In support of PITC and PMTCT implementation, conducted technical trainings, supportive supervision, on-the-job training, distribution of HIV commodities, and strengthening the health system for HIV.
- Initiated Option B+ in three facilities in Juba, enabling facilities to now provide antiretroviral therapy to clients on-site immediately after diagnosis.
- Established home health promoters (HHPs) in all counties in CES and WES to promote healthy practices and service use.
- Trained 1,712 HHPs in different program areas in FY14.
- Actively supporting the national family planning (FP) program and ensuring that FP services are included in routine service provision.
- Chosen member of the MOH-led FP Technical Working Group to monitor and contribute to the revision of the FP training of trainers curriculum for South Sudan.
- Introduced three previously underused or not well understood FP methods to the training: Lactational Amenorrhea Method, progestin-only pills and emergency contraception.
- Maintain a memorandum of understanding with the United Nations Population Fund for the provision of essential maternal health drugs and FP commodities for the 16 counties and ISDP CIPs.
- Trained 476 providers in FP/RH.
- Introducing the contraceptive implant at the PHCC level to increase women’s access to long acting methods.
- Provided services to more than 15,000 new users of modern FP methods, providing over 4,000 couple years of protection.
- Worked with CIPs to support the cholera response in four counties.
- Ensured all partners had the necessary materials on the case definition and treatment flow chart, information/education/communication materials for health education, and WaterGuard for water treatment for the facilities and in the catchment area around outbreaks.
- Distributed nine million tablets of WaterGuard point-of-use treatment (equivalent to 180 million liters of safe water).
- Participated in national activities and discussions leading to the introduction of the Pentavalent vaccine to replace pertussis and tetanus (DPT) vaccine.
- Supported the MOH to print and distribute the Pentavalent Introduction Field Guide for vaccinators in CES and WES.
- Trained 64 county EPI supervisors, cold chain assistants, social mobilizers and CIP facility supervisors as trainers to introduce the vaccine.
Maternal and newborn health
- Expanded work begun under MCSP’s predecessor – the Maternal and Child Health Integrated Program – to prevent postpartum hemorrhage through advanced distribution to pregnant women for self-administration at home delivery, reaching 9,960 women in FY14 with uterotonics immediately after birth.
|Select Health and Demographic Data for South Sudan|
|GDP per capita (USD)||–|
|Maternal Mortality Ratio (deaths/100,000 live births)||2,054|
|Percent of maternal deaths due to HIV||–|
|Skilled birth attendant coverage||10|
|Antenatal care, 4+ visits||–|
|Neonatal mortality rate (deaths/1,000 live births)||52|
|Infant mortality rate (deaths/1,000 live births)||102|
|Under-five mortality (deaths/1,000 live births)||135|
|Treatment for acute respiratory infection||87.8|
|Oral rehydration therapy for treatment of diarrhea||63.9|
|Diphtheria-pertussis-tetanus vaccine coverage (3 doses)||24|
|Percent of districts with >80% DPT3 coverage||–|
|DPT3 coverage equity ratio (wealthiest:poorest quintile)||–|
|Modern contraceptive prevalence rate||5.7|
|Total fertility rate||–|
|Vulnerable populations who slept under an insecticide-treated net (ITN) the previous night**||–|
|Pregnant women receiving 2 doses intermittent preventive treatment for malaria||–|
|Children with fever treated with antimalarials within 24 hours||2.6|
|HIV Prevalence, adult||3.1|
|ART coverage, adult||–|
|Density of physicians (per 1,000 population)||–|
|Density of nurses & midwives (per 1,000 population)||–|
|Total Health Expenditure per capita (USD)||–|
|Sources: Population, Southern Sudan Center for Census, Statistics, and Evaluation 2010; Demographic information and health systems, World Bank; MMR, newborn health, child health, DPT3 coverage, family planning, malaria, SBA, and ANC4, Southern Sudan Household Health Survey 2006; ART coverage and maternal deaths due to HIV, WHO; HIV prevalence, 2010 Sudan United Nations General Assembly Special Session Report
*Calculated from DHS data as number of pregnant women and number of children under five who slept under an ITN the previous night divided by the total number of pregnant women and children under five.