Learn more about our on-the-ground efforts to improve child and maternal health in South Sudan through our partnerships with innovative local healthcare and social enterprise organizations Read on

Social Enterprise Models Randomized Controlled Trial

Cape Breton University is working with BRAC South Sudan and Uganda, the South Sudanese and Ugandan Ministries of Health, and a team of African and Canadian partners to identify the most effective ways to incentivize community health workers for their efforts in reducing child and maternal mortality in their communities. Further details available on IDRC’s Innovating for Maternal and Child Health website and this video.


South Sudan Physician's Organization

The South Sudan Physician Organization (SSPO) is an NGO run by South Sudanese medical doctors. Many of them were once "lost boys" who were forced to flee southern Sudan in the early days of its conflict. The boys (and two girls) trained to become doctors in Cuba, became Canadian citizens as refugees, and returned to South Sudan when the 2005 Comprehensive Peace Agreement ended war with Sudan.

In partnership with the Ministry of Health, SSPO has established a clinic in the town of Bor. SSPO is working with Cape Breton University to train and support Community Health Workers to serve vulnerable populations, including individuals including internally displaced families from the conflict.


South Sudanese Refugees in Uganda

Conflict in South Sudan has displaced 2.3 million people, with 35% taking refuge in Uganda. In this context, Dr. Odwa Atari and Dr. Kevin McKague are exploring how income-generating livelihood activities and other interventions can be used to support primary health care for South Sudanese refugees in Uganda.

In their study, Using Livelihoods to Support Primary Health Care for South Sudanese Refugees in Kiryandong, Uganda they found that primary health care and livelihoods can best be supported by an integrated combination of:

  1. Providing standardised training to local Village Health Teams (VHTs)
  2. helping organise VHTs into village savings and loan association groups; and
  3. Supporting VHTs with training to establish sustainable income generating activities.
These integrated interventions that address income-generating activities for community health workers can meet the basic needs of front-line volunteer primary health care staff and better enable them to improve the health of their communities.


Chlorhexidine Umbilical Cord Care to Reduce Neonatal Mortality

We are working with the South Sudan-based non-governmental organization Better Health Care Organization (BEHCO) and the Ministry of Health to support the scale-up of their successful Grand Challenges Canada pilot project to introduce chlorhexidine antiseptic gel to the country for the first time.

In South Sudan, 64% of neonatal deaths are caused by infection, and umbilical cord sepsis is one of the main pathways leading to neonatal death. In traditional approaches to newborn care, mothers use old rags and clothes for delivering and warming the infant, and apply various combinations of soil, ash, unsafe water, and herbs to the umbilical cord.

Clinical trials showed that chlorhexidine antiseptic gel applied to the umbilical cord reduced neonatal mortality by 23% in Asia and resulted in new WHO standard-of-care recommendations. BEHCO’s pilot showed a neonatal mortality reduction rate of 15% - 31% in the South Sudanese context and led to the Ministry of Health adopting chlorhexidine as the standard for cord care in the country, and including chlorhexidine on its list of essential medicines.


Barriers to Implementing Tuberculosis Programs

The World Health Organisation estimates the incidence of tuberculosis in South Sudan to be 140 per 100,000 for all forms of TB cases. To address this high rate of TB, Dr. Sheikh Tariquzzaman and Dr. Kevin McKague studied “TB Reach”, a tuberculosis education and health program delivered by BRAC South Sudan. Their findings, published in the South Sudan Medical Journal, help contribute to understanding how local knowledge, attitudes and practices influences TB program effectiveness in Lakes State, South Sudan.


Adolescent Sexual and Reproductive Health Practices

From 2011 to 2014, a program aimed to improve sexual and reproductive health practices among adolescent girls was implemented by the non-governmental organization BRAC in partnership with the Government of South Sudan. Implementation of the program in South Sudan faced more challenges than comparable efforts in other African countries. This motivated Reajul Chowdhury and Dr. Kevin McKague to investigate further. Their study, published in the South Sudan Medical Journal found a strong cultural preference for girls to demonstrate their fertility by beginning to have children at an early age (13–16 years) and to have many children (8–12). They also found that to be effective in South Sudan, adolescent sexual and reproductive health programs must take the current social norms and practices into account and learn from the successes of HIV/AIDS education programs.


Micro-franchised Community Health Workers

Funded by Grand Challenges Canada, and in partnership with the South Sudanese Ministry of Health, this pilot project tested a novel, micro-franchised social enterprise business model to allow 200 community health workers to generate income, and incentivize their work to reduce maternal and child mortality in South Sudan.


Vocational Training

In addition to working with community health workers, we have studied entrepreneurship and employment opportunities through vocational training, with leanings captured in two reports: