Joy Mukaire, executive director of the Christian Health Association of Sudan (CHAS), explains the maternal health situation in South Sudan and how CHAS works in collaboration with the community to involve the faith community and traditional birth attendants in maternal care and promoting healthy practices.

1. Maternal and Child Health
in South Sudan
Joy P. Mukaire
Executive Director
Christian Health Association of Sudan (CHAS)
Capitol Hill Briefing
June 2012

2. Christian Health Association of
Sudan – Vision
“All CHAS member
organizations visibly and
effectively participating
in health service
delivery and
contributing to the
attainment of health
outcomes for South
Sudan”

3. CHAS Membership
 CHAS has 73 members drawn from:
 Episcopal Church of Sudan
 Catholic Church
 African Inland Church
 Presbyterian Church
 Pentecostal churches
 Sudan Presbyterian evangelical Church
 Muslim faith groups for HIV/AIDS related work
 PLHIV Network

4. The Situation
 South Sudan has the highest maternal mortality ratio in the
world (2,054/100,000)
 South Sudan HHS 2010 estimated that only 46.7% of
pregnant women attended one ANC visit
 Only 14.7% of deliveries are attended by trained health
professionals. Institutional deliveries accounted for just
12.3% of births
 Contraceptive prevalence rate is 4.7%.
 Total fertility rate is 6.7
 Individual’s life expectancy is 42

5. The Situation
 Common for child marriages as early as 13 or 14 years
for girls. Parents marry off girls for a bride price.
 Early sexual engagement and pregnancy in young single
girls result into pregnancies with complications at
delivery, leading to high maternal mortality rates during
pregnancy and delivery.
 High school dropout at puberty: Girls kept out of
school when they start their menses - considered a sign
of maturity or readiness for marriage. Leading to a high
illiteracy rate (88% among women and 63% among men).

6. CHAS Maternal & Chid
Health Priorities
 Work with Traditional Health Care Support Systems:
 Household Level
 Religious Leaders
 Cultural Leaders
 Traditional Birth Attendants (TBAs)
 They are highly trusted and respected by communities, and
could effectively promote healthy decisions at the
household levels.

7. Working with Influentials at the
Household Level
• Husbands & In-Laws: A
woman’s pregnancy is
everyone’s business
• Community education
through a outreach
workers

8. Working with Cultural & Religious
Leaders
 Work with cultural & religious
leaders to advocate for changes in
practices in the perception about
women and child bearing – to trust
the health system
 For example, tribal practices –
spear masters and labor vs.
taking a woman to a hospital
 Target: Cultural & Religious Women
Leaders through Ministry of Gender
 Community Leader Workshops

9. Results
 Conducted leadership and management training for religious
leaders from 13 institutions
 Supported 2 large scale advocacy events focusing on the
issue of “empowering women and girls to reduce maternal
mortality”
 ANC attendance at 6 FBO facilities in Western Equatoria
and Lakes State has increased
 Records of eligible households, numbers served now exist
at community and facility level is happening

10. Training Traditional Birth
Attendants (TBAs)
 TBAs serve 88% of deliveries
 Goal: Train TBAs to bring women to
health care facilities for: family planning,
immunizations, delivering babies,
PMTCT, etc.
 Helps support the TBA in building skills
and reaching women for ALL services
 Trained and supported 78 community
outreach workers
 Trained 64 TBAs: 2 trainings so far

11. Shukran