Monitoring health service delivery
Project Title: South Sudan Health Pooled Fund Location: South Sudan Client: DFID, DFAT, EU, CIDA, SIDA Date: November 2012 - April 2018
The South Sudan Health Pooled Fund is a GBP 120m multi-donor fund used to ensure the delivery of health care and hospital referral services in 8 out of South Sudan’s 10 states. The programme aims to reduce child and maternal deaths, while also strengthening the health system.
Following decades of civil wars, South Sudan gained independence in 2011 and began to re-establish its national health system. Maternal and child health indicators remained some of the lowest in the world. Significant gaps in systems, human resources, capacity and drug supply were exacerbated by the disruptive effect of increased violence in 2013.
Montrose has been directly supporting the Government of South Sudan to improve health care across eight states since 2012. This has included the supportive management of 39 county level contracts to deliver effective health service delivery and improve performance monitoring systems. It has required a significant level of political and context sensitivity, particularly when working across States which are split by national government and opposition groups engaging in active combat.
As part of the programme, Montrose has worked closely with all levels of government to provide appropriate technical training, mentoring, and supervision to strengthen lasting capacity. The focus of the programme is to ensure tangible improvement in the effectiveness of national systems through collaboration and partnership, rather than vertically imposed implementation. This model has allowed for significant policy engagement and subsequently embodies a South Sudan-owned response.
Over the course of the project, Montrose has worked with the Ministry of Health and their delivery team at state level to enhance reporting systems; to respond to health data; to identify and deliver against measurable performance targets; and to improve coordination across service providers ensuring a unified health focus at state level. In addition health providers have been trained in key health interventions for reducing maternal and new born deaths. As a result, South Sudan has seen an increase in the number of skilled birth attendants overseeing deliveries, improved immunization figures, and improved ante-natal care which culminate in an improved outlook for maternal and child health in South Sudan.
The programme operates in a particularly fragile context which has fluctuated between conflicts for decades. Capacity at both ministry and service delivery levels is low; systems are weak and impacted by an unpredictability of resources, medical supplies, and personnel. Population movement is high and the average citizen’s livelihood security is routinely impacted not only by conflict, but also by a harsh natural environment, and poor infrastructure and support systems. By understanding the context and operating effectively within it, Montrose and the HPF programme have made significant improvements in the government’s capacity to respond to these challenges. Other donors are now buying into the model and there is wide recognition that the project has demonstrated a contextually responsive and effective systems gains in a highly complex environment.
To view more projects click on the links below.