Annals of Tropical Medicine and Public Health

EDITORIAL COMMENTARY
Year
: 2017  |  Volume : 10  |  Issue : 6  |  Page : 1413--1414

Strengthening childbirth services in conflict-affected regions of South Sudan


Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Thiruporur-Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Strengthening childbirth services in conflict-affected regions of South Sudan.Ann Trop Med Public Health 2017;10:1413-1414


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Strengthening childbirth services in conflict-affected regions of South Sudan. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 6 ];10:1413-1414
Available from: http://www.atmph.org/text.asp?2017/10/6/1413/222700


Full Text



Pregnancy or childbirth related deaths have been extremely common among women, especially those who are from poor socioeconomic status and are living in low-resource settings.[1] Further, most of these deaths are quite common among vulnerable women (such as young age, rural, or remote areas, etc.), as they fail to avail health care services during their antenatal period or even during childbirth.[1] However, these mortality rates increase to a great extent at times of any humanitarian emergencies owing to the disruption of the routine health care services.[2]

Moreover, it has been repeatedly advocated that presence of skilled care before, during, and after childbirth can play a remarkable role in not only saving the lives of women but also the lives of newborn babies.[2],[3] This is predominantly because of the success obtained in reducing the global maternal mortality ratio in the Millennium Development Goals era.[1] However, millions of women have been affected because of the ongoing conflicts and other forms of emergencies all over the world, therefore it is quite essential that targeted measures must be taken to reduce the incidence of maternal mortality.[2],[3],[4]

South Sudan has been experiencing conflicts since more than 3 years and it has resulted in serious short- and long-term consequences on people from all the age-groups.[2] In fact, all aspects of health, welfare, and quality of life have been compromised due to the ongoing conflict, while women from the reproductive age-group have been affected the most.[2],[3] Further, since the beginning of a new episode of serious violence in South Sudan in the month of July this year, a significant rise in the number of displaced people has been reported across the relief camps.[4] However, these camp sites are already overburdened due to the lack of delivery of health care services from the existing health establishments.[4] In fact, a 35% increase in the number of occupants has been reported in two protection sites in the capital city since the start of fresh violence.[4]

Nevertheless, the path to offer essential health care to women is not that simple, as some of the maternity departments have been converted to emergency surgical clinics to extend emergency surgical care.[2],[4] In addition, the issue of logistic constraints and shortage of drugs or manpower also complicates the delivery of comprehensive reproductive health care (viz. antenatal care, safe childbirth, post-natal care, management of sexual violence, family planning counseling, HIV testing and treatment, etc.) in the community.[4],[5]

The workload of health workers has increased with on an average of four babies are delivered each day, and many practical alterations (like making the sites operational for all 24 hours) have been made to ensure safety of childbirths and provision of essential sexual and reproductive health care to women who are in need.[2],[4] In order to counter the shortage of skilled attendants, midwives have been deployed in these protected sites and they are playing a remarkable role in not only in building trust with the community, but also in assisting home deliveries.[2],[5] Also, strategies have been tried to ensure the presence of a surgical team round the clock to perform emergency caesarean sections at night.[4]

To conclude, a wide range of inequality in access to and quality of reproductive health care has been observed among women exposed to humanitarian emergencies. Thus, it is the responsibility of the stakeholders to implement specific strategies to improve the quality of care and thus minimize the maternal mortality ratio.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization Maternal mortality-Fact sheet N-348. 2015; Available from: http://www.who.int/mediacentre/factsheets/fs348/en/ [Last accessed on 2016 Sep 27].
2Mugo NS, Agho KE, Zwi AB, Dibley MJ. Factors associated with different types of birth attendants for home deliveries: an analysis of the cross-sectional 2010 South Sudan household survey. Glob Health Action 2016;9:29693.
3Valadez JJ, Berendes S, Lako R, Gould S, Vargas W, Milner S. Finding the gap: revealing local disparities in coverage of maternal, newborn and child health services in South Sudan using lot quality assurance sampling. Trop Med Int Health 2015;20:1711-21.
4UNFPA. As displacements soar, Juba's burdened clinics improvise to keep childbirth safe; 2016. Available from: http://www.unfpa.org/news/displacements-soar-juba%E2%80%99s-burdened-clinics-improvise-keep-childbirth-safe [Last accessed on 2016 Sep 27]
5Shrivastava SR, Shrivastava PS, Ramasamy J. Safe childbirth checklist: A simple tool to encourage best practices by skilled attendants. Ann Trop Med Public Health 2016;9:290-1.