Page 2 - Final Huzifa22

Backround

Most important hindrance to leadership functions espe-
Addressing health system bottlenecks particularly at the cially at the states and locality levels are the limited budget
grass root local level have been globally seen as the only for management and development, lack of control over
way to improve the overall health outcomes including financial resources and their fragmentation. Low motiva-
prevention from health hazards, Universal Health Cover- tion among managerial staff due to the above constraints,
age (UHC) and sustainable development. Sudan National as well as low remuneration contribute to the high turn-
Health Policy 2017-2030 places primary health care and over and vacancies in management positions.
universal health coverage high on its agenda, within the
framework of a decentralized local health system. WHO The strengthening of states and localities will underpin
has continued to support the advancement of the country these challenges, including better planning and manage-
towards UHC as the closest partner to the government of ment of people-cantered health services, that include
Sudan. This has been supported by the global endeavor to promotive, preventive, curative and rehabilitative
achieve UHC as the main health global target with the services, based on better data and analysis; better coordi-
Sustainable Development Goals (SDGs). Within the nation of different providers and programmes; and
IHP+, which Sudan was member of since 2011, and the increased capacity to provide and retain health workers.
later formulated UHC 2030, global partners have support- Investment will focus on enhanced capacity at all levels to
ed countries efforts to strengthen their local health system implement the various frameworks required for efficient
and achieve UHC. and effective decentralization taking into consideration
the contextual factors in each state and locality; recruit
Sudan comprises of 18 States each divided into localities, and train staff in planning and managerial skills at the
making up a total of 187. Sudan is a federated republic decentralized level and whole system stewardship at the
with powers devolved to states and localities under Feder- central level; and train health workers to meet shortfalls
al System Act (1999). Legislative and organizational compromising efficient health service delivery. Such inter-
arrangements vary from state to state. Therefore, there vention is presumed to increase local authority to imple-
has been a lack of uniform geographical coverage includ- ment results-based management and to enforce local
ing essential health services, and the financial and socio- accountability for obtaining better service quality and
economic barriers hinder the access to health services for responsiveness, towards ensuring greater equity and
the population. There are remarkable discrepancies improved health outcomes.
between and within states, between rural and urban areas, The project is serve as an implementation model of
between rich and poor and between different localities. Humanitarian Development Peace Nexus (HDPN)
Inequity also manifests in distribution of inputs of health through strengthening governance, capacity building of
system including human resources, health facilities and local management and community engagement. Integrat-
health expenditure. 20 % of existing primary health care ed and comprehensive approaches including “One Plan
facilities are not fully functioning mainly due to shortages One Budget One Report” and “delivering as one”
of staff and/or poor physical infrastructure. Excluding concepts are being promoted and adopted.
Khartoum State, only less than 30% of the primary health-
care facilities provide the primary healthcare essential Project objectives
service package (PHES); treatment of common diseases,
medication dispensing, immunization, reproductive The objective of this project is to strengthen the decen-
health, nutrition and growth monitoring and health tralized health system (DHS) in five states in Sudan to
education services. achieve Universal Health Coverage (UHC), which is one
of the Sustainable Development Goals targets. The proj-
A recent study to determine management and organiza- ect is contributing to building resilient health system
tion capacity of the health system revealed that 86.9% of under the Humanitarian Development and Peace Nexus
managerial posts at state level were occupied compared to that FMOH is planning to implement. Capacities and
only 53.7% in case of localities. This clearly highlights the features of the decentralized health system have a strong
serious managerial capacity limitations at the locality levels influence on the structure, content, the different steps and
and the situation is worse in conflict affected areas. the outcome of the overall national health policies, strate-
gies and plans. Strengthening the decentralized health
system is considered as an essential prerequisite to achieve
UHC.

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