Working to improve maternal, neonatal and child health in South Sudan
Health Advisor, Advisory & Policy Team
"Here... a girl can even have a baby when she is 13 years old depending on if she has had menstrual period... when a girl has menstruated she is already considered a woman...."
(From an in-depth interview, Woman Community Leader, South Sudan)
A couple of weeks ago I attended the Family Planning Summit in London, UK. It was an opportunity for governments, the donor community and NGOs to share experiences and learning about family planning from around the world, and commit to supporting family planning as a key pillar of efforts to improve maternal and child health.
The summit made me think about a trip I am about to make to South Sudan to visit a new BBC Media Action project focused on reproductive, maternal, neonatal and child health. South Sudan has just celebrated its first year as an independent country. Years of war have left its infrastructure struggling to meet even the most basic needs of its people. Our work in South Sudan aims to boost access to information about a number of health issues that are key to supporting thousands of women and children, including family planning.
Family planning is an issue deeply entwined with the health of women and their children. It is estimated that the lives of 1.1 million infants and 79,000 women would be saved, and 7 million miscarriages would be averted, if the current unmet need for family planning was fulfilled in developing countries. Globally, pregnancy and childbirth are the number one killers of girls and young women aged 15-19, causing 50,000 deaths each year. In a country such as South Sudan, once a girl is physically able to get pregnant she is frequently considered ready to get pregnant. The most recent USAID study on family planning in South Sudan says that most girls marry very young, many as young as 14 and 15, and that girls are then expected to get pregnant as soon as possible after the marriage.
But talking about family planning is complex. It is an issue caught up in tradition, culture, societal pressure, religious beliefs, and lack of access to information and services. It can also slip down the agenda as pressures such as the ongoing influx of returnees and scarcities of food and resources hold international and national attention.
As we begin work on our new project, our team in South Sudan has been carrying out research in four regions across the country, talking to communities and building an understanding of the key factors affecting maternal and child behaviours, including family planning. There are many questions to address: what are people’s concerns about family planning? And do they have the information they need to make informed choices? Understanding the challenges of South Sudan’s recent history and independence are critical too. Sulakshana Gupta, our Senior Project Manager in South Sudan, says, "Recent USAID research on family planning in South Sudan shows a desire among families to have as many children as possible for a number of reasons: for dowry, because of high child mortality, or to increase family numbers to compensate for family members who died in the civil war."
We heard the pledges from world leaders at the recent summit – a positive step forwards for family planning. But family planning continues to be a hugely controversial topic for many individuals, couples, families and communities. Politicians and donors are talking openly about family planning at an international level, but in talking at the local level real sensitivity, combined with a deep understanding for a local context, is still required. How will these international pledges to support family planning be carried forward for South Sudan?
I’ll be reporting back on our emerging work in this area in a new blog from South Sudan. Ahead of that I’m interested in hearing from those of you working in this field – if you were in South Sudan, what would you do?
 Singh, S, Darroch, JE (2012), Adding It Up: Costs and Benefits of Contraceptive Services – Estimates for 2012,Guttmacher Institute and UNFPA: New York, USA
Rawe, K et al (2012), Every Woman’s Right: How family planning saves children’s lives, Save the Children: London, UK