Spatial accessibility to basic public health services in South Sudan

Main Article Content

Peter M. Macharia *
Paul O. Ouma
Ezekiel G. Gogo
Robert W. Snow
Abdisalan M. Noor
(*) Corresponding Author:
Peter M. Macharia | pmacharia@kemri-wellcome.org

Abstract

At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.

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Author Biographies

Peter M. Macharia, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi

Assistant Research Officer, Malaria Public Health and Epidemiology Group

Paul O. Ouma, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi

Assistant Research Officer, Assistant Research Officer, Malaria Public Health and Epidemiology Group

Ezekiel G. Gogo, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi

Assistant Research Officer, Malaria Public Health and Epidemiology Group

Robert W. Snow, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford

Profffesor (Principal Investigator); Malaria Public Health and Epidemiology Group

Abdisalan M. Noor, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford

Dr.(Principal Investigator) Malaria Public Health and Epidemiology Group