Abstract

BackgroundSouth Sudan has borne the brunt of years of chronic warfare and probably has the highest malaria burden in sub-Saharan Africa. However, effective malaria control in post-conflict settings is hampered by a multiplicity of challenges. This manuscript reports on the strategies, progress and challenges of malaria control in South Sudan and serves as an example epitome for programmes operating in similar environments and provides a window for leveraging resources.Case descriptionTo evaluate progress and challenges of the national malaria control programme an in-depth appraisal was undertaken according to the World Health Organization standard procedures for malaria programme performance review. Methodical analysis of published and unpublished documents on malaria control in South Sudan was conducted. To ensure completeness, findings of internal thematic desk assessments were triangulated in the field and updated by external review teams.Discussion and evaluationSouth Sudan has strived to make progress in implementing the WHO recommended malaria control interventions as set out in the 2006–2013 National Malaria Strategic Plan. The country has faced enormous programmatic constraints including infrastructure, human and financial resource and a weak health system compounded by an increasing number of refugees, returnees and internally displaced people. The findings present a platform on which to tailor an evidence-based 2014–2018 national malaria strategic plan for the country and a unique opportunity for providing a model for countries in a post-conflict situation.ConclusionsThe prospects for effective malaria control and elimination are huge in South Sudan. Nevertheless, strengthened coordination, infrastructure and human resource capacity, monitoring and evaluation are required. To achieve all this, allocation of adequate local funding would be critical.

Highlights

  • South Sudan has borne the brunt of years of chronic warfare and probably has the highest malaria burden in sub-Saharan Africa

  • The prospects for effective malaria control and elimination are huge in South Sudan

  • There have been deliberate efforts to shift from fragile or post-conflict topbottom systems centered on emergency relief and primary health care administered by international non-governmental organizations (NGOs) to more sustainable development systems managed by the Ministry of Health (MoH) in South Sudan [5]

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Summary

Discussion and evaluation

Following the call by the WHO for scaled-up malaria control efforts [25], coupled with unparalleled availability of resources, targets for control and elimination have been established [26,27,28]. Improved quality routine health facility data has proved useful in assessing the impact of malaria control measures on the incidence of severe malaria in Africa [33], malaria cases and deaths in all age groups [34,35,36] and has facilitated for improved spatial mapping of malaria trends for local programme monitoring and resource planning [37]. More comprehensive and sustained control measures will likely be required to begin to decrease the massive malaria burden These would include; Strengthened BCC, confirmation of outbreaks, epidemic preparedness and response and PSM for malaria commodities; communication systems and infrastructure; regular supervision and feedback mechanisms; human and technical capacity building; improvement in quality assurances and control. Allocation of adequate local financial resources would be critical

Conclusions
Background
Findings
WHO Global Malaria Programme
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