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SOUTH
SUDAN’S
HEALTH
SECTOR
www.ahb.co.ke
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Contents 1. Country Overview
South Sudan, previously part of Sudan, was once
1. Country Overview 2 subdued by the Ottoman Empire where the south was
1.1. Key Country Statistics 2 dominated by slaves. Sudan was under the British-
Egyptian rule.[1] The country gained independence in
2. COVID-19 3 1956. Shortly after conflict commenced, the leaders
of the north wanted to enforce strict Islamic laws
3. Health Overview 3
in the south, which led to a civil war.[1] The Addis
3.1. Key Health Statistics 4 Ababa Agreement briefly halted the conflict, but
then resumed until 2005. until a peace agreement
4. Challenges facing the private health sector 4
was signed allowing power and wealth distribution as
5. Opportunities for the private health sector 6 well as semi self-governing power among the south.
Eventually, South Sudan gained full independence
6. References 7
and was named as the Republic of South Sudan in
2011. It is the world’s newest nation and the 55th
country of Africa.[2]
In 2019, the country had a population of 11,062,113.
The capital of South Sudan is Juba. [3] Christianity is the most prevalent religion in South Sudan
followed by Islam and orthodox animalist religions. Two fifths of the population is made up of
the Dinka tribe while the rest are from the Nuer tribe. There are heterogenous languages from
the Eastern Sudanic sub-branch, but their official languages are English and Arabic.[1] In terms
of trade, South Sudan is the latest country to join the East African Community (EAC) which will
allow them to trade freely among member states.[4]
1.1. Key Country Statistics
57.6 years Life 10.79 GDP 36.65 Exports 28.9 Imports
expectancy growth (annual as a % of as a % of
(2018) %) (2015) GDP (2015) GDP (2015)
Top 3 export products: Top 3 import products: 2050.4 South
Crude Petroleum ($1.63B), Cars ($60.2M), Raw Sudanese million
Forage Crops ($32.1M), Sugar($51.4M), Delivery Balance of trade
Raw Cotton ($13.8M) Trucks ($43.8M)[4]. (2016)
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2. COVID-19 Top 10 causes of death (2019)[13]
The South Sudanese population have been highly exposed to epidemic diseases because of
their weak health system, poor water and sanitation, seasonal hazards and food insecurity
which are exacerbated by the challenge of maintaining the humanitarian supply chain through
nearby countries.[8] The first COVID-19 death was reported on 14th May 2020.[8] As of 12th Malaria HIV/AIDS Tuberculosis Stroke Lower respiratory
January 2021, the total number of reported coronavirus cases stand at 3,662 with 3,165 infection
recovered and 63 deaths.[9]
Reflecting on experience, knowledge and strategies honed during the country’s polio outbreak,
South Sudan has morphed its response team to tackle the COVID-19 pandemic in terms of
Neonatal Diarrheal Ischemic heart Congenital Protein energy
tracking, testing and treating positive cases. The president appointed a new task force to
disorders diseases disease defects malnutrition
control the pandemic. Intensified efforts were deployed to hotspot cities like Nimule where a
mobile laboratory was set up.[8]
The International Organisation for Migration (IOM) of South Sudan worked closely with the
ministry of health and various other partners such as UN agencies and Centre for Disease
Control (CDC) to address numerous facets of response from coordination and partnership,
3.1 Key Health Statistics[14]
tracking and mobility, surveillance, coordination management to addressing the socioeconomic
impact of the crisis.[8] 6.4 26.88 0.69
CHE (% Private health Government
of GDP), expenditure (% health expenditure
3. Health Overview 2018 of CHE), 2018 (% of GDP), 2018
The health system is decentralized and divided into four levels: The central, state, county and
community level. Each level has clearly defined roles, capacity and functions which aim to
1,084
involve local decisions in the overall management of the resources. [10] 21.99 Maternal mortality 36,916
The government of South Sudan has declared that basic health and emergency services should OOP expenditure (Per 100,000 live Under five mortality
be free for all citizens in public facilities.[10] However, the prolonged conflict has significantly (% of CHE), 2018 births), 2008 rates, 2019
reduced the proportion of government spending towards the health system from 8.4% to 2.2%
in 2012. The shortage of funding has forced the majority of the populous to buy supplies
from the private sector whereby 92.5% represents out-of-pocket (OOP) expenditure.[11] The
presence of private health insurance is very minimal, only covering 5.4% of the population
4. Challenges Facing the Private
while the rest of the health services are funded by NGOs.[11]
Qualified human resource is pertinent for health systems to flourish. There is a large shortage
of health workers and has been ever since the civil war.[10] Estimates from 2005 suggest that
there is less than one health worker per 1,000 people, most clustered in Juba, Malakal and Wau Health Sector
– the three largest cities in South Sudan.[10]
• Poor/war-torn infrastructure
Private health service delivery is on the rise, where private facilities have an important role in
providing services that are not met by the public sector. They focus more on curative rather • Political instability
than preventive services.[12] • Lack and poor distribution of human resources.
• Heavy taxes imposed by the government on private facilities
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5. Opportunities for the Private
Sector Do you need more in-
depth information on
• Investment in infrastructure
• Investing in the health sector through funding (health financing)
• Overall health systems strengthening (good governance) South Sudan’s health
• Human resource; planning, training, continuous education, management
• Private health insurance
sector and how your
• mhealth project or business can
contribute?
AHB offers a wide range of tailor-made Need more information on any
market, feasibility and strategy studies
based on your needs. Our market health sector in Africa? Africa
intelligence services are designed Health Business can help you.
to help you gain in-dept insight
in a particular (sub) health sector,
We have an experienced and knowledgeable team
understand the opportunities and
on the ground in Africa that can help you make
challenges for your project or business
informed decisions when it comes to forming
and provide you with recommendations
or further defining your business strategy in any
that allow you to pursue the growth of
health market on the continent.
your organisation in a particular (sub)
sector or region. We create value for your business or project by
leveraging our large and unequalled networks,
our people and our experience in Africa’s health
sector.
AHB’s headquarters are in Nairobi, Kenya and
we work with professionals all over the continent
to provide our clients with the tailormade and
bespoke services that meet their business needs.
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6.0. References
[1] Britannica, “South Sudan - Climate”, Encyclopedia Britannica, 2020. [Online]. Available: https://www.
britannica.com/place/South-Sudan/Climate
[2] World Bank, “Overview”, World Bank, 2020. [Online]. Available: https://www.worldbank.org/en/country/
southsudan/overview
[3] Worldbank ,2021. [Online]. Available: https://openknowledge.worldbank.org/bitstream/
handle/10986/32103/South-Sudan-Linking-the-Agriculture-and-Food-Sector-to-the-Job-Creation-
Agenda.txt?sequence=2&isAllowed=y
[4] WTO, “South Sudan kicks off WTO membership negotiations”, Wto.org, 2019. [Online]. Available: https://
www.wto.org/english/news_e/news19_e/acc__21mar19_e.htm#:~:text=South%20Sudan%20is%20a%20
member,on%2020%20and%2022%20March
[5] World Bank, “Life expectancy at birth, total (years) - South Sudan | Data”, Data.worldbank.org, 2020.
[Online]. Available: https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=SS
[6] OEC, “South Sudan (SSD) Exports, Imports, and Trade Partners”, Oec.world, 2018. [Online]. Available:
https://oec.world/en/profile/country/ssd/accessed
[7] Trading economics, “South Sudan Balance of Trade | 2008-2016 Data | 2020-2021 Forecast | Historical”,
Tradingeconomics.com, 2016. [Online]. Available: https://tradingeconomics.com/south-sudan/balance-of-
trade
For other country reports please visit:
www.ahb.co.ke/publications
[8] IOM, “COVID-19 APPEAL SOUTH SUDAN PREPAREDNESS & RESPONSE PLAN”, 2020.
[9] Worldometer, “South Sudan Coronavirus: 3,662 Cases and 63 Deaths - Worldometer”, Worldometers.info,
2021. [Online]. Available: https://www.worldometers.info/coronavirus/country/south-sudan/
[10] Y. Rajkotia, S. Boulenger and W. Pressman, “Southern Sudan Health System Assessment”, 2007.
[11] R. Lino Loro Lako, R. Basaza, P. Kon Alier, P. Kirabira and D. Ogubi, “Willingness to pay for National Health
Insurance Fund among public servants in Juba City, South Sudan: a contingent evaluation”, International
Journal for Equity in Health, vol. 16, no. 158, 2017. Available: https://equityhealthj.biomedcentral.com/
articles/10.1186/s12939-017-0650-7
[12] Y. Abbas Saeed, “The Potentialities of the Private Health Sector and its Role in Health Services Provision in
the Sudan”, 2011.
[13] IHME, “South Sudan”, Institute for Health Metrics and Evaluation, 2019. [Online]. Available: http://www.
healthdata.org/south-sudan
[14] Worldbank, “Indicators | Data”, Data.worldbank.org, 2021. [Online]. Available: https://data.worldbank.org/
indicator/
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