HRH Research Forum

National Human Resources for Health Observatory

Primary Health Care in Africa- Where does Sudan stand?

Outline

• Primary Health Care a revolution in health• Primary Health Care Now More Than Ever• Sudan: Primary Health Care milestones

Primary Health Care a revolution in health

• After World War II and after the drastic situation health was the world was in need for a health revolution.

• In 1978 during the 30th world health assembly

[WHA] of the WHO primary health care was introduced.

Primary health care is defined as:

“Essential care based on practical, scientifically sound, socially acceptable methods and technologies, made universally accessible to individuals and families in the community through their full participation and at a cost the community and country afford to maintain.”

Primary Health Care Now More Than Ever

The WHO revisited Alma-Ata known now as Almaty to sit once again and readdress PHC assessing its flaws and renewing it in a new spirit expressing that through the world health report of 2008

“Primary health care: Now More Than Ever “.

PHC Renewal

PHC 2008 puts an emphasis on four areas of strategic importance:

1. Addressing Health inequalities;2. People-Centered care;3. Better public policies;4. Stronger leadership.

Primary Health Care Now More Than Ever

The four primary health care- reforms are:1. Universal coverage to improve health equity;2. Service delivery to make health systems

people centered;3. Public policy to promote and protect the

health of the communities; 4. Leadership to make health authorities more

reliable.

Sudan-Primary Health Care milestones

• As early as 1973, Sudan adopted primary health care [PHC] as the main strategy to improve the health status of individuals, families and communities.

• In 1976 (before Alma- Ata 1978) Sudan National Health Plan implemented the PHC.

Primary Health Care milestones

At 2010 and in response to the WHO report for 2008 “Primary Health Care: Now More Than Ever” the Federal Ministry of Health’s Directorate General of Primary Health Care decided to reform the basic health unit aiming:

Aims:Increase coverage of the basic health units network services at

all levels: through revising the road to health map; introducing the medical assistant cadre and the mobile groups/clinics.

Improve the quality of the services: Adding the following cadres: family medicine physician, bachelor and diploma of midwifery and replacing the medical assistants with technicians.

Achieve the highest results with the available resources: Providing all services and cadres.

Provide sustainable services: Rehabilitation of the administrative skeleton, strengthening health system, capacity building and financing.

Types of PHC facilities:

• Family Health Unit which is structured and staffed to deliver the essential package of Primary Health Care [PHC].The family health unit formerly known as the ‘Basic Health Unit’ serves a population of 5,000 and is run by a Medical Assistant [MA]. There are 1892 family health units scattered throughout the 15 states.

• Family health centre formerly known as the ‘PHC centre’ is the first referral level for the lower-level facilities. It provides services for a population of 10.000. There are 2307 family health centers spread within the 15 states. It used to be headed by a medical officer but now by a family medicine physician.

• Rural Hospitals are the referral PHC facilities.

• Locality Hospitals are higher level facilities few in numbers and mostly urban.

2010

The current national average for coverage in Sudan is one PHC facility per 6,816.86.

Population Coverage by PHC Facilities, Sudan 2010 .

Northern

B.Nile

S.Kordofan

R.Nile

ElGaze

ira

Elgadarief

W.N

ile

Kassala

Sinnar

N.Kordofan

Elkhartoum

R.Sea

N.Darfo

ur

W.D

arfour

S.Darfo

ur

0

5000

10000

15000

20000

25000

The numbers of PHC Facilities in 14 States by Affiliation, Sudan 2010

90.7%

3.9%2.9% .3%

.4% .0%1.7%

MOH / Locality Health Insurance NGO Police Military University Private

The coverage of PHC Facilities by the Minimum Package of PHC Services in 14 States, Sudan 2011

Hospital/localty Rural Hospital Urban Health Centre Basic Health Unit Rural Health Centre All0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0% 73.8%67.7%

52.5%

21.9%

3.8%

19.0%

Coverage of PHC Facilities by the Comprehensive Package of PHC Services in 14 States, Sudan 2011

Hospital/localty Rural Hospital Urban Health Centre Rural Health Centre Basic Health Unit All0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%47.6%

16.6%

3.9% 3.8%0.7%

5.0%

%of Functioning PHC Facilities in 14 States, Sudan 2010

Northern

R.Nile

R.Sea

Kassa

la

Elgad

arief

ElGaz

eira

Sinnar

W.N

ileB.N

ile

N.Kordofan

S.Kord

ofan

N.Darf

our

W.D

arfour

S.Darf

our

.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

74.0%87.8% 92.6% 88.1% 93.8%

85.8% 89.9% 87.1% 89.7% 88.8% 86.9%94.9%

68.6%

83.5%

Yes % No %

Distribution of Functioning PHC Facilities by Facility

Hospitals Urban Health Centre Rural Health Centre Basic Health Unit

0

500

1000

1500

2000

2500

319385

1071

2106

References Primary Health Care Revitalization Strategy ,The Republic of Sudan-Federal Ministry

of Health-Directorate General for PHC and Preventive Medicine

Sudan Primary Health Care Facility Survey In Fourteen State December 2010

 

Questions

Primary Health Care in America

Meghan is currently pursuing her Masters of Science in Public Health degree at Johns Hopkins Bloomberg School of Public Health, in the department of Population, Family, and Reproductive Health.

Her focus is on strengthening reproductive health services in fragile states, and will pursue her doctoral studies in this field in the next few years. At Johns Hopkins, she works as a research assistant and teaching assistant in the Center for Refugee and Disaster Response. In Khartoum, she is working as the project coordinator for the Reproductive and Child Health Research Unit's new project in Kassala state.

Primary Health Care in Sweden

Therese Svan Åström graduated from medical school at Linköping University in Sweden in June 2011 and she works as a medical doctor at a hospital in the northern, rural part of Sweden. Therese is doing her internship at RCRU as a research assistant until end of January 2012. Therese has a great interest in global health and wants to do continuous work

abroad in the future. In her spare time

Thank-You