gms | German Medical Science

Background: Sudan remains one of the largest countries in Africa and one of the most densely populated countries on the continent with more than 30 million inhabitants. The increasingly large population, as well as armed conflicts and inter-communal hostilities affecting the country over the past 10 years, have considerably weakened Sudan’s healthcare system. The country has a long way to go to revitalize its healthcare practices and to establish a proper and effective health service delivery system that benefits every citizen of the country.

The causes and rate of maternal death in Sudan are aggravated by ongoing conflicts and resulting displacement of population. The key indicators related to maternal health, including maternal mortality, child mortality and child malnutrition, are all exacerbated by conflicts, especially in the Darfur region. While the exact maternal mortality rates for the five Darfuri states are unknown, they are estimated to approach the higher estimate. In fact, Darfur is probably among the most dangerous places in the world in which to give birth.

Aim: In 2013, UNAMID and the North Darfur State Ministry of Health signed a Memorandum of Understanding on training 50 village midwives in North Darfur. The overall objectives of this joint project was to reduce the insufficiency of maternal health services across the remote and isolated communities; empower people “at-risk”, especially pregnant women and other vulnerable community members; and reduce the maternal mortality and child mortality cases in the identified communities.

The project was implemented within twelve months of intensive theoretical and practical sessions covering a wide range of issues related to reproductive health. It was sponsored through the UNAMID’s community-based labour intensive projects (CLIPs) financed from the United Nations Department of Peacekeeping Operations. The training was conducted at the Midwifery School in El Fasher. Selected students were hosted in the school for the entire period of the training and participated in various types of training activities, including lectures, practical sessions, group work, homework, presentations, demonstrations, etc.

Method: 50 women were selected by the SMoH Reproductive Health Department from various localities in North Darfur, based on the gaps identified during the needs assessment in those areas. The project was implemented within twelve months of intensive theoretical and practical sessions covering a wide range of issues related to reproductive health.

The project was carried out in three phases:

• First phase: theoretical sessions.
• Second phase: practical sessions in models.
• Third phase: practical sessions in health centres for antenatal care and maternity hospital for conducting deliveries. During this phase, the students were trained on how to identify complications and on early referral to avoid obstetric complications.

Result: At the end of the project, the trained midwives were deployed to their respective localities to provide midwifery services to 20,000 people in North Darfur state. Based on the success of the initiative, similar projects have been developed and are currently being implemented in West Darfur and Central Darfur states.

Conclusion: Reducing maternal mortality is one of the major challenges to the healthcare system in Darfur. In the current circumstances, UNAMID and other international organizations should continue to invest in reducing the maternal and child mortality rates in Darfur, by mobilizing the existing resources and advocating for availability of all services that are directed toward improving the maternal health in the region.