South Sudan

Strengthening Midwifery Services in South Sudan Phase 2 (SMSII)

2020 was the Year of the Nurse and Midwife, but it was overtaken by COVID-19. If anything, what COVID-19 showed us is the indispensability of nurses and midwives, especially in under-resourced settings.

— Dr Tedros Adhanom Ghebreyesus, Director-General, WHO on International Day of the Midwife

Women continue to have babies. COVID-19 has not stopped women from becoming pregnant. COVID-19 has not stopped mothers from having children. Midwifery and nursing are professions where social and physical distancing cannot be applied. We are delivering babies without a mask. Malaria has not run away because COVID has come.

– Doris Lamunu, Program Manager, SSNAMA

For some midwives and nurses in rural areas, sometimes three or four weeks go by without PPE. The community is mostly illiterate. And they do not believe COVID-19 is even real. They tell us, “We don’t have clean water. We don’t have soap. Why should I wear a mask?”

– Agnes Juan Silver, Secretary General, SSNAMA

South Sudan Nurses and Midwives Association (SSNAMA) advocated for more PPE to be made available and delivered through a series of public engagement campaigns and videos on WhatsApp.

COVID tests cost $250 USD.
The average wage for midwives is under $10/month.

Strengthening Midwifery Services in South Sudan Phase 2 (SMS II)  aimed to increase the availability of skilled healthcare providers, especially midwives, in order to reduce maternal and infant mortality in South Sudan. It is a collaboration between the Canadian Association of Midwives (CAM) and the South Sudanese Midwives Association (SSNAMA) to improve health outcomes and gender equality across the country through midwifery education and association strengthening.

SMS II (2016-21) was a United Nations Population Fund (UNFPA)‑led project supported by the South Sudan Ministry of Health (MOH) and funded by the governments of Canada and Sweden.

SMS II included the Peer‑to‑Peer Mentorship Program, a twinning‑based mentorship model that matched in‑service midwives from SSNAMA with their counterparts from CAM.

Let’s go! And change our associations! And let SSNAMA shine in Wau community. Let’s go and start our business, with the same spirit we got from here. After making a profit, SSNAMA chapters can grow, and become bigger and bigger.

– Midwife in Wau, South Sudan

With support from donations received from Canadian midwives (almost $5,000 CAD), SSNAMA continued their efforts to reach their goal of becoming financially independent from international donors. Through innovative business trainings delivered by VOSDO, and following market research, each SSNAMA chapter will open businesses designed to financially support the chapter so that midwives can do what they do best: Save Lives.

Through their tireless work and increased investment in education and training,
maternal mortality has fallen from
2,000+ per 100,000 in 2010 to under 700 in 2020.

In 2020-21, all educational facilities have been interrupted for long stretches due to COVID-19. The already fragile education system and replenishment of new midwives and nurses was further delayed. Some classes moved online, but in areas where only 20% have internet access, virtual teaching is not really a viable option.

Despite the setbacks caused by COVID-19, SSNAMA continued to disseminate innovative recruitment materials to high school and college students. The materials promote the professions of midwifery and nursing as viable and valuable career paths.

Before COVID shut down everything, SSNAMA members created workshops on adolescent health and sexuality. They included frank talks about menstruation, wet dreams and avoiding unwanted pregnancy. The young women in the class were all given menstrual hygiene kits, which consisted of washable pads, a washcloth and soap. With it, girls can continue to go to school, even during their periods, instead of spending time sitting on ash, isolated from the public and missing valuable education time.

SSNAMA joined the International Council of Nurses (ICN) and celebrated their admittance in 2020.

To us, as an association, it is a big turn and we will use it for advocacy in a bigger way. Now we can proudly feel that we are members of the international nursing community. For the nurses, it will lift the profile of the nursing profession in the country, and we are so happy that this will provide us an opportunity to participate fully in the activities of the ICN.

– Repent Khamis George, President, SSNAMA