Worsening humanitarian crisis in South Sudan prevents teenage girls from accessing family planning services

A refugee woman from the Dafur region

A worsening crisis in South Sudan caused by internal conflict has left over four million people displaced. An estimated 85% of these are women and children. This conflict and resulting mass displacement has prevented many people, including women and girls, from accessing essential healthcare services – particularly family planning information and services, which are not always included in crisis response.

“As a ministry we are reviewing our policies in emergency response and preparedness and ensuring that Sexual Reproductive Health (SRH) services are incorporated in these policies. This will help reduce cases of where young people fail to access family planning services” Kuotwel Mading, Deputy Director General-Ministry of Health South Sudan.

According to the latest South Sudan Demographic and Health Survey (DHS) the median age of sexual debut in South Sudan is at 14 and 300 of every 1000 teenage girls are pregnant, one of the highest rates of adolescent pregnancy in sub-Sahara Africa.

The situation has been compounded by the influx of more than 300,000 refugees into South Sudan from Sudan, Ethiopia, Democratic Republic of the Congo (DRC) and other neighboring countries, putting further strain on already overstretched health system.

Knowledge of contraceptives among young people is exceptionally low, with 81% South Sudan young people surveyed unaware of any contraceptive method. Nearly three-quarters of the population is under 30, and 90% live in rural areas. (SS DHS 2022)

South Sudan has a total health budget of US$77 million — 2% of the national budget. Only 1% of the Ministry of Health’s (MoH) budget is directed to reproductive health, even though they have one of the lowest Contraceptive Prevalence Rates (CPR) in sub-Saharan Africa at 4%. This leaves little funding to procure family planned commodities for use in the public sector, relying instead on donors and international partners to support the procurement of essential health commodities.

When FP2030’s South Sudan delegation attended the International Conference on Family Planning in Pattaya, Thailand, in November 2022, they were looking for solutions. The FP2030’s East and Southern Africa (ESA) Regional Hub was barely a month old, and during was during a meet-and-greet at the FP2030 booth, the South Sudan delegation connected with Ugandan focal points. The South Sudan delegation wanted to learn about Domestic Resource Mobilization (DRM) for family planning because they were having major challenges persuading the government to invest in family planning. FP2030 staff set up an introductory conversation between them and partners from Uganda who had been working with civil service organizations (CSOs) and parliamentarians and had successfully advocated for DRM.

The South Sudan delegation was able to meet with the Uganda Family Planning Consortium in person after the Anglophone Africa Focal Point Workshop in June. During that meeting, they learned how Uganda developed a coalition of civil society organizations that engaged with parliamentarians to advocate for domestic funding for family planning. They learned the steps they needed to take to develop a similar coalition in South Sudan.

South Sudan is the newest nation in Africa to make an FP2030 commitment, and it has one of the lowest investments in health budgets. However, South Sudan has strategically committed to improving its health outcomes through its FP2030 commitment and its focus on the Sustainable Development Goals. South Sudan launched its FP2030 commitment and pledged to increase its health funding to 12% and invest 3% of that to family planning.

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