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.
25,000.00
20,000.00
15,000.00
10,000.00
5,000.00
0.00
The numbers of PHC Facilities in 14 States by Affiliation, Sudan
2010
The coverage of PHC Facilities by the Minimum Package
of PHC Services in 14 States, Sudan 2011
80.0%
73.8%
67.7%
70.0%
52.5%
60.0%
50.0%
40.0%
30.0%
21.9%
19.0%
20.0%
3.8%
10.0%
0.0%
Hospital/localty
Rural Hospital
Urban Health
Centre
Basic Health Unit
Rural Health
Centre
All
Coverage of PHC Facilities by the Comprehensive Package of PHC
Services in 14 States, Sudan 2011
50.0%
47.6%
45.0%
40.0%
35.0%
30.0%
25.0%
16.6%
20.0%
15.0%
10.0%
3.9%
3.8%
Urban Health
Centre
Rural Health
Centre
5.0%
5.0%
0.7%
0.0%
Hospital/localty
Rural Hospital
Basic Health Unit
All
of Functioning PHC Facilities in 14 States, Sudan 2010 %
100.0%
80.0%
60.0%
87.8%
40.0%
92.6%
88.1%
93.8%
85.8%
89.9%
87.1%
74.0%
89.7%
88.8%
86.9%
94.9%
83.5%
68.6%
20.0%
.0%
Yes %
No %
Distribution of Functioning PHC Facilities by Facility
2500
2000
2106
1500
1000
1071
500
319
385
0
Hospitals
Urban Health Centre
Rural Health Centre
Basic Health Unit
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