Healthcare Foundation Organization (HFO)

1. Mothers are still dying from pregnancy and childbirth-related complications in South Sudan: The Country is one of the highest maternal death rates in the world at 789 deaths per 100,000 live births. The infant mortality rate for South Sudan in 2019 63.207 deaths per 1000 live births, a 1.8% decline from 2018 only.

2. HFO is proposing recruitment of qualified with better motivation (pay), strengthening RH services for the mothers spouse before, during and after childbirth, enough reproductive health kits. health promotion at the household, with ministry of health to incorporate some existing strengths and weakness in maternal and child health services in order to boost and increase services to rural villages for every mother and new born to get services equally.

3. By doing the above interventions, mothers and their new born mortality is solved and they will have a better life and healthy community in the country.

South Sudan is among the countries with high maternal mortality rate stand at the 789 deaths per 100,000 live births, and infant mortality rate at 63.207 death in 1000 lives birth According to UNFPA, UNICEF, WHO. 

In South Sudan from the population of >11 M people, about 0.5 m women of childbearing age are at risk of maternal and child related deaths. Weak health system, lack of qualified midwives and other health workers in the country mainly rural community. Many women die due to preventable death that is caused by include postpartum hemorrhage (bleeding after delivery), eclampsia, obstructed labor, and sepsis. Many developing nations lack adequate health care and family planning, women have minimal access to skilled labor and emergency care. 

The distant for a mother to travel is as far as day or many hours walking. No good road in most of the places in South Sudan. About 200 million globally and approximately 810 women died daily from preventable causes related to pregnancy and childbirth. 94% of all maternal deaths occur in in low income countries. Young adolescents (aged 10-14) face a higher risk of complications and death as a result of pregnancy than older women. 

Appropriate care provided by skilled health professionals competent in sexual and reproductive health care, before, during and after childbirth can save the lives of women and newborn babies.

This solution will aim to increase the services of maternal and child health in the rural villages where there is no or limited services. Purchase the RH and medical equipment for maternal service delivery to avoid rupture of RH commodities. There will be community mobilization. Qualified midwives will be deployed will have necessary supplies to conduct deliveries as clean and as safe as possible.

There will adequate transportation of supplies and staff from head Quarters to the rural villages using local boat or canoe local made this the best and cheapest technology in South Sudan that aids transportation hard to reach areas such swampy and no road places. HFO will improve infrastructure of existing health system by both modern building modality where building materials will be both local made and some will be purchased in the big shops such cement, brick or blocks and iron. poles can be locally purchased with labor contributed by community. We will use other existing supplies, services in the health facilities already exists to promote MCH. 

There is about 50,000 women of childbearing age at risk of maternal mortality in the country that need to be served and about 20,000 newborn at risk if nothing is done. 

This solution will solve the problem by targeting about 60% of mothers at higher risk (30,000) women of childbearing age with Maternal and child health services among most vulnerable states (Jonglei, Upper Nile, Unity states) in Country, and about 30% of newborn that might be at risk of birth related complications that can easily be prevented (10,000). 

This will also target the parents they can be involved in decision making of mothers about their lives and how the women can be supported to access health facilities, this engagement with fathers, mothers in laws telling them the importance of maternal and child health care. 

The community leaders (women group, youth association and county commissioners and local authority are the pillars been having meetings and communication with HFO field team to identify their needs and this exercise is what we do all the times using our team of experts  on ground. Improving MCH services will make a big change on their lives and create healthy community. 

The solution is aligned to the problem because the maternal and child health services that are affordable, available and accessible to vulnerable and marginalized population will definitely improve, solve, and reduce the high maternal infant moralities in the most affected states. In so doing the there will be healthy mother and her new born child that results to health community. where there will be good community engagement, the community leaders will embrace the services and take the ownership and they will support it. HFO is taking a challenge on maternal and child health care by providing MCH services.

The other competitors can be International and National NGOs that are running health project, and so many others but mention the few. However, Healthcare Foundation Organization will be very different in response modality. Many actors have been investing in South Sudan health system for quite long time but they have been missing community component of engagement fully, important support of the project activities when they are involved in the first place. 

HFO has been studied a lot of the field projects all the time about 80% of local leaders are not aware on what is happening around them. This makes some if not all project implementation fail to achieved a desired goals. 

We are going to do it differently this time if given opportunity, we always use local people to be the head of project design and implementation which is accountability to affected population (AAP). embrace the strategy of community engagement using feedback mechanism between community staff and HFO. 

There will be committee that will make sure every activity is done according to the plan. Our solution will be unique because the innovation will be done through a different dimension, such as youth, women groups, people with disabilities be involved in decision making about the services and where the services shall go in their own community. We will make sure every one is reached on time.

Photo 1. Village health Committees meeting with HFO about service delivery.

This solution is a new application on an existing technology, this will use software of computer software applications such mailings, internet, and others, then it will also use hardware like printers and other electronics. This technology is used to communicate, with staff and other stakeholders, sending reports and information. In the use emails, skype, whatsApp. HFO has internet connection that enable the team working in hard to reach areas to be able to send and share their daily activities reports.

In health facilities, both urban, Peri-urban and rural community, the technology for waste management is incinerators and waste pit disposals that local made using local cheap and easy technology that can be designed in a local ways and make good use of sanitation and waste management (biodegradability system. 

HFO has been having been field experiences and we use every available technology for example some scary technology where someone from the Western world would not accept that such transport systems work in South Sudan but they work. see the photo below

Photo: 3 Speed boat that is used to transfer patients for further medical care in the hospital through river Nile.

These technology has been saving lives in the South Sudan since operation lifelines Sudan in mid 1900s up to now. It is the only cheap and readily to use technology. actors or NGOs use these technology all the times, and hire them or purchases them some of these boats and modern made in Africa and other are locally made in South Sudan. Every person depends on their use.

HFO projects have been using these technology all through its work in the rural areas. South Sudan is land lock in such situations people are so creative to come up their own solution that can serve them and solve their problems.

The main objective of this project for 2020 is to focus on improving and increasing access scale-up to lifesaving emergency/essential primary healthcare services to most vulnerable populations in Jonglei Unity and Upper Nile states especially IDPs, returnees and host community where there are no or limited health services and high burden of prone disease outbreak such as cholera,malaria measles and public health priorities outbreak like whooping cough, rubella meningitis. This project will ensure the scaling up the provision of Lifesaving emergency healthcare access to vulnerable populations focusing reducing the major causes of morbidity and mortality. People in Need of humanitarian services as 20 February February 2020, Some 6.5 million people in South South more than half of the population could be in acute acute food insecurity at the height of this hunger by May to July 2020 women, men boys and girls are most vulnerable to communicable and non-communicable diseases; whose populations do not access to world bank supported health facilities because inaccessibility and scarcity of health facilities covering the all population in these two counties. Mothers are still dying from pregnancy and childbirth-related complications in South Sudan: The Country is one of the highest maternal death rates in the world at 789 deaths per 100,000 live births. The infant mortality rate for South Sudan in 2019 63.207 deaths per 1000 live births, a 1.8% decline from 2018 only.This will be through

integrated approach. This strategic objectives through following activities.

A) Reduce excess morbidity and mortality of mothers and their new born children
1. Reproductive health services                                                     
2. Case management for selected diseases
3. immunization against vaccine preventable diseases
4. IPC in health facilities.
5. Capacity building for health care workers

6. Provision of CMR and MHPSS services.

7. Provision of BeMONC / CeMONC services.   

C) Increase access to services for survivors of SGBV, disabled, mental health disorders and monitoring health insecurities
1. Capacity building of health professional for providing CMR RH, and MCH services              

2. Provision of CMR  services at health facilities                                            3. Provision of drugs and medical supplies to provide CMR  services

4. Capacity building of health professional for providing  MHPSS services                                                                                                                                                         

My Solution serve around 149,000 population in Jonglei and Northern Bahr El Ghazal states among this population 5,960 women and their 2980 babies in a period of 2 years. We are planing to serve 10,000 mothers and 5,000 new born children in 1 year with this solution, and about 30,000 50,000 mothers and 25,000 5,000 new born children with maternal and child health services by the end of 5 years.

This solution will specifically achieve the following goals.

1. Comprehensive health to mothers and their new born children

2. Healthy mothers and children in the community

3. Proper employment of midwives

4. Strengthening of maternal and child health services in South Sudan rural community

5. Clean delivery facilities established by the end of 5 years

6. Enough RH, MCH supplies that do not easily rupture

The goals will be achieves through employment of qualified midwives and other health care workers, Good community awareness, formation of feed back mechanism committees that over see the implementation of the solutions. HFO will have proper monitoring and evaluation process of the project and recommendations. These goals achievement will be done through a lot of collaboration with community authority Ministry of Health, state ministry and other partners in the countries that do the same or almost similar to this solution will always be consulted.

The plan for this solution is in place the following barriers and expected to happen before, during or during the implementation.

1. Transportation difficulties of supplies from the HQs to implementation sites

2. Lack of funds to sustain the project for a longer period of time (up to 5 years, The funding HFO has secured is only going to last for 1 years, and after that we do not what is going to the health services being implemented.

3. South Sudan fragility due to conflict, this the bigger barrier in the country for decades, There are have been all times disruption activities due either to political or communal violence.

4. Market prices are so high and keep on getting high to fluctuation of dollar rate against the local currency. Purchasing items in South Sudan is high but getting items abroad is tripling due to transportation barriers either in the borders or even within. It is even worse now that the COVID-19 Pandemic is also arising and affecting every part of the country and create lock down and impediments

5. Culture barriers like preventing young mothers form attending Antenatal care or deliver to the health facility as dictated by parents and/or parent in law.

6. Technical capacity in the Ministry of health that slow down the implementation health policies. There are gaps in the national ministry of health to follow the policies, that will make it difficult run the implementation smoothly.

The ways to mitigate the barriers are:

1. HFO is going to invest in local and cheapest transportation and making sure the supplies and patients reach the destinations on time

2. We will continue looking for more funds in the country and outside the country so that project has to continue and save lives and ease suffering of mothers and their children and be able to have clean delivery with health babies.

3. UN, and other peace builders will be encourage to continue engage the leaders to achieve a lasting peace so that the communities. Engaging community leaders can be sensitize to to work with youth to prevent cattle raiding by youth that cause a lot of communal violent.

4. More financial institution need to be created to reduce the fluctuation of market prices. This will have difficult mitigation since it involves 

5. Cultural barriers are very important to addressed because these the driving seats for failure of any projects as the main target population are women and girls that are always under influence by elders and parents on what to do. The best way to mitigate this is engage with the community elders and local authority and fathers and mothers and spouse.

6. Technicality weakness will be  addressed by working strongly with Ministry of health all various stages ( National, state, County and payam levels).  

My solution is a larger Organization strategy, This is Healthcare Foundation Organization (HFO) is non governmental and non profit making serve the need of vulnerable people in South Sudan.

The Organization is have 147 full time employees, 32 part time workers and 5 contractors and 11 volunteers. That makes a total of 195 workers altogether.

HFO has a great team with excellent skills and knowledge, group of Clinicians, Nurses, midwives and paramedics. They have been trained in best universities and health care institutions they have practiced medicines for a long time some of them are new in the field of health but continue to learn in health scientific changes. I have worker in health care the last 15 years and I love changing the community from habit to new normal that make them realized they can make a difference. Our team are working towards goals and are very well informed things that are making the world a better place for our children. We are very different from others and we mean to serve the needy.

HFO is partnering with UNICEF, (United Nation Children's Funds) CMD (Christian Mission for Development south Sudan), EDA (Episcopal Development Aid) South Sudan, United Nation Office for Coordination of Humanitarian Affairs UN-OCHA and Action Against Hunger United States of America (ACF-USA).

1. UNICEF does the mentor-ship as fund manager for World Bank health project ins South Sudan and HFO is the implementing partner on ground.

2. UN-OCHA is fund manager for Country based Pool funds (CBPF) and HFO is the implementer to OCHA

3. CMD is in the consortium with HFO and EDA, CMD takes the lead of consortium group in WB funding, 3 agencies support 24 health facilities ( CMD has 14, HFO has 5 and EDA has 5).

4. ACF-USA takes lead in CBPF funding working together with HFO in the field actvities, HFO take health service activities and ACH-USA takes on protection, WASH and Food security under SSHF (South Sudan Humanitarian Funds).

The Model I am taking is to give health to children and mothers in South Sudan. The health need is so impacted in a negative way where preventing death of mother can the most important thing to do. Our staff volunteers take the lives and need of our beneficiaries seriously and we stand to protect their values and integrity at all time. We employ people who do the best to provide services in real time need by the community. and we respect our beneficiaries regardless of who they are and where they come from in the community. We interact with them through health education session, health promotion campaigns and out patients services in the hospital and health centers. Our beneficiaries need these services because this is the only way they can get a healthy start, the health care system has been devastated by long term conflict since 1980's, there are no enough essential services in South Sudan in a decades. Solve can have a good chance to show their money through HFO because we change lives and put a positive impact to the community who are in need of such services example Maternal and Child services that can give positive life and change the community to a better future.

HFO is raising money through Funds for NGOs, UN agencies, various world government that are willing to support South Sudan vulnerable community.

We also work hard to approach people outside to continue funding this health project in order to avoid gaps that can be created by lack of funds.

We expected by the end of the year we will be able to raise 2-3 million USD for the 3-5 years project continuation. We raise base don charity basis of no profit making, our core is about healing and impact knowledge on people.

1. HFO would like Solve team to help funding gaps to our solution. we require up to 40,000 to 50,000 USD for 2020 support. In one of the barriers we posted above financial barriers is the biggest problem we face in South Sudan to perfect our solution in order to provide health to mothers and children.

2. Technical capacity we welcome Solve team to help in mentoring our team and sharp us more than ever to be part of continuous solution to them and work as their partners that they can trust.

Solution technology is the best partnership we would wish Solve Team to look into with our team members. Having a good technology help solve today's problem as far the changes in technology and climate changes emerges.

We would want our selves and our beneficiaries grow in healthy mood, we would like to see a healthy population by the end of this solution period and can remain a good and self reliant community that can have their own resource mobilization strategy.

Solve team would be needed to support this innovation and would want to see HFO grow to continue serving the population in their names.

1. SOLVE Team would a potential members in our partnership for mentoring.

2. UNICEF, we would like to continue having them stay and partner with us in ares of implementation.

3. University of Juba faculty of sciences

4. CMD in implementation project in the field.

Our services delivery at the recent and the past aimed at preventing and treating maternal and New born preventable conditions that can easily be prevented or treated. HFO and its team are so qualified because we are doing the work with community and by the community. We have engagement proficient in the community we serve and there is no doubt that our team will achieve the goal of this funding and we will produce good results of healthy mothers and new born children.

Team will use the funds for treatment and prevention of common illnesses of mothers and their newborns, we will use the fund for training healthcare workers in remote areas to equip them with the knowledge and skills to do the work better.