Renewed conflict in South Sudan has displaced 2.3 million people outside the country, of whom 789,098 (35%) have taken refuge in neighbouring Uganda. Eighty-two percent of South Sudanese refugees are women and children. With increasing barriers to operating within the country due to ongoing instability, some organisations supporting primary health care in South Sudan have also turned to exploring how South Sudanese refugees in neighbouring countries can be assisted.
As action researchers with personal interests in South Sudan, we have worked to generate practical knowledge that can best contribute to both scholarly understanding and actionable implementation. Prior to our current work with South Sudanese refugees, we had collaborated with BRAC South Sudan (a non-governmental organisation) and the South Sudan Physicians Organization to explore how social enterprise income-generating activities can support primary health care via community health workers. These experiments, funded by Grand Challenges Canada and in partnership with the South Sudanese Ministry of Health, included micro-franchising models, fixed and mobile clinics, and mobile health (mHealth) applications designed to improve maternal and child health.
This exploratory work was leveraged and extended with additional funding from the International Development Research Centre, the Canadian Institutes of Health Research and Global Affairs Canada under their Innovating for Maternal and Child Health in Africa initiative. This follow-on work is utilising a randomised controlled trial (RCT) methodology to understand the South Sudan Medical Journal Vol 12 No 2 May 2019most cost-effective ways to motivate and incentivise community health workers to improve primary maternal and child health care in both South Sudan and Uganda.While undertaking this research it became increasingly challenging to implement a large-scale RCT in South Sudan due to the high levels of population displacement. Whereas the Ugandan portion of the RCT is ongoing, we began to explore ways to support South Sudanese refugees outside the country. The purpose of this most recent work, which was funded with an additional grant from Grand Challenges Canada, was to assess the health and livelihoods needs of South Sudanese refugees in the Kiryandongo settlement camp in Uganda and develop a plan for further implementation and learning.