Improving Availability of Life-saving Reproductive Health Commodities to Flood and conflict-affected Populations in Prioritized Areas of South Sudan. The country has some of the worst health statistics in the world. The maternal mortality ratio is estimated at 1050 per 100,000 live births (UNFPA, UNICEF, World Bank Group, UN estimates, 2017). The majority of women (89%) deliver their babies at home. Amidst the critical shortage of human resources for health, skilled birth attendance stands at a low 14.7%. The South Sudan Household and Health Survey (2010) shows a total fertility rate of 7.5 children. The contraceptive prevalence rate is 4.5% for all methods and 1.7% for modern methods. The mean HIV prevalence rate was 2.7% in 2012, with adolescents and youth as the most affected group. About 56.9% of new HIV infections occur among persons aged 10-34 years. The adolescent birth rate of 158/1,000 girls aged 15 – 19 years is partly attributable to the high rate of child marriage of 40% before 18 (2010 SHHS). Child marriage and teenage pregnancy contribute to the high school dropout rate in South Sudan. There is limited access to health services, including reproductive, maternal and adolescent health care, including serious shortages of Reproductive Health supplies.

This is a complementary core-pipeline project to support the scaling up of immediate response to address effects of food, insecurity/conflict and Hepatitis E outbreak in the priorities counties in South Sudan. The project aims to support the setting up mobile health services, including SRH service and expanding health services in the priority counties, scale up health services, support PHCCs in Western Equatoria State (Yambio, Tambura, Ezo, and Nagero counties) affected by sub-national violence, and Unity State (Leer, Guit, Panyijiar, Rubkona and Mayendit Counties) and Upper Nile State (Maiwut and Canal/Pigi) affected by the flood. The critical activities for this project include ensuring the availability of SRH supplies to enable the provision of SRH services and clinic management of rape. Through this SSHF project, UNFPA will procure, preposition, distribute and monitor the rational use of emergency reproductive health kits to health partners operating in functional static and mobile clinics in the affected areas. This is in alignment with UNFPA's role of managing the reproductive health core pipeline on behalf of the health cluster. Like all pipeline projects, the identification of needs and allocation of supplies will be coordinated within the health cluster. 

The project will target 16,500 people, among whom 12,375 are women and adolescent girls, and 4,125 are men and boys.  An estimated 7,800 pregnant women will receive clean delivery kits, 720 will be treated for rape and other forms of GBV. The rest, 7,980, will receive other SRH services, including management of miscarriage and complications of Abortions, management of sexually transmitted diseases, safe deliveries at the health facilities. 

To expedite delivery, the emergency reproductive health kits will be sourced from inventory stock through UNFPA Procurement Services Branch and shipped to Juba-South Sudan by air. The deployment of supplies to the eleven (11) field locations in South Sudan will be coordinated through the Logistics Cluster however, whenever timely delivery is not possible, UNFPA will contract private transport service providers to deliver the supplies in a timely manner.  Provision will be made for travel to affected areas to supervise, monitor the distribution and use of RH supplies and conduct refresher training of service providers whenever required.