Sudan Country Brief
Community Health: Policy and Implementation Landscape Mapping in the Middle East and North Africa Region 2024
Highlights
Country Context
The Republic of Sudan is a country in Northeast Africa with a total population of 48.1 million. Sudan has experienced conflict and political instability over the past two decades, including two civil wars and a protracted conflict in the western region of Darfur. In 2023, fighting broke out between the Sudanese Armed Forces (SAF) and paramilitary Rapid Support Forces (RSF) in the capital, Khartoum. Since then, the country has been in a state of war with violence occurring across the country, and especially concentrated in Khartoum and Darfur. Over the past year, the war has created significant instability in the country, leading to further crisis, insecurity, and internal displacements.
In terms of administrative systems, the health system in Sudan is decentralized. The Federal Ministry of Health (FMoH) is responsible for policymaking and strategic planning as well as health legislation, standards and guidelines, training of different health care personnel and overseeing and monitoring performance of State Ministries of Health (SMoHs) in addition to financial and technical support to the States. It is also responsible for regional and international relations in addition to declaration and control of epidemics. State ministries of health are responsible for planning, implementing of national health policies, standards and guidelines, establishment of PHC facilities, provision of secondary and tertiary health services, overseeing localities' performance and for providing support to the localities. Localities are, in turn, responsible for provision and management of primary health care (PHC) services, health promotion and community participation.
Overview of Community Health
In 1976, PHC was endorsed in Sudan as the principal health care approach with an aim to reach rural and underserved populations. Community health is part of this approach and community health workers (CHWs) are formally recognized as health care personnel and are deployed in health care settings. In addition, in 2012, Sudan endorsed the Universal Health Coverage (UHC) approach.
Sudan has a long history of community health service delivery. Services are often delivered through vertical programmes leading to some duplication between states and localities. Several policies and initiatives have been undertaken by the FMoH to reform community health, including through the National Health Recovery and Reform Strategic Plan (NHRR - SP) 2022-2024, and the PHC Expansion Project, among others. The protracted state of conflict and ongoing war in the country negatively impacts efforts to harmonize and monitor existing programmes.
