A recent UN report found South Sudan maternal mortality at 1223 maternal deaths per 100,000 live births, 40 newborn deaths per 1000 live births, and 26 stillbirths per 1000 births. In comparison, Tanzania has 283 and 20, and 18, respectively. These poor outcomes are driven by many factors, including ongoing conflict and instability coupled with climate change and COVID-19, all of which have led to a dire humanitarian crisis.

Laerdal Global Health and the American Academy of Pediatrics recently trained midwives from 15 healthcare facilities in South Sudan in Essential Newborn Care.

South Sudan gained independence in 2011, making it one of the world’s youngest countries. Despite efforts to strengthen the health system, and expand access to care via community health services, less than half the population is able to access health facilities. Combined with a shortage of skilled birth attendants, South Sudan has some of the worst maternal and newborn health outcomes worldwide.

Remote training as a solution

Accelerated by the Covid-19 pandemic, but already in progress to help create access to training for healthcare providers working in humanitarian settings, the AAP in collaboration with Laerdal Global Health, developed ENC NOW! This remote facilitation tool enables remote facilitation, which means no need for trainers to travel to the location to facilitate the WHO Essential Newborn Care Course (formerly Helping Babies Breathe and Helping Babies Survive).

Through the USAID MOMENTUM program, which works in partnership with countries to scale up health interventions and improve the overall health and well-being of mothers, children, families, and communities, a pilot training of trainers, was held in Juba. This training was facilitated by Global Mentors from AAP who were supported by local facilitators. They were trained as part of an effort by UNFPA and supported by LGH, to create a critical mass of trainers in countries with the highest maternal and newborn mortality rates in the African region.

During the remote training, the Global Mentors used the ENC NOW! remote facilitation tools and other open-access learning materials available from hmbs.org. The WHO Essential Newborn Care Course Materials (formerly Helping Babies Breathe) was used, as well as the new LGH innovation for assessments known as LIFT. LIFT collects data from knowledge and skills checks and helps facilitators collect and analyze important data about individual and group progress.

The second step of the project is currently in progress: training of frontline healthcare providers in the 15 facilities. During this phase, the 15 trainers use the printed ENC materials, NeoNatalie and other Newborn products. In addition, the trainers receive mentoring that will take place remotely over the course of several months in the context of an ongoing, two-way relationship between the Global Mentors and the 15 Facilitators.

In addition to ongoing communication via email and other communications platforms like WhatsApp etc., the Global Mentors will deliver tailored virtual sessions designed to support the project in their long-term ENC implementation efforts.  The goal of the mentorship process is for the Global Mentors and AAP staff to assist MOMENTUM with building a sustainable training program in collaboration with relevant health authorities in South Sudan.

MOMENTUM has expressed interest in expanding the project approach to other countries in the region as a result of the notable benefits of remote training and other training innovations in settings like in South Sudan.