South Sudan

Q1/2012 Nursing & Midwifery College Update

May 24, 2012

Bilha Achieng and Jonathan White

Project Background

South Sudan’s maternal mortality remains the highest in the world, at 2,054 deaths per 100,000 live births; 200,000 women die in childbirth every year according to the 2006 South Sudan Health Survey. High levels of maternal mortality are linked to: poor access to quality reproductive health services, including family planning, access to skilled birth attendants and access to emergency obstetric and neonatal care. Fewer than 20 certified nurses and even fewer registered midwives, 4 in total, exist in all of South Sudan, a population of 9.6 million. 

Photo: The first class of Midwifery students starting off the second year of training.

Real Medicine Foundation, in collaboration with the Government of South Sudan, UNFPA, UNICEF, UNDP, WHO, St. Mary’s Hospital Juba Link, Isle of Wight, and the Japanese International Cooperation Agency (JICA), and in partnership with and with financial support from World Children’s Fund, has established South Sudan’s first ever accredited College of Nursing and Midwifery (JCONAM). The consortium aims to provide a scalable working model for this college that offers a 3 year diploma for Registered Nursing and Midwifery and is envisioned to be extended to other strategic locations within the newly independent country of South Sudan. This graduated level of nurses and midwives aims at filling the gap of professional skilled care services, destroyed as a result of the more than two decades of civil strife and war.

Project Goals:

To improve the quality of and access to professional health care services by imparting the necessary skills through a three-year diploma program in either nursing or midwifery at the first College of Nursing and Midwifery in South Sudan accredited by the Ministry of Higher Education and Juba University that offers a diploma of Registered Nursing and Midwifery Status.

Photo: Students attending lecture

Project Objectives:

Provide model courses in Registered Nursing and Registered Midwifery in the first National Health Training Diploma Institute in South Sudan

Provide a curriculum recognized by all ministries associated with education in the ROSS (new designation for the new Republic of South Sudan, replacing GOSS)

Provide leading edge skills laboratory and library for the students

Provide improved clinical setting for student training

Provide highly qualified instructors and tutors for the duration of the three year program

Provide an unprecedented model of health care sector capacity building for South Sudan

Provide a sustainable solution to South Sudan’s Maternal and Infant Mortality Rate, the former, which is the highest in the world at 2,054/100,000 as per the 2006 South Sudan Household Survey.  Approximately 200,000 women die each year giving birth.     

Summary of RMF/WCF-sponsored activities carried out during the reporting period undereach project objective):

Implemented activities in-line with RMF sponsored activities and project objectives include:

Support to the Ministry of Health, Republic of South Sudan and project partners in the coordination and implementation of project activities over the reporting period. Also in line with the approved college annual work plan.

Continued facilitation of inter-linkages with UNFPA, MOH and other stakeholders in ensuring quality assurance in the implementation of both nursing and midwifery curricula in the diploma programme.

Contribution of essential content by college tutors in the review of the draft diploma midwifery curriculum which will be later finalized and endorsed by the Ministry of Health for use by all Diploma National Health Institutes.

Continued education and assessment of nursing and midwifery students

Procurement of college books, teaching and learning aids, office and skills laboratory equipment

Holding of meetings attended by project partners

Admission of new students selected by MOH for the 2012 intake in JCONAM

Transportation of students from respective states to Juba at the beginning of the year

Registration of RMF as an International Non-governmental Organization (INGO) in South Sudan

Photo: The new classroom block constructed by JICA

Results and/or accomplishments achieved during this reporting period:

JCONAM resumed academic functions on the 15th of January 2012 after closing for the December holidays. The second year nursing and midwifery students started their first semester during this quarter upon return from their respective states with most students reporting in by the last week of January. Unfortunately due to failure by one nursing and one midwifery student to pass their end of year examinations and consequent supplementary examinations, the college administration discontinued the two students from their courses and JCONAM. They were however admitted into other public health institutes at enrolled level.

Second year midwifery students were posted to the main hospital soon after reporting for the first semester. They were rotated within the previously allocated maternity wards, which included: the antenatal clinic, antenatal ward and the gynecology ward. The second year nursing students remained in class to continue with theoretical learning.

The November 2011 to January 2012 interviews culminated in at least 450 students being admitted into various national health training institutes across the 10 states. More than 1,000 candidates applied for admission into the various institutes undergoing a rigorous interview process led by the Ministry of Health-Directorate of Training and Professional Development and assisted by tutors within these institutes and other stakeholders. During the first week of February 2012, JCONAM admitted a new class of 30 nursing and 31 midwifery students into their first year. The first two weeks of their admissions were characterized by; changes in courses (from registered nursing to registered midwifery and vice versa), changes in education program (from diploma in either Nursing and Midwifery to enrolled level, lab technicians etc. and vice versa). These changes were mainly due to errors in registration after the interview process. By the end of the month, all students had settled into their respective courses and institutes.

The college recruited an additional international tutor for the midwifery program. The tutor was contracted under the International United Nations Volunteer Program (IUNV). Rosemary Mugabe joined the project in early January 2012 and will be working closely with the other Midwifery tutors-Judith Apondo and Fekadu Alemu to train the first and second year students. The Nursing department comprises of: Repent Khamis and Justina Mkoma. The principal doubles up on both courses when either department is shorthanded.

VSO-South Sudan (A UK based non-profit) sponsored one clinical instructor to JCONAM to provide hands on support to the college tutors in both nursing and midwifery education programs.

Construction and renovation by both UNDP and JICA was completed during this quarter. The MOH carried out an overall inspection of the new hostel facility alongside UNDP. Minor adjustments were suggested on the structures with particular focus on the kitchen and mess hall. After the improvements were made, UNDP purchased mattresses, beds, reading tables and chairs, which were fitted into all 62 rooms. The first year students have already occupied some of the rooms with the second year students scheduled to move in during the second quarter. Construction and renovation of the classroom blocks by JICA was completed in February. On the 7th of March, JICA officially handed over the facility to the MOH in a colorful ceremony at the college facility. JICA’s contribution towards JCONAM was attributed to the lack of functional units in which students could be taught. Both educational programs were taught in what are now the practical room/skills laboratory and the conference room. On this day, JICA handed over a rehabilitated block with 2 new classrooms and a newly constructed block with 2 additional classrooms. Both the first and second year students now have their own designated areas of learning. JCONAM however still faces the challenge of financial resources that will facilitate the construction of another classroom block for the third intake.

During this quarter, JCONAM also received additional furniture in the form of lockable cupboards from UNFPA. These cupboards were to be placed in: the skills laboratory, library, tutor’s lounge and principal’s office.

RMF is now recognized as a registered international non-governmental organization (INGO) in South Sudan. Prior to its registration RMF worked with UNFPA guided by a co-funding agreement for the direct financial support of JCONAM. As of 28th January 2012, the South Sudan Ministry of Justice and Legal Affairs registered RMF as an independent organization. RMF South Sudan will thus seek to enter into agreements with several/different government department to establish other developmental projects/programs.


Photos: Ribbon cutting with South Sudan MOH and Dr. Tahino, Head of JICA Sudan.  

Number served/number of direct project beneficiaries:

With the latest 2012 admissions into JCONAM, the current population stands at a combined number of 95 nursing and midwifery students. The continued support of the MOH and its developmental partners has thus facilitated the sponsorship of all students in their respective diploma courses.

Upon graduation after the three-year course, the registered nurses and registered midwives will provide a much-needed service within the states and counties at facilities level. The services offered by this cadre of graduates are also expected to extend into the community through health education, community mobilization and home care among others.

The review of the registered midwifery curriculum has also necessitated the review of the registered nursing curriculum. The JCONAM and MOH are currently soliciting the support of its funding partners to support the review process in 2012.

Photo: Skills Lab Demonstration

Plans for next reporting period: 

Roll out of RMF annual work plan and budget as an independent INGO in South Sudan

Continued sponsorship of JCONAM nursing and midwifery students in the first and second year

Procurement of required uniforms, stationery, office and skills laboratory equipment, internet equipment, teaching and learning aids for the second quarter

Support in the recruitment payment of additional college staff such as clinical instructors, librarian, finance and administration officer, cleaners and security guards.

Success story(s) highlighting project impact: 

Two female midwife students were discontinued from their courses in 2010 and early 2011 due to pregnancy cases. The MOH had earlier agreed to allow for these students to continue with normal learning despite being pregnant however, it negatively affected their academic progress and they opted to defer. Both students were re-admitted into the first year in early January 2012 and allowed to resume into the midwifery program. When asked, the students said that they had been chosen among thousands of applicants in 2010 to make a difference in South Sudan and would not let anything deter them.

Country Page: South Sudan Initiative Page: Juba College of Nursing and Midwifery