South Sudan

Third Incoming Class of Nursing and Midwifery Students Starts

May 23, 2013

Dr. Taban Martin Vitale 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.

Second year midwifery student taking the weight and height of a mother at ANC

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 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.  

As of April 2013:

  • Rehabilitate the infrastructure at Juba Teaching Hospital, beginning with the Pediatric Wards.
  • Rehabilitate, and supplement, equipment set at Juba Teaching Hospital, beginning with the Pediatric Wards.
  • Provide regularity to supplies of basic medical devices, disposables, and pharmaceuticals, complementing the items received from the National Ministry of Health.
  • Provide equipment maintenance and spare parts management.
  • Organize on-site clinical training, beginning with general equipment use and care, and pediatric emergency care.

First year midwifery students for a lecture session

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 program.

Sponsorship of first, second and third year nursing and midwifery students at the Juba College of Nursing and Midwifery through provision of uniforms, skills laboratory equipment, clinical training equipment, books, stationery and Information Technology (IT) equipment.

Coordination of RMF activities with other organizations and UN agencies supporting the Juba College of Nursing and Midwifery by participating in meetings and conferences.

Continued support of high speed WIFI internet services for JCONAM and Juba Teaching Hospital (JTH).

Results and/or accomplishments achieved during this reporting period:

  • 60 new Nursing and Midwifery students joined JCONAM in January 2013.
  • Procured and delivered 60 bed mattresses, blankets, bed sheets and pillow cases for the new first year students, who are now comfortably settled into their new accommodations at the students’ hostel on the JCONAM campus.
  • Procured and delivered a full semester’s supply of surgical gloves for the students in clinical practices to ensure infection control. The students in clinical practice reported a big improvement in infection control measures during the first quarter due mostly to the sufficient supply of gloves.
  • Installed and connected 6 additional desktop computers to the Internet in addition to the 4 computers newly connected during the previous quarter. This means that there are now 10 Internet connected computers available for the students to use at the College’s Computer Lab, which greatly increases their access and usage of the latest educational health materials.
  • Paid the quarterly subscription of Internet services for JCONAM and Juba Teaching Hospital (JTH) Resource Centre.  The Internet services at JCONAM are accessible for the 13 college teachers/tutors and the student population, while the resource center at JTH is accessible by RMF staff and JTH medical staff.
  • The RMF South Sudan team in Juba received and delivered $10,000 worth of donated medical supplies and teaching materials to JCONAM from Cindy Urbanc and her US donors.  The team was pleased to host Cindy, a US registered Nurse-Midwife and PhD candidate, in Juba on January 17th and 18th while she brought the supplies directly to Juba and visited JCONAM and the JTH wards as part of her thesis research for Respectful Maternity Care.
  • Coordination of RMF activities and participation in meetings/workshops together with other NGOs and UN agencies supporting JCONAM and other National Health Training Institutes (NHTIs)
  • Participated in the review of the National Nursing and Midwifery Strategic Plan for the year 2013- 2017.
  • Assessment and identification of the company for constructing a structure/shed to house/protect the new generator at the student hostel; provided down payment.  
  • Assessment and identification of the construction company to renovate Pediatric Ward 5 of Juba Teaching Hospital.
  • Received MOUs with the National Ministry of Health and the leadership at Juba Teaching Hospital for our work at Juba Teaching Hospital.
  • Renewed RMF South Sudan’s NGO registration.
  • Renewed MOU with the Ministry of Health for RMF’s work at JCONAM.
  • Designed and placed RMF logo signboards for donor recognition.

Cindy Urbanc and RMF South Sudan team deliver the boxes of donated medical supplies to JCONAM

Tutors demonstrating some of the donated items

B.1. Infection control

During the first quarter, RMF procured and delivered surgical gloves to the school which helped the students during their clinical practice rounds in the health facilities.  JCONAM students greatly appreciated this support offered in ensuring infection control during their rounds.

The students had difficulties earlier due to the inadequate supply of consumables by the Ministry of Health which was worsened due to the increasing number of students in clinical areas.

With a consistent supply of gloves for all the students in their clinical areas, the students are now able to deliver quality nursing and midwifery care for the community and observe directly the results of good infection control during their work.

A second year nursing student inserting a canular in a neonate using gloves procured by RMF

B.2. Distribution of mattresses and beddings

JCONAM started in 2010 with only one batch of students, the current third year students. Now, the campus is almost completely filled with students from first year to third year. The new first year nursing and midwifery students reported to the College in mid January 2013 and were faced with a lot of challenges upon arrival due to a shortage of accommodation materials and the mistiming of funds by the MOH and other partners. There were no mattresses, blankets or other bedding materials for them, forcing some students to sleep on the floor, while others went to stay with their relatives/friends within Juba town. This in turn interrupted the first week of the sessions.

RMF stepped in and acted swiftly after hearing directly from the principal of JCONAM and purchased 60 mattresses, pillows, blankets and bed sheets. The students and the college administrator acknowledged RMF as one of the most responsive and active partners of JCONAM, without which it would be much more difficult to manage the college.

First year nursing and midwifery students receiving mattresses and beddings procured by RMF

B.3. Antenatal Clinic (ANC)

Mary, a pregnant mother from Atlabara in Juba, spoke to us while attending a JCONAM Antenatal Clinic about her prior experiences with the Antenatal Ward a few years ago at Juba Teaching Hospital.

Midwifery student palpating Mary’s abdomen during Antenatal visit in Juba Teaching Hospital

Mary noted that three years ago when she was attending an ANC at JTH, she was totally discouraged by the fact that there were far too few midwives on duty and that the mothers all had to wait for a very long time to see anyone and did not receive appropriate health information. This then forced most of the mothers to opt for home delivery, greatly increasing their health risks, rather than attending skilled deliveries conducted in the hospital.

However, this time, Mary reported a significant improvement as she did not have to wait in long lines and she interacted with the midwives freely receiving adequate health information regarding pregnancy care and delivery plan.  She believed the better service now is due to the increasing midwifery workforce as a direct result of JCONAM and acknowledged RMF as an organization behind the initiation of the College. She said with this trend many more mothers will want to attend antenatal care and deliver at the Hospital rather than at home.

A nursing student giving a DPT vaccine

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