Sudan Presentation IGAD Regional Workshop for Global Fund Application

Background Population size of the country: 33,289,406 (2008 Census) people No of the districtsies/localities of the country 18 States, with 184 localities. Population size in the cross border areas is about 7,980,568 No of the districts in the border areas (IGAD borders) 9 States( S Darfur, S Kordofan,,W Nile, Sinnar, Blue Nile, Gadarif, Kassala, West) No of the villages in the borders 45 Villages Average population size per village 50000

Health and Community systems A.Health tier B.B. Primary health service coverage in general 86% Only 24% of PHC facilities provide the full package of essential PHC services (immunization, nutrition, ANC, essential drugs, prevention and diagnosis and treatment of common diseases), while the rest provide only part of this package. 12% of the existing facilities are not fully functioning, due to staff shortage or poor physical infrastructure (NHSS, 2008– 2008). Population groups who tend to have a disproportionate low access to health and community services, including HIV, Malaria and TB prevention and treatment services.

B. Primary health service coverage in specific to cross border areas Conflicts in Sudan and neighboring countries has resulted in over 2 million IDPs and refugees, concentrated in Darfur, Kordofan, Khartoum, White Nile and eastern States. IDPs are vulnerable groups across many health indicators due to forced mobility, poverty and dislocation. Services to IDPs are often disrupted due to ongoing conflict or other political factors. There are an estimated 4 million people who are nomadic who are also deemed to have higher vulnerability. In addition to IDPs and refugees, population groups who are mobile for economic reasons, such as truck drivers, may also have limitations in accessing services.

c: Existing constraints, gaps(1)  The biological and behavioral magnitudes of HIV/AIDS epidemic in CBMP is not yet deeply reconnoitered.  Size and behavioural dynamics of key populations at higher risk for HIV infection and other vulnerable groups remain  Limited coverage with HIV/AIDS comprehensive package of services.  Poor access and utilization to services provided. 7/3/2015

Existing constraints, gaps(2)  Continuation massive movement of hard to reach populations (illegal immigrants, seasonal workers and returnees ),  Provision full package of services to them.

Plans to improve health service coverage in the cross border areas (1) Generate health strategic and information system concerning cross-borders, mobile population and their hosting communities. Carry out HIV/AIDS studies and surveys to identify the profile, size and magnitudes of epidemic among CBMP and their hosting communities.

Plans to improve health service coverage in the cross border areas (2) Provide HIV preventive services package to CBMP and hosting communities. Awareness raising Extension of VCT sites as well as mobile VCT services. PMTic and reproductive health services. TB and STIs services. 7/3/2015

Plans to improve health service coverage in the cross border areas (3) Strengthening existing hotspots Establishing new sites a long border of Sudan with South Sudan.central Africa and Shad. Logistically Technically

Joint planning and alignment of TB and HIV strategies, policies and interventions Plans for further alignment of the TB and HIV strategies, policies and interventions at different levels of the health systems and community systems The barriers that need to be addressed in this alignment process

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