1. Director for Nutrition, MOH/RSS
South Sudan Maternal Infant and Young Child Nutrition (MIYCN) Strategy and Guidelines
Rebecca Alum William
Director for Nutrition, MOH/RSS
December 12, 2016
Johannesburg
9/19/2018

2. Outline of the presentation
Introduction to South Sudan: Demographics, Administrative divisions and Map.
Country Situation and efforts
Purpose, Goal and objectives of the MIYCN Strategy
Strategic action of the MIYCN
Next steps
Challenges

3. South Sudan overview
South Sudan attained her independence on the 9th July 2011
Area coverage 644,329 KM2
Population of 8.3 m (2008 Census)
Male 4.29 m
Female 3.97 m
Population density: 15.8 KM2
Capital city: Juba

4. South Sudan overview Cont…
The country has a decentralized system of Governance with a national government and a decentralized system of four levels –
National
States
Counties - 80
Payams
Boma

5. Health facilities in Country
Total of four Teaching Hospital (National Hospitals)
7 state Hospital
27 county hospital
358 Primary health Care centers
1010 Primary health Care Units

7. Country Situation 40.3% 17.3% 19.4% Health Status indicators
SSHHS(2006)
SSHHS(2010)
Maternal Mortality Ratio (per 100,000 live births)
2,054
789
Under Five Mortality Rate (per 1,000 live births)
105 99
Infant Mortality Rate(per 1,000 live births) 67 64
Stunting (% of under five children)
34.4
31.1
Underweight (% of under five children)
32.9
27.6
Under five Wasting
22.7
Contraceptive prevalence rate(%)
4.7
Antenatal attendance 1st visit(%)
46.7
40.3%
Antenatal attendance 4th visit(%)
9.3%
17.3%
Births attended by skilled H/Ws(%)
14.7
19.4%
Caesarean section rate(%)
0.5

8. Country Situation Cont…..
Selected Service coverage indicators
SSHSS (2010)
DPT3 Coverage(%) 59
Measles(MCV %) 62
Selected Health System Indicators
Deliveries attended by a skilled attendant
19.4%
Institutional deliveries
11.5%
Mother-to-child-transmission (women living with HIV)
135,000
Children living HIV
18,000
Neonatal Mortality rate (/1000 births) 39

9. Infant and Young Child Feeding practices in South Sudan%
SHHS 2006 and 2010

10. Current Efforts
Services for treatment and prevention of nutrition are on-going pls mention scale and numbers to show the reach
Increased access to quality nutrition data; SMART and IPC Analysis
Development of guidelines for Nutrition
- CMAM guidelines and training Packages,
- MIYCN strategy, guidelines and Training Packages are developed as a road map for sustainable development for South Sudan

11. MIYCN strategy and Guidelines: the purpose, Goal and Objective
It serves as a guide for the government and all stakeholders involved in the conceptualization, planning, implementation, supportive supervision, and monitoring of MIYCN and related preventive interventions
GOAL: To strengthen the health status of the population by improving the health and nutritional status of mothers, infants, and young children and their wellbeing through an effective delivery of the basic package of health and nutrition services (BPHNS).
Objective: To reduce the burden of malnutrition in pregnant and lactating mothers by 20%, and stunting in children under five years of age by 10% by year 2025

12. MIYCN strategy development process1
Desk review, meetings, interviews, group discussions (March-April 2016) 2
Consultation, setting goals and objectives to review a 1st draft of the strategy (May 8 to 10,2016) 3
Consultation to review a 2nd draft of the strategy and the 1st draft of the guidelines (June 14 to 16,2016) 4
Consultation to Review the third draft of the strategy and guidelines (July to August,2016) 5
Finalization process: with inputs and suggestions from all partners (July to September,2016) 6
Developing of Training Package (September to November,2016) 7
Validation Workshop (November 2016)
Planning and costing of the MIYCN strategy 6th -8th December 8
Endorsement by the Senior Management Committee (6th December 2016)

13. MIYCN MIYCN strategy: components
Endorse key policies and regulations
Improve maternal nutrition
Optimal Infant and Young Child Feeding practices
Intesectoral integration
Multisectoral integration
Capacity Building and Service Strengthening
Advocacy and SBCC
Research, information, monitoring and evaluation
Resources Mobilization and support

14. MATERNAL, INFANT AND YOUNG CHILD NUTRITION STRATEGIC ACTIONS - 2016 to 2025
Develop and disseminate key policies and regulations
Improve maternal nutrition
Promote, and support optimal Infant and Young Child Feeding practices
Support optimal Infant and Young Child Feeding in difficult circumstances (HIV/AIDS, emergencies e.t.c)
intra-sectoral integration (Health and Nutrition 

15. MATERNAL, INFANT AND YOUNG CHILD NUTRITION STRATEGIC ACTIONS - 2016 to 2025 cont….
Multi-sectoral integration (Food Security and Livelihood, WASH, Protection, Education and Shelter)
Inter-sectoral: Maternal and Child Health, Immunization, Reproductive Health, HIV/AIDS.
Capacity Building and Service Strengthening
Advocacy and Social Behavioural Change Communication
Research, information, monitoring and evaluation
Mobilise resources and technical support

16. MIYCN strategy: expected outcomes by 2025
Indicators
Baseline (%) (2016)
Target (%) (2025)
Increase the rate of early initiation of breastfeeding within the first hour of life from 48 75
Increase the rate of exclusive breastfeeding in the first six months 45 70
Increase continued breastfeeding up to two years from 38 60
Increase the timely introduction of complementary foods 21 50
Increase the Minimum Dietary Diversity (children six to 23 months) 18 40
Decrease the low birth weight 5 2
Reduce childhood stunting by 10% 31
Reduce childhood wasting to less than 13% 23 13
Zero percent increase in childhood obesity in urban areas -
Five percent reduction from baseline anaemia in women of reproductive age (There is no baseline for anaemia in women)*
Twenty percent reduction in the Proportion of women aged 15 to 49 years with low body mass index (<18.5 kg/m2)
(-) means we have no baseline, and we need to immediately conduct a national
Why 2015: Align with the national health policy and the global targets for MIYCN (WHO is tracking progress)

17. MIYCN strategy aligned with international and national recommendations…like
International Code of Marketing and WHAs,1981 to 2016
The Baby Friendly Hospital Initiative,1991
The ILO Maternity Convention,2000
The Global Strategy for Infant and Young Child Feeding,2002
WHO Essential Nutrition Actions, 2013
The Sustainable Development Goals,2015
GOSS National Health Policy, and the GOSS Boma Health Initiative,2016
World Health Assembly Resolution (65.6) on the development of a comprehensive plan for MIYCN,2012
WHO comprehensive implementation plan for MIYCN,2012
WHO Essential Nutrition Actions evidence and guidelines,2013
World Health Assembly recommended MIYCN global indicators, 2014
GOSS National Health Policy,2016
GOSS Boma Health Initiative,2016

18. MIYCN strategy: Next steps…
Launch of the MIYCN strategy
Printing and dissemination
Advocacy and promotion with donors and other agencies
Capacity building (master training, training of trainers, cascade training)
Integrate MIYCN into the Boma Health initiative for community ownership
Reporting, Monitoring and evaluation

19. Lessons learned in development of the MIYCN strategy
Advocacy to the MoH senior management for leadership and ownership.
Consultative process especially with the various government line ministries and communities and also involvement of all implementing partners and the UN agencies was key in the development of the strategy
Formation of the MIYCN TWG as a core group which expedite review process and technical inputs

20. Challenges
Policy environment: No nutrition policy to re-enforce implementation of international regulations
No county wide nutrition data
Male engagement
Data and analytics: lack of good baseline data for guiding the strategy
Programming environment: political instability and insufficient HR capacity , limited funding to support scale up

21. Commitment statement from the Honorable Minister of Health Republic of South Sudan, Dr. Riak Gai Kok
“ Yes, we are in emergency, but we must balance the situation with development to give a future for the young generation”
9/19/2018

22. Thank you for listening !
9/19/2018