The maternal mortality rate in South Sudan continues to be one of the highest in the world (2021).   South Sudan has one physician per 65,574 people and one midwife per 39,088 people.  One in seven women die in pregnancy and childbirth.

In 2012, during a visit to Pewsey, Samuel told us about the need for properly trained Traditional Birth Attendants (TBA). This request was prompted by the death of five mothers and babies at birth that year. Sudan generally has a shockingly high maternal mortality rate women often giving birth alone or with an untrained TBA.

Nzara had no hospitals and no doctors, nurses or trained midwives.  Women often gave birth alone.  Consequently, many mothers died in labour or the babies were still-born or died within a few hours.   In many cases death could be avoided with some basic medical knowledge.

Sadly, the knock-on effect of a lack of schools and educational facilities meant there were too few candidates with sufficient education to undertake full midwifery training.

To try to begin to address this problem, and provide an interim solution, The Foundation funded several one week-long courses organised by CHAS (the Christian Health Association of Sudan) in 2013 to train Traditional Birth Attendants.  A Traditional Birth Attendant differs from a midwife in that they are not academically trained but learn from apprenticeship involving informal training on how to take care of pregnant women, conduct deliveries and provide post-natal services. 

The first course was planned for 20 women but so great was the demand that 36 women turned up to be trained.   The picture below shows the women with their medical kits.

In review it was reported by Bishop Samuel Peni:

With Support from Pewsey Community, we were able to train 36 Traditional Birth Attendance (TBA) and provided them with kits that helped each of them to help serve the community. This training helped the TBAs to improve in their service to the community and we are glad that the rate of death of pregnant mothers has dropped significantly as a result of the work they have done. In 2011 we recorded that 2 in every 5 births ended in either death of the infant or mother or both the mother and the child. But with the trainings of the Community Health Promoters, who went to every home in the villages, and the training of TBAs, we have been able to improve the community greatly. The years 2012 – 2013 we have recorded an average of one death in every 10 pregnancies. Around the populated church mission area, where we recorded many deaths of mothers in childbirth in 2011, we have recorded zero for the years 2012 – 2013 for which we are grateful. This is great news!

In 2014 a second course was planned and funded by The St. Timothy Foundation thanks to a generous individual donor. At this second course 30 new TBA’s have been trained and the original 36 received a refresher course and new supplies for their kits. 

The trained TBA’s meet in Nzara regularly and are able to offer valuable support to the mothers.

In due course it is hoped that the education system will allow people with good enough skills to be able to train as qualified midwives. In the meantime, the TBA System is proving to be a viable and highly effective alternative. The women selected for training are respected among their communities because of their age and experience and are often being called upon by a relative when an expectant mother is about to give birth.

In 2014 it was recorded that one out of seven pregnant women in the South Sudan area died due to pregnancy related causes.  With less than 100 midwives for the entire country there is an urgent need for an increase in health workers.  Around the Nzara area the figures were even more shocking.  In 2011, 4 out of every 10 births ended in death for either the mother or baby or both.  In 2012 to 2013 figures showed no pregnancy related deaths and the good work continues.

However, in 2021, there is still much to do as malnutrition is still a factor for many; orphaned children are subject to exploitation; only 7% of the population has access to sanitation resources; high illiteracy features at 88% amongst women.

Other risk factors include Tuberculosis at 146 cases per 100,000, HIV/AIDS is at epidemic levels and, diabetes and cardiovascular disease are on the increase.  All contribute as risk factors for maternal mortality.

The 2021 statistics are taken from the Borgen Project.