Sudan: Humanitarian access snapshot

This briefing note gives a snapshot of the humanitarian access situation in Sudan following the start of fighting in April 2023 as well as some insights into the overall humanitarian access situation since the military takeover in October 2021.

Flood Assessment in South Sudan November 2022

Like many countries around the globe, South Sudan is facing unprecedented impacts of climate change. Since 2017, it has experienced heavy downpours which have resulted in rampant floods. For instance, between July and October 2021 alone, 856,000 people were affected by floods and 389,000 were uprooted from their homes.
Aware of the gravity of the situation and the need for urgent interventions, the Relief and Rehabilitation Commission (RRC), with funding from the UNDP, conducted a rapid assessment of the flood situation. The report presents the most recent information on the current flooding of large parts of South Sudan and its repercussions for people and for social and political stability. The results of the assessment indicate that the floods caused huge humanitarian, development, and peacebuilding challenges.
The report provides actionable recommendations for addressing immediate to long-term recovery, and to build the resilience of the vulnerable populations and communities in South Sudan.

Hiding in plain sight: IDP’s protection strategies after closing Juba’s protection of civilian sites

When civil war broke out in South Sudan in 2013, people from the Nuer minority ethnic group became targeted by government forces and sought protection in United Nations peace-keeping bases which expanded and became known as Protection of Civilian sites (PoCs). In 2020, responsibility for these sites was handed over to the transitional unity government despite protests from human rights groups and internally displaced persons (IDPs) and lack of a clear plan to address security and basic needs. This article describes both the history of events around this transition as well as how life changed for camp residents after this handover, particularly the decrease in security inside and outside the camps, the strategies IDPs have adopted to hide their ethnic identities and how this affects IDPs’ hopes, plans and participation in civic life.

Cholera question bank

These resources are intended to support operational social science research to be used in cholera preparedness and response activities.

Socio-behavioural insight for community-centred cholera preparedness and response In Mozambique, 2023

This brief explores socio-behavioural determinants including local knowledge, perceptions, practices, and structural factors influencing cholera transmission dynamics. The brief has been developed to support response actors develop prevention and control strategies to rapidly contain the outbreak and prepare for a potential scaling up of the response in view of the imminent rainy season. It emphasises the vital importance of these strategies being community-centred and identifies gaps in knowledge and evidence.

‘Who Can Sing the Song of MSF?’ The Politics of ‘Proximity’ and Performing Humanitarianism in Eastern DRC

This article explores the complexities of the brokerage work conducted by Congolese MSF staff working in a ‘field’ that is not a distant, liminal space, but their country (and region) of origin. They have complicated and heterogeneous political and social histories, networks and perceived identities in the areas where MSF works. This ‘proximity’ is a double-edged sword: local staff are essential to networking with armed actors and political authorities, as well as translating the meanings of policies and principles into practice, yet they find themselves either at risk, or perceived as a risk, or both.
The article is based on eight months’ ethnographic fieldwork in North Kivu – in the provincial capital Goma, and in Masisi. It draws from 180 interviews with present and former MSF fieldworkers with experience in North Kivu since 2005, in particular, fifty different Congolese employees with experience in Masisi,

Researcher Effects in Survey-Based Research: Insights from Research in South Sudan

The article contributes to the literature that argues that researcher effects also occur in quantitative research. It shows that in policy-relevant research reflexivity is necessary to strengthen research results. Researchers working in conflict-affected, impoverished environments, and donors requesting evaluation and measurement, should be encouraged to take positionality into account and to ask questions about research practices.

Strategic Response Plan For The Ebola Virus Disease Outbreak In The Provinces Of North Kivu And Ituri Democratic Republic Of The Congo July – December 2019

This document sets out the Ministry of Health’s strategic response to the Ebola Virus outbreak in North Kivu and Ituri provinces in 2019. Taking into account the impact of insecurity in these regions, the plan details how the government planned to scale up the response by focussing on: the detection and rapid isolation of cases; intensifying case management and public health intervention around any confirmed case; strenghtening community engagement as well as the health system.

Revitalised Agreement on the Resolution of the Conflict in The Republic Of South Sudan (R-ARCSS)

This peace agreement, the Revitalised Agreement on the Resolution of the Conflict in the Republic of South Sudan (R-ARCSS), was finalized in September 2018, and marked an attempt to quell violent conflict in South Sudan, and ushered in a ‘transitional period’ that would lead to elections in 2024 (this has recently been extended two years). The agreement was brokered by the Intergovernmental Authority on Development (IGAD).

National Action Plan for Health Security, Republic of South Sudan

This National Action Plan for Health Security from the Republic of South Sudan details the country’s health security strategy for 2020-2024 including annual reporting, after action reviews, joint external evaluations, simulation exercises and other assessments, within a One Health framework.

Monthly Humanitarian Situation Report South Sudan

This Situation Report from the WHO on South Sudan offers an overview of the humanitarian situation in January 2023, including the state of measles transmission and vaccination response, Covid-19 vaccination, cholera and the distribution of health emergency kits.

South Sudan Spontaneous Refugee Returnees December 2021

This overview from UNHCR and the South Sudan Relief and Rehabilitation Commission (RRC) presents details about the state of South Sudanese refugees in the region, and specifically, about their patterns of returnees in late 2021.

Republic of South Sudan National Health Policy 2016-2026

Written by the Ministry of Health of the Republic of South Sudan, the National Health Policy 2016-2026 puts forth new paradigms for health service delivery, health financing, strategic information, leadership and governance, human resources for health, and access to essential medicines to ensure improved health services for South Sudan.

Fishers’ perceptions of climate change, impacts on their livelihoods and adaptation strategies in environmental change hotspots: a case of Lake Wamala, Uganda

Fisheries resources support livelihoods of fishing communities but are threatened by over-exploitation, habitat degradation, pollution, invasive species and climate change. We identified adaptation strategies, which if promoted and their constraints addressed, could increase resilience of fishers to the influence of climate change and sustain their livelihoods.

Indigenous climate knowledge in southern Uganda: the multiple components of a dynamic regional system

Farmers in southern Uganda seek information to anticipate the interannual variability in the timing and amount of precipitation, a matter of great importance to them since they rely on rain-fed agriculture for food supplies and income. This system of indigenous knowledge leads farmers to participate as agents as well as consumers in programs that use modern climate science to plan for and adapt to climate variability and climate change.

How Seasonality and Weather affect Perinatal Health: Comparing the Experiences of indigenous and Non-Indigenous Mothers in Kanungu District, Uganda

Maternal and newborn health disparities and impacts of climate change present grand challenges for global health equity, and there remain knowledge gaps on how these challenges intersect. This study examines how mothers are affected by seasonal and meteorological factors in Kanungu District (Uganda) through a community-based study with mothers and health workers. The causal pathways through which weather and seasonality may affect size at birth as reported by Kanungu mothers were consistent with those frequently reported in literature elsewhere, including maternal energy balance (nutritional intake and physical exertion output) and seasonal illness. Non-Indigenous mothers frequently relied on livestock assets or opportunities for less taxing physical work than Indigenous women, who had fewer options when facing food shortages or transport costs. Findings point to specific entry points for intervention including increased nutritional support in dry season periods of food scarcity, increased diversification of wage labour opportunities,

Moral distress among Ugandan nurses providing HIV care: A critical ethnography

The phenomenon of moral distress among nurses has been described in a variety of high-income countries and practice settings. No research has been reported that addresses moral distress in severely resource-challenged regions such as sub-Saharan Africa. Through critical ethnography, this paper describes the manifestation and impact of moral distress as experienced by central Ugandan nurses providing care to HIV-infected or -affected people. Participants described their passion for nursing and commitment to patients and experienced moral distress when a lack of resources put patients’ wellbeing at risk. The trauma imposed by systemic challenges on the nursing profession was acknowledged, as was the perception that the public blamed nurses for poor patient outcomes. However, participants were determined to serve to the best of their abilities and to take satisfaction from any contributions they were able to make.

Motherhood and Social Repair after War and Displacement in Northern Uganda

This article considers the relationship between processes of return after mass displacement, and social repair. We look to the everyday as a space of negotiation and renegotiation of social relationships that make life meaningful. The article considers these propositions in the context of forced displacement of up to 90% of the Acholi population during the height of war in northern Uganda from 1986-2008, and in the processes of mass return after the war. It takes as a point of departure the efforts of two sisters as they struggle to overcome their displacement from family networks, and seek to restore their status through the performance of Acholi notions of motherhood. Their efforts are collectivized by working with other female heads of households to trace paternal clans, and secure a future for their children. The concept of social repair, we suggest, illuminates the way return involves the day-to-day processual negotiation of relationships.

Building Climate Resilience in Fragile Contexts: Key Findings of BRACED Research in South Sudan

This paper is a synthesis of key findings from research undertaken with the BRACED research portfolio which aimed to influence and strengthen the delivery of BRACED programming in South Sudan and national and subnational climate related programming in the future. Key findings included: climate change and conflict are poorly correlated in South Sudan; there is extensive knowledge of drought and flood resistant sorghum at the local level; many communities believe flood and drought is God-sent and they have low levels of power to tackle it; women are deeply affected by a changing climate given their dependence on natural resources; and land tenure and the management of commons areas may offer opportunities for peace dividends and conflict resolution. These findings offer opportunities for stakeholders in South Sudan to work together for meaningful change. These changes will need to occur at micro, meso and macro levels to be transformative in nature.

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

Despite efforts to avert the negative effects of malaria, there remain barriers to the uptake of prevention measures, hindering its eradication. This qualitative case study explored factors influencing uptake of malaria prevention strategies among pregnant women and children under-five years and the impact of COVID-19 in a malaria endemic rural district in Uganda. The study found that although pregnant women and caregivers of children under-five years recognized symptoms of malaria infection, healthcare-seeking was not apt as some respondents used alternative approaches and delayed seeking formal healthcare. It is imperative to focus on the promotion of malaria prevention strategies and address drawbacks associated with misconceptions about these interventions, and promotion of health-seeking behaviors. As COVID-19 exacerbated the effect of malaria prevention uptake and healthcare seeking, it’s critical to recommit and integrate COVID-19 prevention measures in normative living and restrict future barriers to healthcare access.

Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era

Global debates about vaccines in the era of Covid-19 currently focus on questions of supply, with attention to unjust global distribution. At the same time, vaccine demand and uptake are seen to be threatened by hesitancy, often attributed to a globalised anti-vaxx movement and misinformation and conspiracy, now reaching African populations. Underplayed are socio-political contexts of vaccines and how they are interpreted within African settings. We explore these through a ‘vaccine anxieties’ framework, considering both desires for and worries about vaccines, as shaped by bodily, societal and wider political understandings and experiences in local and national settings in Uganda and Sierra Leone. In considering the socially-embedded reasons why people want or do not want Covid-19 vaccines, and how this intersects with supply, access and distribution in rapidly-unfolding epidemic situations, we bring new, expanded insights into debates about vaccine confidence and vaccine preparedness.

Developing strategies to address barriers for tuberculosis case finding and retention in care among refugees in slums in Kampala, Uganda: a qualitative study using the COM-B model

Globally, displaced populations face an increased burden of tuberculosis (TB). Uganda is currently hosting unprecedented big numbers of refugees from the East African region. This study aimed at exploring the barriers to and facilitators for TB case finding and retention in care among urban slum refugees and suggestions on how to improve. It utilised a cross-sectional qualitative approach conducted among refugees in an urban slum in Kampala City, Uganda. Ultimately, it identified key barriers to TB control among refugees living urban slums in Kampala-Uganda, including; poor access to health services, limited knowledge about TB, TB stigma, language barrier and lack of facilitation of community health workers. Identified intervention strategies included: education, training, enablement, environmental restructuring and persuasion. The findings could serve as a guide for the design and implementation of interventions for improving the same.

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