By Sara Seper, Senior Associate, Knowledge Management and Strategic Communications and Shahla Abdalla, Senior Program Manager, MOMENTUM Integrated Health Resilience

One goal of MOMENTUM Integrated Health Resilience is to help improve the ability of individuals, communities, and health systems, particularly within fragile settings, to respond to shocks and stresses. The project operates in several countries with ongoing instability and conflict, including Sudan, where project activities have been underway since 2021.

On April 15, 2023, conflict between the Sudanese Armed Forces and a paramilitary group, Rapid Support Forces (RSF), erupted. This has led to civilian deaths, internal and external displacement of millions of people, and has exacerbated the ongoing humanitarian crisis. The current conflict comes after years of instability and repeated coups within the country. Despite multiple calls for a ceasefire, it has been difficult for many international aid organizations to continue to provide relief to the Sudanese people. In the midst of this current crisis, MOMENTUM has been able to leverage its strategic partnership with the South Kordofan Midwifery Association (SKMA) to continue to support the essential maternal, newborn, and child health (MNCH) services many Sudanese people rely on.

MOMENTUM began its partnership with SKMA in September 2022, to help improve the quality of MNCH services and to strengthen the association’s capacity to deliver these services. The Association is a relatively new, independent professional midwife organization. Their goal is to assist midwives to provide high-quality and evidence-based maternal and newborn care; influence reproductive, maternal, newborn, and child health policies; and advocate for and represent all midwives in Sudan’s South Kordofan state. MOMENTUM trained two SKMA midwives, Batol Soulman and Mawhib Abdalnabi Malik, who also serve as the State Ministry of Health Director General and the Reproductive Health Focal Point, respectively, within the State Ministry of Health. This partnership helps to institutionalize knowledge among local partners, increasing their capacity to provide quality MNCH services.

At the beginning of this partnership, MOMENTUM helped SKMA assess its current ability to support and provide MNCH services.  Using this information, MOMENTUM then provided training aimed at improving the capabilities and functions of SKMA and preparing it to develop and grow. With this support, SKMA is now better equipped to conduct clinical mentoring of the providers of MNCH services, coordinate supportive supervision visits for health facility staff, and facilitate improved data collection and reporting systems.

SKMA supports midwives in three different localities, Kadugli, Dilling, and Habila, to strengthen their competency and confidence. Between January and April 2023, the midwifery association conducted on-the-job training and clinical mentoring for 100 facility-based midwives and 43 community health workers on maternal and newborn health care. This included such topics as danger signs during pregnancy, complications during pregnancy and delivery, neonatal resuscitation, prevention of mother-to-child transmission of HIV, and referral criteria for sexual and gender-based violence during pregnancy. Along with training and mentoring, the SMKA/MOMENTUM partnership helps address ongoing challenges with work environments and supply shortages.

The conflict reached South Kordofan state in June 2023, a few months after the initial hostilities broke out. As expected, it has severely affected the ability of health staff to operate and move safely to and from health facilities. However, through this partnership, MOMENTUM and SMKA continue to conduct clinical mentoring and provide supportive supervision visits to health facility staff to ensure they are able to maintain quality services during the crisis. Specifically, MOMENTUM and SMKA have conducted 33 clinical mentoring sessions, and have mentored 180 midwives and 51 community health workers.

Clinical mentors have adapted to the changes by switching to public transport rather than private cars to move around more safely within their respective localities. SKMA supervisors in the regional hub of Kadugli use the telephone to maintain contact and provide support when they cannot physically reach all health facilities.

The future is uncertain during this time of crisis in Sudan. However, MOMENTUM and the South Kordofan Midwifery Association will continue to leverage their partnership to address challenges in providing high-quality care to mothers and their babies, elevating the knowledge and capacity of local midwives to provide this level of care, and including them as key partners in emergency preparedness planning and response interventions.