Expanding Safe Motherhood Practices to Remote Bomas in South Sudan

Published on April 22, 2022

A nurse, referred by a Boma health worker, assisting Ayuen with breastfeeding her newborn at Bor State Hospital. Photo credit: Ajak Manguak Agau, MOMENTUM Integrated Health Resilience.

It was October 21, 2021 when 20-year-old Ayuen Garang Kuol went into labor in Tibek, her rural village—known as a boma.* Tibek is in the Greater Upper Nile area of South Sudan, which was then experiencing the most catastrophic flooding the region had seen in 60 years. The nearest health facility was inoperable.

A boma health worker—part of the Boma Health Initiative—recognized signs that Ayuen might be having labor complications. In partnership with the Boma Health Initiative, MOMENTUM Integrated Health Resilience trains health workers to monitor for signs that a mother’s or child’s health might be at risk so they can provide appropriate services or refer these clients for emergency care.

The boma health worker took Ayuen to the Bor State Hospital where the staff found the baby was in distress. Fortunately, due to the knowledge and support of her health worker, Ayuen gave birth safely. Both mother and baby are well.

Building the Capacity of Health Workers

Access to health care for many in South Sudan remains severely limited after decades of conflict and under-funding. In March 2017, the government introduced the Boma Health Initiative to help improve access to essential health services for villagers like Ayuen. The Boma Health Initiative is designed to strengthen linkages between communities and health facilities and improve community ownership and governance of health services.

USAID MOMENTUM, a global partnership for health and resilience, is committed to strengthening local and national capacities to build on health gains made in fragile settings for mothers, newborns, and children. MOMENTUM is helping the government expand the Boma Health Initiative, including in Ayuen’s Bor County.

An estimated 4,500 women die in childbirth in South Sudan annually.1, 2 Together with local partners, we are helping mothers and babies stay healthy during and immediately after childbirth. “I was nervous and anxious about pregnancy and giving birth,” Ayuen said. “I thank the Boma health worker for [her] commitment and [for] escorting me to the hospital.”

Expanding the South Sudan Boma Health Initiative is one example of how MOMENTUM builds the capacity and resilience of ministries of health and local partner institutions while advancing evidence-based practices, approaches, and interventions so villagers like Ayuen get the health services they need when they need it most.

*A boma is a small geographical area consisting of villages and households.


  1. Roser, Max and Hannah Ritchie. “Maternal Mortality.” 2017. https://ourworldindata.org/maternal-mortality
  2. United Nations Children’s Fund (UNICEF). South Sudan Country Office, Health: December, 2019. https://www.unicef.org/southsudan/media/2086/file/UNICEF-South-Sudan-Health-Briefing-Note-May-2019.pdf

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