Working with Dr. JenipherTwebaze of non-governmental organisation BRAC South Sudan and Dr. Ahmed Julla of the Ministry of Health, Republic of South Sudan, Dr. Kevin McKague of the Shannon School of Business at Cape Breton University (CBU) has been awarded $1 million to conduct research into how community health workers can become more effective in one of the poorest countries in the world.
The proposal – South Sudan Health Worker Incentives – was selected as one of 20 successful proposals to be administered by the Ottawa-based International Development Research Centre under the Innovating for Maternal and Child Health in Africa program funded by the Canadian Government.
South Sudan is the newest country recognized by the United Nations, emerging from decades of civil war with the Republic of Sudan in 2011. Internal conflict emerged in 2013 and is still not resolved.
Fifty five per cent of South Sudanese do not live within walking distance of a health clinic, and the government is only able to invest $27 per person in health services, compared to the Sub-Saharan African average of $96 per person and the North American average of $6000. As a result, the country has some of the worst health statistics in the world. Thirteen and a half per cent of children born in South Sudan do not survive to the age of five. The maternal mortality rate is the highest in the world at 20 maternal deaths per 1000 live births.
The project designed by McKague and his collaborators in South Sudan aims to explore how novel systems of health service delivery, based on ‘social enterprise’ models and community health workers, can help address the health needs of a population of 10 million served by less than 200 medical doctors and less than 2000 trained nurses.
Dr. McKague said, “With clinics and health posts too far away to be accessed by most people, our research supports the idea of bringing basic health care to the people in their homes. In South Sudan, this happens through more than 1500 local community health workers trained in the basics of primary health care by our partner BRAC South Sudan. Previous research has found that non-financial incentives like awards and recognition can be an even more powerful motivator than financial rewards like a salary for community health workers. What we do not know, however, is which types of non-financial incentives are most effective in this context. This is what our randomized controlled trial research aims to conclusively reveal. We strongly believe that our findings will be relevant in all developing countries that employ community health workers to reduce maternal and child mortality.”
Dr. Jenipher Twebaze, the Director of Research for BRAC Africa said, “The importance of this research-based intervention in an area that has suffered from conflict will benefit many stakeholders in health in South Sudan and beyond. The project will provide valuable information on how best to improve maternal and child health in South Sudan by focusing on the main providers of health – community health workers.”