Dr. Salma Mohamed Mekki Kanani
Nile University, Khartoum, Sudan
Purpose: In 2015, in collaboration with aligned state ministries, an NGO established a static clinic to serve AboShouk and the neighbouring AlSalam camps (North Darfur-Sudan). A very low utilisation rate was registered. A client satisfaction survey was conducted to explore the clients’ opinions, recognised obstacles and limitations. Results showed 43% lacked knowledge about the services, 63% mentioned social rejection, family unacceptability, fear of stigma, 87% could not aff ord the cost for transportation or fees. This paper will exhibit the intervention to address this challenge.
Design: This is a descriptive case study showing how, starting in 2017, the purpose of the AboShouk clinic was augmented to act as a social development centre. A community owned network of women leaders, one from each geographic sector of the camp, was established. They coordinated the training of a number of volunteer community-based service deliverers who received comprehensive training supervised by the Ministry of Health. They referred cases to the clinic and made follow-up home visits and performed health promotion functions. The programme focused on community engagement, raising awareness, and delivery of high quality reproductive health services, with an emphasis on reaching youths and vulnerable populations. The women leaders provided the necessary support for women in need of medical services. They also liaised with the local sheikh or Omda (the civil community leaders) for girls’ education, women’s empowerment activities, and skills development for mini income generating projects for poor households. They initiated community engagement and mobilisation. They raised awareness either inside the clinic or as outreach through seminars, mobile TV shows, drama, and songs in local dialectics. This intervention was aimed at increasing the clients’ accessibility and utilisation rate of services. In the long run, it is expected to reduce maternal and child morbidity and mortality in the camp.
Findings: The utilisation rate increased considerably. In 2017, the clinic provided sexual reproductive health (SRH) services to 38,640 people through the AboShouk clinic, of which 7,831 clients were provided with contraceptive services and 125 clients were provided with abortion-related care.
Value: This intervention can be replicated in other settings where the security status is fragile and the knowledge, attitude and practice of the community needs promotion, especially during the post-peace era.
Keywords: service utilisation; reproductive health; humanitarian settings; community network; civil leadership