Health in South Sudan

The Ministry of Health sets national policy and standards, while State Ministries of Health supervise implementation. Counties organize facility networks, budgets and primary-care delivery, and Payams and Bomas connect health services with communities. WHO, UNICEF and nongovernmental organizations provide technical, financial and operational support. The 2024–2027 health-sector plan covers about 1,158 facilities in 40 lots with support from roughly 28 NGOs. The usual care pathway begins in the community. A Boma Health Worker, or BHW, supports households and links them with the Boma Health Initiative, known as BHI. The next level is often a Primary Health Care Unit, or PHCU, or a Primary Health Care Centre, or PHCC. These facilities may provide health promotion, prevention, diagnosis, treatment, rehabilitation and palliative care. Fixed vaccination posts, outreach teams, mobile clinics, standalone maternity units, private clinics and nutrition sites can provide functional alternatives when a regular facility is distant or unavailable. County hospitals handle primary hospital care and emergencies. State hospitals provide secondary care. Juba Teaching Hospital and referral hospitals in Wau and Malakal provide tertiary or highly specialized services. A medical referral may therefore move from a PHCU or PHCC to a county hospital, then to a state or tertiary hospital. Referral records and feedback are inconsistent. Local transport may use a vehicle, boat or ambulance, depending on the area. The reviewed sources did not verify a nationwide public emergency telephone number, so the nearest facility or local health partner should be identified in advance where possible. Access remains uneven. About 56% of the population lives within 5 kilometres of a health facility, and the health workforce is about 7.9 workers per 10,000 people. BHI services cover about 52% of Bomas, with more than 10,500 trained community workers. Conflict, flooding, displacement, poor roads, insecurity, seasonal conditions and facility damage can interrupt care; 43 facilities were reported as looted or damaged by February 2026. In 2026, about 5.7 million people were assessed as needing health assistance. Primary care supports immunization, antenatal care, tetanus vaccination, nutrition screening and malaria, HIV and tuberculosis services. The second measles-containing vaccine dose was introduced nationwide in 2025 for children at 9 and 18 months. The four-dose R21/Matrix-M malaria vaccine targets children aged 5 to 23 months; it began in July 2024 and expanded to 80 counties in 2025. Delivery uses fixed posts, outreach and mobile services. Malaria treatment coverage was reported at 97%, while HIV viral-load suppression was 81.3%. Mental-health service coverage was only 0.4%, showing that availability differs greatly between services. After treatment, follow-up may continue through a PHCC, BHW, outreach team or another facility. HIV, tuberculosis, non-communicable disease, mental-health and nutrition follow-up depends on the facility. Complication checks after treatment, pregnancy or birth may require a return visit, but medicine continuity and referral feedback are not reliable everywhere. Patients should confirm the next appointment, available medicines and transport arrangements before leaving a facility. The Transitional Constitution, Article 31, and the National Health Policy place government responsibility for free primary health care and emergency services for citizens. This policy does not establish that every facility provides free medicines, tests or transport. Out-of-pocket spending represented 34.4% of current health expenditure in 2025, and there is no reliable nationwide tariff list. Patients may therefore face charges for medicines, diagnostics or transport. In 2025, essential-medicine stockouts were reported in 45% of facilities in the relevant monitoring, with selected products unavailable for an average of 238 days for oral rehydration salts and 48 days for chlorhexidine. Service Charters exist in many, but not all, facilities. A formal nationwide complaints pathway was not established in the reviewed sources. Practical continuity depends on early care-seeking, keeping vaccination and antenatal appointments, following referral instructions and checking local information about services, medicines and transport. Health indicators from the MICS 2025 survey and the DHIS2 health information system are not directly comparable because their definitions and data sources differ. For example, skilled attendance at birth was 51% in MICS 2025 and 19.5% in DHIS2 reporting, while facility delivery was 44%, at least one antenatal visit was 56%, four or more visits were 35% and postnatal care within two days was about 45%.