UNPFA in Sudan

Context:

Sudan Population Profile

Following the independence of South Sudan, the 2008 Census shows a total population of 30,894,000 people. Estimates for 2011 suggest a total population of 33,419,000 people.

Source: 2008 Population Census and 2010 Sudan Health and Household Survey

Mortality rates remain high at 17.2 deaths per 1,000; infant mortality is 118 per 1,000 live births. Life expectancy at birth is about 60 years.  The life expectancy shows an increased trend over the years (from 38 years in 1956), although it increased at a slower pace between 1993 and 2008. National poverty rate stands at 46.5 per cent with regional disparities ranging from 26 per cent in Khartoum State to 69.4 per cent in North Darfur State. Gaps also exist within states and between different localities.

Maternal mortality varies widely between regions (highest MMR is 334.9 in South Darfur state and lowest is 105 in Sinnar state). It is typically higher among the poor, rural and nomad populations. In 2010, half of deliveries were assisted only by a Village Midwife; just one fifth were delivered by skilled health personnel. HIV prevalence rate is 0.67 per cent reflecting a concentrated epidemic among most at-risk populations. Current trends, however, suggest an increase in HIV prevalence to 1.12 per cent by 2015.

Sudan has always had a highly mobile population. There is a significant nomadic population (up to 10%), heavy seasonal labor migration and large outmigration; Sudan is the source of both skilled and unskilled labor for most of the Gulf States. In recent years, major population migrations have also been due to conflict and climate change and desertification. Sudan has over four million Internally Displaced Persons (IDPS), many in large camps in Darfur and many settled in margins of the urban areas.

Close to half of women in Sudan are illiterate. Women are disadvantage in most communities and the majority of women who work are engaged in unpaid work and in the informal sector activities. Women and girls continue to suffer disproportionally from conflict. Gender-based and sexual violence and exploitation of women and girls is widespread in conflict-affected areas. Female Genital Mutilation/Cutting and child marriage are also wide spread. FGM/C prevalence rate stands at 65 per cent despite intensive campaigns to eradicate the practice.

Despite the high youth population (62 per cent), the role of young people in social and political life is limited. While government seems to recognize the importance of a greater role by youth, their specific needs and rights such as education, training and employment are not considered a priority. Over 20 per cent of young people are unemployed. A quarter of young people living in urban areas and half of those living in rural areas are poor. Despite high rates of early marriage, 95 per cent of married adolescents do not have access to family planning.

UNFPA Response

Maternal and Reproductive Health

Sudan's health sector is severely underfunded. One quarter of the population has no access to health facilities and only 19 per cent of the primary health care facilities provide the minimum health care package. While 66 per cent of the functioning rural hospitals can now provide basic emergency obstetric and neonatal care, less than half of them provide comprehensive emergency obstetric and neonatal care services needed to save lives.

Despite the low capacity of the government institutions and the underfunded health sector, demand for and universal access to reproductive health information and services has increased. The current country program supported programs to strengthen basic and comprehensive Emergency Obstetric and Neonatal Care services, increase availability of child spacing commodities, and to train professional and village level midwives, in addition to programs for prevention and management of fistula and HIV. Activities are carried out in regular and in conflict and post-conflict settings.

UNFPA assists in the development of national and state capacities to formulate/review medium- and long-term policies and strategies. Policies supported include National Health Policy, revised National Reproductive Health Policy, National RH Communication Strategy; Maternal and New-born Mortality Reduction Roadmap, National Strategy for Scaling up Midwifery and National Reproductive Health Commodity Security Operational Plan. Support has been provided to HIV policy development and to behavioral surveillance and operational research for implementation of HIV/AIDS program.

Support is also extended to improve service delivery through development of service delivery protocols and guidelines, conduct of operational research, surveys and studies and advocacy and community outreach. Reproductive health has become a standard part of emergency preparedness and response in humanitarian settings.

Because of the geographic dispersal of underserved populations (rural and remote areas, IDPs camps and nomads), major support has been provided to training hundreds of Village Midwives for deployment in these areas; state level midwifery schools have been rehabilitated and equipped. In addition, a two-year Midwife Technician diploma and a four-year Bachelors of Science of Midwifery have been initiated to improve the availability of skilled birth attendants.

Population and Development

The National Population Council and the Central Bureau of Statistics receive support to develop their capacity to produce, analyse and disseminate data. By far, the biggest role of UNFPA in Sudan over the past few years was the support provided for the 2008 National Population and Housing Census. The conduct of the census was a critical component of the Comprehensive Peace Agreement and as the first national census in many years, census data provides the base for planning at the national and state levels. The data continues to be analysed and widely used by governments and other data users including the academic institutions and the private sector.

To enable Sudan to better respond to population dynamics, UNFPA has supported the NPC to revise the National Population Policy. Assistance is also being provided to develop a National Strategy for the Development of Statistics - a system that will mainstream statistics within policy development processes at national, sector and state levels. This will strengthen further the Government capacity to carry out the next census, planned for 2016.

As Sudan has a large cohort of young people, (62 per cent), youth issues remain a major population challenge for Sudan. UNFPA is supporting capacity building of youth organizations and networks and advocacy campaigns to enhance youth participation in development planning and in monitoring processes at the national and state levels. The National Youth Strategy 2012-2037 has been adopted and Youth Parliaments, including in Darfur, have been established to advocate for and enhance youth participation. Nine youth centres were supported in Kasala and Gedaref and have become gathering points for youth mobilization and activities.

To help Sudan address the impact of the environment on population and vice versa, UNFPA is working with UNEP to promote dialogue and foster linkages between the UN, government and non-government institutions working on population and the environment at the national and state levels. A series of workshops have been held in Khartoum, South Darfur, Gedaref and North Kordofan to engage governments, development partners, civil society inclusive of pastoralist, farmers and women's Unions, academia (Universities of Khartoum and Nyala, Agricultural Research Stations) and the media to understand the linkages between population and the environment and to develop mitigation strategies.

Gender and Gender-based Violence

The current program focuses on promoting gender equality and empowerment of women in Sudan in both development and humanitarian contexts. Specific focus is on prevention and response to all types of gender-based violence - including FGM/C, early marriage and sexual violence, especially in conflict and post-conflict settings.

Support has been provided to government institutions for policy development and implementation. Milestones achieved include the development of the National Women Empowerment Policy, the National Action Plan on Combating Violence against Women and the Strategy to Combat Female Genital Mutilation in a Generation. While elements of the WEP and the GBV policies have been incorporated into the National Quarter Century Development Plan, support has been provided to monitor the Program of Action of the WEP at the national and state levels.

At the state and community levels, and in partnership with governments, universities and communities and the media, a wide range of projects have been implemented to advocate and raise awareness about gender-based violence, collective abandonment of FGM and early marriage. Although FGM practice is deep rooted in tradition, the number of communities declaring collective abandonment has been on the rise. For example, communities in Tuti Island, Abu si'id and El Jazeera Aba have declared collective abandonment bringing the total number of communities declaring collective abandonment to 470.

As a result of sustained advocacy by UNFPA, national and international development partners, the Ministry of Justice and the Parliament are currently reviewing, with a view to amend, 88 articles in the Penal Code and the Family Law that are considered violations to women rights.

Humanitarian Response

Since 2004, UNFPA has been responding to the situation in Darfur addressing both humanitarian and recovery needs. UNFPA supports improving access to reproductive health care services and prevention and management of GBV, AIDS and Fistula in an integrated manner. Although the program mainly focuses on the delivery of emergency life-saving services such as Emergency Obstetric and Neonatal Care (EmONC) and health care for GBV and Fistula survivors, support is also extended to build capacities of line ministries and other implementing partners. Besides rehabilitation and equipping of local health facilities, UNFPA supports training of VMWs and their deployment to rural areas and nomadic communities as well as training medical doctors in EmONC, FP and PAC. Support for community mobilization and awareness-raising to organize and sensitize women, men, community leaders and youth is also provided.

As the lead of the RH sub-sector (under the Health Sector), and as the lead of GBV sub-sector (under the Protection Sector), UNFPA coordinates humanitarian interventions of the UN and other humanitarian actors in these two areas.

Along with other UN agencies, UNFPA contributes to the Sudan Humanitarian Work Plan 2012. The objective of the plan is to provide basic assistance, find durable solutions for displaced people and strengthen national partners to deliver humanitarian assistance. This year, the HWP included over 330 projects with a budget of $1.1 billion. UNFPA contributes to the Health and Protection Sector objectives of the plan and provides humanitarian assistance and emergency response for conflict-affected as well as natural disaster-affected populations. Interventions aim at improved access to reproductive health care services and GBV prevention and management, including implementation of the MISP for emergency situations.