Country of Focus: South Sudan

I am Mathew Jocker. I work in South Sudan at the Sub-national level with World Health Organization. My main work as State EPI Officer at State level and involved in EPI/SIA I planning at state level and at National level, and at facility I do supportive supervision during SIA activities , EPI and Vaccine preventable disease, I also monitor outreach activities implemented by partners at health facility level and at county level. Follow-up Acute Flaccid Paralysis (AFP Surveillance and conduct detail case investigation and 60 days follow-up of identified AFP cases,. I also prepare monthly reports on activities carried within the month including outcome of vaccination activities submitted from counties, analyses the data, submit to National level and provide feedback to the county team

There is still widened equity gap in South Sudan and efforts are been made by introducing outreach services, PIRI to bridge the gap and improve upon the coverage of routine immunization. But the challenge in South Sudan is that:

- Children living in urban areas are less likely to be immunized.

- Insufficient and inadequate human resources (HR) for vaccination at health facilities making services inaccessible are likely to affect coverage.

- Communities which are very hard to reach at Urban Areas are likely to be affected since resources are available but they are not utilizing the services.

Equity in my understanding is where every child in an area or vicinity eligible for vaccination has equal opportunity and access like other children anywhere else which they are eligible without any hindrance.

Engaging with the Community and Social Mobilization: Connecting with the disadvantaged in urban settings

Some of the challenges that have been highlighted in the literature for the disadvantaged in urban areas is the loss of social cohesion, lack of traditional hierarchies, multiplicity of languages, discrimination based on ethnicity, poverty, religion and the effects of the high cost of living on volunteerism. On the other hand, urban communities are more likely to have access to media, including social media and there are more associations, civic groups and CSOs with social agendas.

Urban immunization may have the advantage of having more resources available, for instance a large pool of health workers either trained or enrolled in training institutions. But with the competition for these resources, they may be more expensive and they are often not allocated to those areas/families in greatest need. Availability of technology and networks allows for early adoption of the use of SMS and real time reporting to monitoring and replenishment of vaccines and supplies. There is a worldwide call for integration of immunization with other health activities. This is a good call and will go a long way to improve upon equity and immunization coverage. This is because most health partners are coiling out and their interventions needs to be sustained to achieve the desired set target of equity and improving coverage. Health services needs to be resourced.

Making health care accessible to the people by providing health post and supporting healthcare workers with the needed logistics in order to carry out health outreaches to these deprived arears. health care workers posted to such Urban areas need to be well accomodated in the communities so as to provide such health services.