Spatial accessibility to basic public health services in South Sudan.

Area of Science:

• Public Health
• Health Services Research
• Geographic Information Systems (GIS)

Background:

• South Sudan's health sector was underdeveloped at its 2011 independence.
• A national health strategic plan aimed for 70% of the population to be within 5 km of a health service provider.
• Ongoing civil conflict impacts health facility functionality.

Purpose of the Study:

• To assess population access to public health facilities in South Sudan.
• To compare complex walking-time access metrics with simpler distance-based metrics.
• To identify vulnerable counties for priority health service expansion.

Main Methods:

• Utilized public data on health facilities, population, roads, land use, and elevation.
• Calculated population fraction within 1-hour walking distance to curative service facilities.
• Compared this metric with the proportion of the population within 5 km of a facility across 78 counties.

Main Results:

• In 2016, only 25.7% of the population could reach a facility within a 1-hour walk, and 28.6% within 5 km.
• Out of 1747 public health facilities, 294 were non-functional.
• Both complex and simple metrics identified the same high-priority, vulnerable counties.

Conclusions:

• Health service access in South Sudan is poor, with significant disparities between counties.
• Simple metrics can be valuable for assessing health access, especially with incomplete travel data.
• Targeted expansion of clinical services is crucial for the most vulnerable populations.