SOUTH SUDAN

Twenty-six-year-old Natabo was one of the first at the water point in her village when CGPP South Sudan showed up to distribute the COVID-19 vaccine. “I have not heard of anyone who got vaccinated in this village. I am happy to be the first, not only in my family but also in my community,” she said. “If the vaccines were not brought to us, no one would have got it.” As a mother of three who lives in a village that has no schools nor health facilities, she did not think the vaccine would arrive in Nasikina Village—located in Kapoeta South County in Eastern Equatoria State. For her and her neighbors, medical facilities, like school facilities, are a 26-kilometer—or two-hour—walk.

CGPP South Sudan has been working in villages like Natabo’s since 2011, originally only in polio and routine immunizaiton work, but has since expanded to COVID-19 integration and global health security, focusing the already-existing polio infrastructure in community-based surveillance (CBS) on priority diseases and conditions: acute flaccid paralysis for polio, measles, Ebola virus disease, and COVID-19, reducing the rate of zero-dose children. The same CBS is now expanding to include priority zoonotic diseases in South Sudan such as rabies, anthrax, brucellosis, bovine tuberculosis, Rift Valley fever, and yellow fever.

Over 2,000 volunteers and workers make up the CBS network, which provides integrated diseases surveillance, supports risk communication and community engagement activities, conducts active search cases, and implements cross-border surveillance activities. CGPP South Sudan also supports national independent campaign monitoring for polio and measles.

The CGPP surveillance system has been effective in insecure environments and where the population has limited access to health facilities, like Natabo’s village. It involves a network of unpaid community key informants (CKIs) who are plugged in to the daily flow of community life and would likely be aware of a person with signs and symptoms suggestive of a disease. CKIs are supervised by volunteer boma health promoters (BHPs) who link community key informants to public health services and CGPP project supervisors. Some examples of CKIs are faith-based leaders, chiefs, headmen, traditional birth attendants, traditional healers, local clinic owners, women and youth leaders, and teachers.

The nature of the CBS system structure through the network of CKIs also provides a link to share health messages and actively listen to community concerns. The project integrates COVID-19 awareness messaging on prevention and detection into the ongoing sensitization for polio, Ebola and measles to educate the community on the diseases and address misinformation and miscommunication, particularly among rural communities frequently excluded due to lack of access to health information.

Resources