Title:
Health system factors influencing Maternal health service provision in conflict-affected settings in Khartoum, Sudan
Authors:
Hassan, Amal Hassan Abdullah
Place:
Amsterdam, The Netherlands
Publisher:
KIT - Royal Tropical Institute [etc.]
Year:
2025
PAGE:
xi, 47
Language:
En
Subject:
Maternal Health – Lessons Learned
Keywords:
Maternal Health, Conflict-Affected Settings, Service Delivery, Governance, Human Resources for Health
Abstract:
Introduction Sudan has long faced high maternal mortality, compounded by fragile health systems and political instability. The outbreak of armed conflict in April 2023 severely disrupted maternal health services in Khartoum State, causing the collapse of critical infrastructure, mass displacement, and restricted access to healthcare. Understanding how conflict affects maternal health service delivery is essential for shaping responsive health systems in fragile contexts. Objective To explore health system factors influencing the provision of maternal health services in conflict-affected settings in Khartoum State, Sudan, focusing on governance, service delivery, and human resources for health. Methodology This mixed-methods study was guided by the WHO Health System Framework (2007). It combined a comprehensive literature review with key informant interviews involving professionals from government, UN agencies, and INGOs. Results Maternal health services in Khartoum were critically disrupted by the conflict. Governance became fragmented, and decision-making was decentralised and inconsistent. Service delivery collapsed due to insecurity, destruction of infrastructure, looting of supplies, and referral system breakdowns. Human resource shortages were exacerbated by displacement, poor working conditions, and insecurity. Despite these challenges, community midwives played a vital role in sustaining maternal healthcare. Conclusion Conflict has magnified existing health system weaknesses. Fragmented governance, workforce shortage, and disrupted service delivery severely affected service provision and quality of care. Investing in decentralised governance, midwifery training, workforce retention, and context-adaptive solutions is essential for rebuilding resilient maternal health services in Sudan and similar fragile contexts.
Organization:
KIT - Royal Tropical Institute, VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Country:
Sudan
Region:
Northeastern Africa
Training:
Master of Science in Public Health and Health Equity
Category:
Research
Right:
@ 2025 Hassan
Document type:
Thesis/dissertation
File:
pWDzmbqbch_2025121611245620.pdf