Delivering Health Facility Register Books in Western Bhar el Ghazal

Every day, health facilities all over South Sudan are recording their patient information in register books that are developed by the South Sudanese government, funded by wealthier country donors and delivered by NGOs. A register book records the history of each patient in a single line as they pass through the various departments in the health facility.

There are no clinical notes in South Sudan nor any computer databases at the local level.  Health information is recorded in these books and the data from there is aggregated in weekly and monthly reports.Below is an example of an outpatient register book. Note that it is a badly formatted composite image.

There are also no doctors or nurses in the rural parts of Western Bhar el Ghazal.  Rural clinics are known as either Primary Health Care Centers (PHCC) or Primary Health Care Units (PHCU).  PHCCs, which can contain several hospital-like departments,  are bigger than PHCUs, which are usually a single clinical room.  Both are still small, understaffed, possibly run by generous and dedicated Community Health Workers (CHW) and a variety of other staff such as Traditional Birth Attendants (like a midwife but with much less formal training).

The field trip around Western Behr el Ghazal took myself, my Team Leader Patrick and Victoria, the Ministry of Health representative to Mbili, Kuajina, Mapel and, the following day, to Rocrocdong, Achongchong and Akorup to deliver register books and see the final stages of a new PHCU/PHCC being built.  The road was surprisingly flat but still dusty and unpaved.  We passed by burnt fields, giant kilns designed for curing bricks and many herds of cows and goats with intended use for the dowry system – none of which I photographed but there will be more trips and more photos to come.

Pictured above from left to right: Patrick, the HealthNet TPO Western Bhar el Ghazel team leader, Victoria from the state Ministry of Health and the Mbili Community Health Worker holding MOH Register Books.

Pictured above: A typical clinical room at a PHCC.

Pictured above from left to right: Patrick, the HealthNet TPO Western Bhar el Ghazel team leader, Victoria from the state Ministry of Health and the Kuajina Community Health Worker again holding MOH Register Books.

Pictured above from left to right: Mapel Community Health Worker, Victoria from the state Ministry of Health and the Patrick, the HealthNet TPO Western Bhar el Ghazel team leader holding MOH Register Books .  The bright South Sudanese sun over exposed this important picture.

Pictured above: HealthNet TPO staff with MOH and PHCU staff in front of the old Achongchong PHCU.  Notice that it is a very basic, one room house with a corrugated metal roof.

Pictured above: The newly built Achongchong building complex comprising of three separate buildings that will house many different clinical departments. This building replaces the corrugated roof clinic pictured above.  HealthNet TPO is the NGO responsible for the construction of this complex.

 

Pictured above: The newly constructed Arokup building where no health facility existed before.  As with Achonchong, HealthNet TPO is responsible for the construction of this site. The two health facilities are only a ten minute drive apart but for many who can only walk to see a health care worker, the distance is enormous, making this new clinic essential for maintaining the basic health services of the nearby community..

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