NURS FPX 8014 Assessment 2 Global Issue Problem

Name

Capella university

NURS FPX 8014 Global Population Health

Prof. Name

Date

Global Issue Problem Description

The health of expecting mothers throughout pregnancy, birth, and after childbirth constitutes a critical global health issue. Maternal health care maintenance directly benefits infant health outcomes and reduces maternal death risks while creating better well-being outcomes for families and communities. The World Health Organization (WHO) recorded 287k women lost their lives due to pregnancy-related conditions in 2020, and South Asia and sub-Saharan Africa contained most of these deaths (Mahada et al., 2023).

The reasons for death include postpartum hemorrhage, infections, hypertensive conditions complications, dangerous abortions, and restricted labor. The pregnancy and delivery risk factors get worse when patients have anemia or malnutrition or when they are infected with HIV/AIDS or other infectious conditions.Maternal mortality rates have a major impact on the efficacy of healthcare systems because they show how various regions can access and get high-quality medical care.

NURS FPX 8014 Assessment 2 Global Issue Problem

The Maternal Mortality Ratio (MMR), which is determined by the number of maternal deaths per 100,000 live births, varies across wealthy and developing countries. High-income countries maintain an MMR below 10 per 100k live births, while lower-middle-income countries have an MMR over 400 per 100k live births (WHO, 2024). The World Health Organization (WHO 2023) reports that South Sudan holds the leading position regarding maternal mortality ratio at 1223, followed by Chad at 1063 and Nigeria at 1047 among Sub-Saharan African and South Asian populations.

Maternal health emergencies in South Sudan remain out of control because hospitals provide no emergency obstetric care, medical staff is scarce, and health facilities are insufficient. The health needs of pregnant women remain restricted because both poverty and continuing political conflicts block their access to vital pregnancy care. The correct solutions need active community work, international help, and policy changes to resolve these issues.

Analysis of the Problem

The population of South Sudan faces significant risks during childbirth because the MMR stands at 1,223 per 100,000 live births, according to WHO (2023). The worldwide death risk during pregnancy and childbirth remains dangerously high for numerous women because this country has one of the world’s highest Maternal Mortality Rates. The Blend of insufficiently trained birth attendants, poorly maintained medical facilities, and political turmoil intensify the situation for female childbirth mortality.

Nations and Populations Affected

Even though maternal health is a worldwide concern, South Asia and Sub-Saharan Africa bear the brunt of it. Nigeria (1,047 per 100,000) and Chad (1,063 per 100,000) are two countries with high maternal death rates, in addition to South Sudan. Individually, women of reproductive age who live in rural areas with poor access to healthcare services—particularly those living in conflict areas—are most impacted.

MMRs are significantly lower in high-income countries worldwide; industrialized nations such as Sweden and Japan maintain rates below 10 per 100,000 live births (Wakasa et al., 2021). Women in wealthy countries receive full maternal care during childbirth, but those in South Sudan and other low-income countries face potentially lethal risks. This stark disparity reveals disparities in health around the world.

Health Inequities Across Countries

There are several reasons that maternal health issues and MMR varies across nations. Let us understand this through the focus country of South Sudan compared to other nations. Some of the common inequities occur due to the following reasons:

• Healthcare Access Gap: More than 99% of newborns in wealthy nations like Sweden and Canada are attended by trained medical personnel, guaranteeing safer delivery. In contrast, South Sudan has a high maternal death rate due to a significant lack of doctors and midwives, with just one qualified birth attendant per 10,000 people (WHO, 2023).
• Resource Disparities: Nations like Japan and Germany devote large sums of money to maternal healthcare, offering emergency obstetric care and well-equipped facilities (Wakasa et al., 2021). However, with just three referral hospitals and a population of nearly 11 million, many women in South Sudan give birth at home without medical help.
• Political Instability and Conflict: While stable countries guarantee continuous maternal healthcare services, South Sudan’s civil war has destroyed medical facilities, evicted millions of people, and restricted access to prenatal and postnatal care, putting the health of expectant mothers and newborns at even greater risk (Elamin et al., 2024).

Potential Social and Political Ramifications

Maternal health issues that lead to high MMR have certain consequences that disturb the social and political arena of a community or a country. Some of them are mentioned below (Mamkhezri et al., 2022): 

• • Increased Mortality and Orphaned Children: Thousands of children lose their mothers each year due to a high MMR, making them susceptible to exploitation, inadequate schooling, and malnourishment in a society that is already precarious. This makes it more difficult for extended relatives and aid organizations to give care.
  • Economic Burden: Women’s deaths during their prime working years aggravate poverty by lowering household income and labor force participation. Complicated deliveries also result in substantial medical expenses for families, further straining their finances.
  • Political instability: Dissatisfied citizens get more agitated and call for governmental change due to inadequate healthcare services. Because an ill and malnourished population is less productive and more vulnerable to exploitation, weak maternal health services also jeopardize national stability.

 

• Increasing Gender Inequality: Women are kept in cycles of poor health and financial reliance by inadequate maternal care, which perpetuates structural gender imbalances. Women have fewer options for education and employment when they lack access to reproductive healthcare, which impedes the advancement of society as a whole.

Social Determinants That Impact the Problem

Socioeconomic, political, cultural, and geographic factors significantly impact maternal health in South Sudan. Many women are unable to receive necessary maternal care because of multiple reasons, particularly in rural areas. In the absence of comprehensive reforms, these issues will continue to exist, exacerbating economic suffering and health disparities.

Socioeconomic Factors Influence

In South Sudan, where 76% of the population lives below the poverty line, maternal health is severely hampered by widespread poverty and a lack of resources (World Bank Group, 2024). Unassisted home births are common because many women cannot afford prenatal care, transportation, or hospital bills. The low literacy rate among women further contributes to poor maternal health outcomes because many are unaware of the hazards associated with pregnancy and the healthcare facilities that are accessible.

Furthermore, the issue is made worse by a lack of proper healthcare infrastructure; only a few health facilities are completely operational, and the majority of them are located in metropolitan areas, meaning that rural populations have little to no access to critical maternal health services (Mamkhezri et al., 2022).

Political Factors Influence

South Sudan’s healthcare system is among the most unstable in the world and heavily reliant on foreign assistance due to years of civil war and continuous political unrest. Because of the government’s low investment in healthcare, maternal health programs are underfunded and unable to grow their services to meet demand. According to WHO, less than 2% of the national budget is allocated to health-related funding, and people have to pay about 54% of health expenses from their pockets (WHO, 2022). Resources are further depleted by corruption and poor administration, which take money away from vital maternal health services and hinder the successful application of policies. Pregnant women and newborns would be disproportionately affected by the lack of access to healthcare in the absence of improved governance and accountability (Elamin et al., 2024).

Cultural Factors Influence

Cultural customs and beliefs significantly influence maternal health-seeking practices. Because of a long-standing mistrust in contemporary healthcare, many women rely on traditional delivery attendants, which raises the possibility of difficulties and maternal fatalities. Access to healthcare is further limited by gender conventions, which postpone urgent care by requiring women to obtain consent from men before seeking medical help (Ekwuazi et al., 2023). Furthermore, more than 52% of girls marry before turning 18 in South Sudan, indicating that early marriage and childbearing are still common (Madut, 2020). High rates of teenage pregnancies result from this, greatly raising the mortality rate for both mothers and babies.

Geographical Factors

The geographic distribution in South Sudan creates severe obstacles regarding access to healthcare for people living in rural areas. Women from rural communities experience restricted or complete denial of essential maternal healthcare services because all operating healthcare facilities exist mainly within urban settings. Women in their childbearing years encounter serious obstacles to reaching hospitals in time because the inadequate infrastructure does not provide enough roadways and transportation methods. Political unrest and continuous violent situations in numerous areas have established unsafe environments that prevent women from accessing necessary healthcare services.

Future Predictions

Unresolved maternal health problems in South Sudan will keep this country at the forefront of world maternal death statistics, thus worsening both economic struggle and gender disparity and humanitarian response needs. The combined approach of healthcare infrastructure funding with women’s education improvement and culturally relevant interventions would lead to substantial maternal death rate reduction. Healthcare regulations enhancements and locally developed community knowledge make long-term benefits of improved health outcomes for women and children a reality according to Elamin et al. (2024).

Strategies and Gaps

South Sudan has deployed several approaches to manage maternal health during past periods. The implementation of mobile clinics, midwife training programs, and emergency obstetric care services in South Sudan is supported by the WHO, UNICEF, and Médecins Sans Frontières (MSF). The healthcare system currently depends heavily on outside support, which makes service sustainability impossible due to changes in international funding allocation (Mwilike et al., 2024). The NGO approach to supervising traditional birth attendants (TBAs) serves to improve maternal healthcare results, primarily in rural locations where healthcare expertise is scarce. Although these programs have made maternal care more accessible, they frequently lack necessary medical resources, which has led to very modest drops in maternal mortality rates (MacDonald, 2022). 

Furthermore, the South Sudanese government implemented free maternal and child healthcare services in certain areas. Still, the program could not have a long-lasting effect because of ongoing financial difficulties and subpar execution. Political unpredictability and inadequate infrastructure further limited the efficacy of these initiatives in enhancing maternal health outcomes. 

NURS FPX 8014 Assessment 2 Global Issue Problem

The current approaches to enhancing maternal health in South Sudan emphasize policy changes, technology-driven solutions, and community-based health interventions. In some areas, antenatal care visits have increased, and maternal fatalities have decreased due to organizations’ emphasis on community-led initiatives that empower local women through midwifery training and maternal health awareness campaigns (MacDonald, 2022). 

Given the nation’s inadequate healthcare system, telemedicine and mobile health (mHealth) solutions have become cutting-edge ways to connect women with medical professionals and offer maternal health education, especially in rural areas. These digital health tactics can potentially increase access to care if extended greatly (Knop et al., 2024). International partnerships and policy changes also seek to integrate maternal health services into national programs better and enhance government support for healthcare. Despite the potential of these initiatives, maintaining long-term gains is extremely difficult due to political and economic volatility.

Future Predictions

Political stability, ongoing international aid, and healthcare investments are all critical to South Sudan’s maternal health in the future. In the next ten years, maternal mortality rates will decline due to sustained investment in healthcare facilities, support for female education, and community engagement. Access to maternity care can be enhanced, especially in rural regions, by combining mobile health solutions, more robust medical facilities, and skilled midwives (Mahada et al., 2023). The combination of ongoing political unrest and declining foreign aid would impede progress, resulting in South Sudan’s high maternal mortality rates and worsening healthcare disparities. To achieve long-term improvements in maternal health, the country should undertake strategic healthcare efforts; otherwise, it will continue to rely on humanitarian aid.

Conclusion

Three major conditions, including financial challenges, barriers to healthcare, and unprecedented political instability, cause excessive maternal mortality rates in South Sudan. International organizations and non-governmental groups provide beneficial support to sustainability issues even with ongoing unresolved challenges. Effective long-term improvement of maternal health requires technical advancements, enhanced government funding, and systemic healthcare system development. The main health activities in the community need to focus on educational programs alongside cultural transformation to improve maternal healthcare status. Foreign support for South Sudan and new legal measures will enable the nation to reduce maternal death rates and enhance health conditions.

Appendix A: Project Proposal

Title: Community-Based Maternal Health Initiative in South Sudan

Maternal mortality is a significant issue in South Sudan due to the nation’s inadequate healthcare system, precarious political climate, and socioeconomic barriers. This project aims to improve maternal health outcomes through a Community-Based Maternity Health Initiative (CBMHI) by integrating mobile health (mHealth) technologies, increasing access to maternity care, and training midwives.

Project Objectives

1. The training program should prepare 200 community midwives as competent birth attendants for two years to provide safe prenatal and delivery services to rural communities.
2. The community should organize lectures about protection during pregnancy and instructions for spotting early warning signs.
3. The development of a mHealth platform must provide pregnant women with automated appointment notifications and medical staff with access to maternal health educational content.
4. Local clinics will boost healthcare infrastructure when they join forces to receive the necessary resources for maternal healthcare delivery.

Target Population and Setting

This project focuses on pregnant women in rural South Sudan, where access to healthcare is severely restricted. To guarantee accessibility, the project will be carried out in nearby villages and community health facilities.

Assumptions Made

• International funding and governmental support will be combined to sustain training and resources.
• The rising number of mobile phone users will enhance the success rates of mHealth solutions.
• Community leaders and traditional birth attendants will support the cultural acceptance of modern maternal health procedures.

Methodology

The initiative follows a community-driven, evidence-based approach with the following key components:

• International organizations should partner with the Sustainable Midwives Community Network to teach delivery safety techniques alongside delivering medical supplies to community health professionals and traditional birth attendants (Mahada et al., 2023).
• According to Mahada et al. (2023), Community Education and Engagement combine workshops about maternal health with local leadership collaboration and multilingual educational materials distribution efforts to promote awareness throughout the community.
• Mobile Health (mHealth) Solutions: Provide telemedicine consultations for high-risk pregnancies in rural locations, set up a 24-hour maternal health hotline, and implement SMS health alerts (Knop et al., 2024).
• Policy Advocacy and Sustainability: Work with government organizations to gain long-term funding, incorporate midwife training into policy, and monitor progress through community feedback and decreases in the maternal mortality rate (Ekwuazi et al., 2023).

Stakeholders and Implementation

• South Sudan’s Ministry of Health: For financing and policy support.
• International organizations and NGOs: For both technical and financial support.
• Traditional birth attendants and community leaders will help the cultural integration.
• To continue providing maternity healthcare services, local health workers are needed.

Expected Outcomes

• Within three years, there will be a 30% rise in skilled birth attendance in the target areas.
• Decrease in avoidable maternal fatalities as a result of prompt medical attention.
• Increased awareness of maternal health among expectant mothers and their families.
• Because this project aligns with evidence-based solutions, the most vulnerable groups will experience long-lasting gains in maternal healthcare.

Appendix B: Meeting Summary

Speaking with a public health official about the Community-Based Maternal Health Initiative (CBMHI) gave me important knowledge about the prospects and difficulties of implementing maternal health initiatives in South Sudan. The presentation’s main points were the necessity of maternal health education, midwife training, mobile health solutions, and fortifying the healthcare system. The public health officer reaffirmed the necessity of incorporating this project into national health policy and emphasized the significance of government cooperation and the sustainability of financing sources.

One important lesson learned was how crucial it is to coordinate the project with other government and non-profit initiatives to minimize duplication and optimize impact. Feedback also underlined the necessity of culturally appropriate educational initiatives that involve community leaders and traditional birth attendants to guarantee acceptance and efficacy. This experience helped me better appreciate the financial and policy limitations on global health projects. To increase the project’s viability and long-term success, I intend to improve the concept by adding a more detailed financial sustainability plan and effective community participation techniques.

References

Ekwuazi, E. K., Chigbu, C. O., & Ngene, N. C. (2023). Reducing maternal mortality in low- and middle-income countries. Case Reports in Women’s Health, 39, e00542. https://doi.org/10.1016/j.crwh.2023.e00542 

Elamin, A., Abdullah, S., ElAbbadi, A., Abdellah, A., Hakim, A., Wagiallah, N., & Ansah, J. P. (2024). Sudan: From a forgotten war to an abandoned healthcare system. BMJ Global Health, 9(10), e016406–e016406. https://doi.org/10.1136/bmjgh-2024-016406 

Knop, M. R., Hayashi, M. N., Lin, R., Saing, C. H., Ung, M., Oy, S., Yam, Y., Zahari, M., & Yi, S. (2024). Impact of mHealth interventions on maternal, newborn, and child health from conception to 24 months postpartum in low- and middle-income countries: A systematic review. BMC Medicine, 22(1), 196. https://doi.org/10.1186/s12916-024-03417-9 

NURS FPX 8014 Assessment 2 Global Issue Problem

MacDonald, M. R. (2022). The place of traditional birth attendants in global maternal health: policy retreat, ambivalence, and return. Springer EBooks, 95–115. https://doi.org/10.1007/978-3-030-84514-8_6 

Madut, K. K. (2020). Determinants of early marriage and construction of gender roles in South Sudan. SAGE Open, 10(2), 215824402092297. https://doi.org/10.1177/2158244020922974 

Mahada, T., Tshitangano, T. G., & Mudau, A. G. (2023). Strategies to reduce maternal death rate and improve the provision of quality healthcare services in selected hospitals of Vhembe District Limpopo Province. Nursing Reports, 13(3), 1251–1270. https://doi.org/10.3390/nursrep13030107 

Mamkhezri, J., Razzaghi, S., Khezri, M., & Heshmati, A. (2022). Regional effects of maternal mortality determinants in Africa and the Middle East: How about political risks of conflicts? Frontiers in Public Health, 10, 865903. https://doi.org/10.3389/fpubh.2022.865903 

Mwilike, B. E., Welsh, J., Nyamuryekung’e, K. K., Nyaruchary, A. J., Pembe, A. B., & Gross, M. M. (2024). Midwife-led mobile antenatal clinic: an innovative approach to improve utilization of services in Pwani, Tanzania. International Journal of Environmental Research and Public Health, 21(11), 1446–1446. https://doi.org/10.3390/ijerph21111446 

Obels, I., Laurence, H., Straetemans, M., Gurp, M. van, Lutwama, G. W., & Jacobs, E. (2025). Determinants of health seeking behaviour in South Sudan: A cross-sectional household survey. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-024-19798-8 

Wakasa, T., Ueda, H. I., & Takeuchi, M. (2021). Maternal death analysis based on data from the nationwide registration system in Japan (2010–2018). Pathology International, 71(4), 223–231. https://doi.org/10.1111/pin.13076 

WHO. (2022, December 8). Strengthening primary health care in fragile settings: South Sudan. Who.int; World Health Organization. https://www.who.int/news-room/feature-stories/detail/strengthening-primary-health-care-fragile-settings-south-sudan?utm_source=chatgpt.com 

NURS FPX 8014 Assessment 2 Global Issue Problem

WHO. (2023). Analytical fact sheet maternal mortality: The urgency of a systemic and multisectoral approach in mitigating maternal deaths in Africa rationale. https://files.aho.afro.who.int/afahobckpcontainer/production/files/iAHO_Maternal_Mortality_Regional_Factsheet.pdf 

WHO. (2024, April 26). Maternal mortality. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality 

World Bank Group. (2024, December 10). New report reveals that poverty and vulnerability remain endemic in South Sudan, despite the country’s abundant resources. World Bank Group. https://www.worldbank.org/en/news/press-release/2024/12/10/new-report-reveals-that-poverty-and-vulnerability-remain-endemic-in-afe-south-sudan