Reducing Maternal Mortality in Sudan: a hybrid framework

Image from UNDP picture portrait of a young mother from Sudan and her newborn after a health check
Figure 1. Sudan Maternal mortality ratio (modeled estimate, per 100,000 live births). 1990–2015 (WB, 2019).
Figure 2: Proportion of regular visits to antenatal care in conflict-affected states.
Figure 3. The prevalence of contraceptive and unmet need for family planning in Sudan, 2015 (WB, 2019).
Figure 4: Image from Pixaby.
Figure 5: Image from (Manca, et al., 2018).
Figure 6: Image from (Ergo, Eichler, & Shah, 2011).
  • The first component was developed to describe South Africa’s (SA) efforts to integrate chronic disease management into its healthcare system (Davy, Bleasel, Liu, Ponniah, & Brown, 2015). SA resembles Sudan in health inequities and interstate variabilities (World Bank, 2017).
  • The second and third components evolved from the findings of the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD) in SA (Saving Mothers 2011–2013, 2014). Adapting the standard 4-H and 5-Cs leadership models, the proposed framework tackle Sudan’s leading causes of maternal mortality (Figure 6).
  • The fourth component is the MNCH framework, a combination of the health system and action orientated health system framework (Ergo, Eichler, & Shah, 2011). It delineates the required changes in the Sudanese health system and their roles in reducing MMM including the incorporation of prevention, promotion, community engagement, and patient activation.
Figure 7: Image from © Asaad Taha, 2014.
  1. One National Overarching Action Framework,
  2. One Coordination Mechanism,
  3. One Agreed Monitoring, Reviewing, Evaluating, and Learning System (MREL), and
  4. One Stakeholders Engagement & Communication Mechanism (SECM).
Figure 8: The GMHMP Theory of Change © Asaad Taha, 2014.
  • A hodgepodge of hospital protocols for dealing with potentially fatal complications, allowing for treatable complications to become lethal.
  • Hospitals — including those with intensive care units for newborns — can be woefully unprepared for a maternal emergency.
  • Federal and state funding show only 6 percent of block grants for “maternal and child health” go to the health of mothers.
  • In the U.S, some doctors entering the growing specialty of maternal-fetal medicine were able to complete that training without ever spending time in a labor-delivery unit (Martin & Montagne, 2017).
  • Suffering people bring their problems to interested parties: NGOs, CBOs, international aid sources, private foundations, and charities.
  • These organizations process those problems and articulate them in formal grant requests.
  • Grantors receive the requests and, after interpreting those needs, grant the request with restrictions like formal and frequent audits, extensive documentation, and more.
Figure 9: Image by © Asaad Taha, 2014.

Author: Asaad Taha, Ph.D., MSP®, PRINCE2®, Social Entrepreneur | Futurist | Principal Advisor at S4F.Solutions™;

Works Cited

“Three Ones” key principles. (2004, April 4). Retrieved Feb. 4, 2019, from UNAIDS:



Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store
Asaad Taha, PhD

Asaad Taha, PhD


A Social Entrepreneur | Futurist|Principal Advisor @ S4F™ Solutions™