[{"bbox": [96, 152, 1134, 234], "category": "Text", "text": "average in 2022. Hyperinflation combined with the end of subsidized goods led to huge erosion of purchasing power of the population, struggling to cater for basic needs of food, transport and shelter. The crisis was compounded by the effects of the COVID-19 pandemic."}, {"bbox": [96, 257, 1134, 340], "category": "Text", "text": "While the country has ratified several international conventions (including ICCPR, ICESCR and CRPD)², implementing their provisions remains a major challenge. Weak institutional capacities obstruct the implementation of policies to protect human rights, especially the basic rights of women and children."}, {"bbox": [96, 364, 1134, 549], "category": "Text", "text": "Marginalized groups of society remain vulnerable to being left behind, including women and girls, children, internally displaced persons (IDP), refugees, migrants, youth, and persons with disabilities (particularly women and girls). Many areas of the country that have historically been marginalized by successive central Governments, including Darfur, the East and the Two Areas (South Kordofan and Blue Nile), saw increased intercommunal conflict following the political crisis and ensuing security vacuum after October 2021. More than 3 million IDPs live in Sudan, many have for a long time been in camps and neighbourhoods with low access to communal infrastructure and schools."}, {"bbox": [96, 576, 1134, 791], "category": "Text", "text": "Sudan is also facing a food crisis. The 2021/22 cereal crop harvest is expected to be more than 30% lower than the previous five-year average. According to the latest Comprehensive Food Security and Vulnerability Assessment (CFSVA) conducted in first quarter of 2022, 34% of the population in Sudan, amounting to over 15 million people, are food insecure, which constitutes an increase of 7 percent compared to the same time one year ago. With world cereal prices soaring due to the Ukraine war and a shortage of foreign exchange in Sudan, there is a risk that food consumption needs may not be fully met. This comes on the background of already widespread malnutrition among children. **Without progressive increase in the provision of basic social services, Sudan cannot escape the poverty trap.**"}, {"bbox": [96, 815, 308, 841], "category": "Section-header", "text": "**Specific sector context**"}, {"bbox": [96, 841, 1134, 1081], "category": "Text", "text": "The national health system in Sudan is three-tiered, consisting of federal, state and locality levels. The Federal Ministry of Health is responsible for setting standards, legislation and control measures, national policies and strategic planning, capacity building of state and local health systems, international relations, managing external aid, and for monitoring and evaluation. The States are responsible for operational planning, capacity building of human resources and providing secondary care. The Locality is responsible for the provision of primary health care, midwifery, mother and child services, environmental health, vector control and human resource management. Since 1993 Sudan has a National Health Insurance Fund (NHIF) and the 2016 National Health Insurance Act subsequently made health insurance compulsory for all residents, including for refugees. Medicines are supplied by the National Medical Supplies Fund (NMSF)."}, {"bbox": [96, 1106, 1134, 1425], "category": "Text", "text": "The weak performance of the country's health system and poor health status of the population are clearly expressed in the high neonatal mortality rate of 33 deaths per 1000 live births and the Under-5-Mortality rate of 68 deaths per 1,000 live births, with 55% of it due to malnutrition (MICS, 2014); only 77% of births in Sudan are delivered with the assistance of skilled health care providers whereas only 49% of women attend four or more antenatal care visits from skilled health personnel. Despite most maternal deaths being preventable, the country's maternal health indicator performance remains low at 295 deaths per 100,000 live births, of which many deaths due to home deliveries without the presence of skilled birth attendants and lack of emergency obstetric care at medical facilities (UN MMIEG). In addition, the contraceptive prevalence rate is 11.7%(19% urban and 8.7% rural) and the unmet need for family planning is 26.6%³. Twelve per cent of women were first married before age 15 and 38% before age 18, which leads to early childbearing⁴. The prevalence of female -genital mutilation in 2014 was 87% among women aged 15-49 and 32% among girls aged 0-14. Although there is a decrease in the younger cohort, about 40% of women report that they still have the intention to continue this practice to their daughters."}, {"bbox": [96, 1450, 1134, 1532], "category": "Text", "text": "Health and nutrition indicators are worrisome, as they highlight poor and inequitable access to Reproductive Maternal Newborn and Child Health (RMNCH) services, with over 1.5 million women expected to have limited access to life-saving reproductive services, over 2 million children missing their routine vaccination doses, and"}, {"bbox": [85, 1566, 417, 1593], "category": "Footnote", "text": "² Treaty bodies Treaties (ohchr.org)."}, {"bbox": [85, 1593, 408, 1619], "category": "Footnote", "text": "³ DP/FPA/CPD/SDN/7 (unfpa.org)"}, {"bbox": [85, 1619, 408, 1645], "category": "Footnote", "text": "⁴ DP/FPA/CPD/SDN/7 (unfpa.org)"}, {"bbox": [1037, 1680, 1144, 1706], "category": "Page-footer", "text": "Page 5 of 26"}]