The Health Sector Transformation Project (HSTP) is a multi-donor health initiative funded by the World Bank and a consortium of donors. The HSTP implementation is led by the Minis-try of Health through its Project Management Unit (PMU), with UNICEF and WHO serving as managing organizations. Approximately 28 implementing partner health NGOs are delivering services in 40 Lots across the country. The primary goal of HSTP is to strengthen South Sudan's healthcare system by enhancing governance, monitoring, and service delivery. By utilizing integrated service platforms and innovative technology, the project aims to bolster community-level capacity, optimize supply chains, and promote gender responsive social and behavioral change. The HSTP aspires to create a sustainable, government-run healthcare system
capable of addressing the complex health needs of the population, particularly those affected by ongoing crises.

As we embark on another edition of the Health Sector Transformation Project (HSTP) newsletter, I want to reflect on the shared commitment of the Ministry of Health and Partners to improving healthcare in South Sudan. Supported by the World Bank and a consortium of dedicated donors, the HSTP is a testament to our collective efforts to strengthen the health system, with the Ministry of Health, UNICEF, WHO, and approximately 40 health NGOs working together to deliver essential services to underserved communities. This news-letter provides updates on our progress, key milestones, and challenges as we strive to-ward a sustainable healthcare system. Together, we are addressing immediate health needs while laying the foundation for a brighter, healthier future for all South Sudanese. Thank you for your continued support and dedication to this mission. Dr. Santo Malek, DG-IHC & HSTP Project Coordinator, MOH

The HSTP has made significant progress, with project effectiveness al-ready realized.

• All 28 Implementing Partners are fully engaged, facilitating pro-gram implementation across 100% of the 28 Lots across 10 States and 3 Administrative Areas.

•The PMU(MOH) has welcomed new members, including Dr. Kukwaj Nyawello, who serves as PMU Project Manager. The renovated office, supported by UNICEF, has been commissioned by MOH Minister.

•Incentive payments are being processed across several states, and the sales order for remaining assets is nearing final approval. Some assets have already been handed over directly to Implementing Partners by FCDO, while others are being finalized.

•UNICEF has successfully completed the kitting and packing of critical health supplies for all 80 counties in South Sudan. Year two supplies are currently being pro-cured and delivered. To further expedite delivery, UNICEF has increased the number of local road and air transport service providers across the country.

•The World Health Organization (WHO) organized a briefing with UNICEF and HSTP donors, including the World Bank (WB), GAVI, Canadian Embassy, UNDP, British Embassy, EU, and Global Fund (GF). Feedback on the Health Systems Strengthening (HSS) interventions was gathered, and WHO will revise the workplan for the WB endorsement.

•The MOH has developed the three tools to support Universal Health Coverage: (1) a tool to monitor service availability during HSTP transition. It is customized for DHIS2 to provides a baseline of services in HSTP and non-HSTP supported facilities; (2) a tool to assess the implementation of Basic Package for Health and Nutrition Services (BPHNS), which will in-form its integration into the Essential Health Service Package (EHSP); and (3) a tool for analyzing the implementation of South Sudan's Standard Treatment Guidelines (STGs) and Essential Medicine List (EML).

•Preliminary findings are being utilized to optimize essential medicine resources and access to life-saving medicines.

The World Health Organization (WHO) has shared findings and recommendations from consultations with health facilities with UNICEF. Specific medication needs from Al Sabah Children Hospital were communicated to UNICEF for consideration in the upcoming procurement cycle. This collaborative approach ensures that the medicines provided align with the actual needs of health facilities.

The project faced delays in achieving effectiveness due to late disbursement of funds, impacting the timely com-mencement of key activities.

Additionally, challenges arose with the new systems for incentive payments, particularly in validating beneficiary lists, which further delayed payment processing. These issues underscore the need for improved financial flow management and streamlined processes to ensure efficient project implementation.

Flooding due to climate change has affected last mile delivery to some parts that are already affected. This has caused stock out of some antimalarial commodities and tools.

UNICEF is working on a contingency plan to ensure timely delivery of commodities.

There has been reports from the national referral hospitals that the incentives provided covered only a quarter of the health workers.

The MOH PMU operationalization has been delayed by slow progress of staff onboarding and lack of office furniture and equipment. The MOH is engaging UNICEF and WHO to complete the office set up and operationalization and staff recruitment.

The Ministry of Health leadership has been instrumental in the successful implementation of the HSS component to date. WHO and UNICEF organize bi-weekly coordination meetings to dis-cuss updates and align efforts during HSTP implementation. This collaboration enhances coordination and pro-vides opportunities for WHO and UNICEF to leverage resources effectively. UNFPA and UNICEF have coordinated efforts to ensure the effective sup-ply of reproductive health commodities, working together to prevent du-plication and streamline the distribution process. This collaboration optimizes resources and ensures critical reproductive health supplies reach intended beneficiaries efficiently.

Communities at project locations were oriented and trained on the Grievanc-es and Redress Mechanisms (GRM. It was an interactive session aimed at equipping participants with essential skills for managing complaints within the project framework. Key compo-nents included:

Understanding Grievance Mecha-nisms about various types of griev-ances related to project implemen-tation and stakeholder engage-ment, emphasizing the need for robust mechanisms.

Tools and Techniques: The training provided strategies for effective complaint handling, including ac-tive listening, conflict resolution, and prioritization of grievances.

Promoting Transparency and Ac-countability in grievance handling, encouraging stakeholders to voice concerns with no fear of retaliation.

Responsive Communication strate-gies to provide timely updates and reassure stakeholders during the grievance resolution process.

Monitoring and Evaluation includ-ing methods for monitoring griev-ance mechanisms to ensure ongo-ing effectiveness and relevance.

Case Studies and Best Practices from other projects to identify best practices.

confident in their ability to address grievances equitably, fostering an environment of open communication that contributes to project success.