South Sudan

Under Article 31 of the Transitional Constitution of South Sudan of 2011, all levels of government shall promote public health, and establish, rehabilitate and develop basic medical and diagnostic institutions. The government shall also responsible for the provision of free primary health care and emergency services for all citizens.

In line with Schedule B (13) of the Constitution, the establishment, regulation and provision of health care, including hospitals and other health facilities, is within the exclusive executive and legislative powers of a state.
Furthermore, the national and state governments have legislative and executive competencies regarding health policy, among other matters, in line with Schedule B.
Finally, Article 166 (f) on the Local Government establishes the responsibility of local governments to promote self-reliance among the people through mobilisation of local resources to ensure the provision of health and educational services to communities in a sustainable manner.

The National Health Policy 2016-2026 aims to strengthen the national health system and partnerships to overcome barriers to effective delivery of the Basic Package of Health and Nutrition Services (BPHNS) and efficiently respond to quality and safety concerns of communities while protecting people from impoverishment and social risk (page 4).

The policy identifies several priorities and objectives, including strengthening health service organization and infrastructure development for effective delivery of basic services and UHC; strengthening leadership and management of the health system to increase health system resources for improved health system performance; and strengthening partnerships for healthcare delivery and health systems development (pages 5).

The document references several legislative and regulatory sources throughout its text: the Transitional Constitution of the Republic of South Sudan (2005) recognizes health services as a basic human right, which forms the foundation for the National Health Policy 2016-2026 (pages vii, 1, 6).

The policy outlines specific actions related to laws and regulations across all areas of the health system. The policy refers to the establishment of regulatory and legal frameworks to enable professional councils to promote adherence to professional standards and codes of practice under Objective 3.2.1 on human resources for health (page 19). The policy establishes priority on the regulation of the pharmaceutical sector for assurance of quality, protection of the population and public health as part of Objective 3.2.2 on medicines and health supplies (page 20). Under Objective 5 on leadership and governance, the strategy outlines priority (C) to provide an enabling legal environment and regulatory frameworks that support the development of a strong health system, service delivery and professional development. This priority includes concrete actions for the Ministry of Health such as supporting the development of relevant bills for the parliament, formulation of ordinances and by-laws, supporting public health through appropriate legislation and enforcement of health laws, establishment of a regulatory body for health systems research and promotion of biomedical research (pages 25-26). The policy also calls for the regulation of traditional and complementary medicine (page 28).

The main goal of the "South Sudan Health Sector Strategic Plan 2023-2027" is to establish a strengthened national health system and partnerships that overcome barriers to the effective delivery of the basic package of health and nutrition services (BPHNS), and efficiently respond to quality and safety concerns of communities while protecting people from impoverishment and social risk (pages 35-36).

The priorities and objectives identified in the plan include strengthening health service organization and infrastructure development for effective and equitable delivery of BPHNS; strengthening leadership and management of the health system and increasing health system resources for improved health sector performance; and strengthening partnerships for health care delivery and health systems development (pages 36-37).

In the "Background and Introduction" and "Situation Analysis" sections, the plan references several legislative documents to provide context and analysis. For instance, the plan references the 2011 Constitution of South Sudan that mandates the government to promote public health and provide free primary care and emergency services to all citizens (page 6). The Drug and Food Control Authority Act of 2012 is referenced in relation to the limited capacity to regulate substandard and falsified health products (page 27).

The plan defines specific actions related to laws and regulations. For example, it proposes an indicator regarding the development and implementation of guidelines for multi-sectoral collaboration that supports community-based services (page 38). It also highlights the need to update nutrition policy, related legislation and regulatory framework for improving nutrition such as the BMS Code, USI regulation and standards, and the food and beverage regulations (page 41). Furthermore, the plan outlines an indicator on the enactment and implementation of alcohol laws and regulations (page 46). The development of the Mental Health Act is mentioned as a measure to create the legal environment for the promotion of mental health and service delivery (page 46). The plan also specifies the establishment of regulations, norms and standard operating procedures to guide the establishment and management of health facilities as part of the equitable access objective (page 48). Finally, it outlines the need to develop, update, and implement relevant laws or legal frameworks for the health sector for universal health coverage such as Public Health Act, Medical Council Bill, Public Health Ordinances; by-laws, etc. (page 59).