Availability and readiness of healthcare services at primary healthcare centers during the Sudan war: a cross-sectional study.

Abstract

Health services in Sudan have been severely disrupted during the ongoing war, leading to a decline in the availability and readiness of services at the primary care level. This study aimed to evaluate the availability and readiness of healthcare services at Sudanese primary healthcare centers (PHCCs) during the current conflict. A cross-sectional study was conducted in four out of seven safe states in Sudan. Using the Service Delivery Indicator (SDI) survey, the availability and readiness of 15 medical equipment items, 15 vaccines, and 36 essential drugs were assessed. Kruskal-Wallis tests were used to compare indices across states, followed by Dunn's post-hoc test to identify significant differences. A p-value < 0.05 was considered statistically significant. Among the 50 PHCCs included, the mean equipment availability index was 63.6%, while the overall vaccine availability index was 48.0%, with 80% of facilities providing vaccination services. The overall drug availability index was 54.4%, with River Nile State having the highest availability at 67.6%. Vaccine availability indices in Red Sea State (mean = 29%) and River Nile State (mean = 24.4%) were significantly lower than in Gadarif State (mean = 80.7%) (p < 0.001). Additionally, there was a significant difference in drug availability across the four states (p = 0.015). Primary healthcare centers in Sudan face significant challenges during the war, with shortages in medical equipment, vaccines, and essential drugs. Addressing these gaps is critical to ensure service functionality and prevent disease outbreaks. Strengthening supply chains and prioritizing healthcare support are urgently needed.