South Sudan strengthens stewardship and partner alignment around a unified Boma Health Initiative plan

𝐓𝐡𝐞𝐦𝐞: Monitoring Policy Implementation and strengthened government stewardship of community based primary healthcare 

South Sudan’s community health system has long been characterised by fragmentation, with multiple partners implementing parallel programmes, resulting in inefficiencies, duplication, and inequitable service delivery. As the Boma Health Initiative (BHI) rapidly scaled to 38% national coverage, the need for a unified, government-led framework became urgent. Strengthening alignment across partners was essential to ensure effective delivery of SRHR services, particularly for underserved and vulnerable populations.

In February 2026, the Ministry of Health (MoH), with technical and financial support from WISH2 through Options, convened a national BHI Strategic Alignment Workshop in Juba. Options worked with the MoH to prepare the agenda, develop presentation materials and partner alignment templates, and support workshop logistics, including the venue. The workshop brought together 81 stakeholders, including UN agencies and development partners, including UNICEF, WHO and the World Bank, as well as a broad mix of civil society organisations and NGOs active in community health and SRHR service delivery and advocacy, including 18 Health Sector Transformation Project (HSTP) partners. During the meeting, MoH leadership presented the updated BHI Annual Operational Plan and Annual Work Plan for FY 2026/2027, while Options co-facilitated selected sessions, supported discussions, and provided technical inputs during plenary and group work. Options also helped develop the mapping templates used to capture partner activities, resources and geographic coverage, laying out the foundation for a unified national workplan and budget.

The workshop marked a critical shift towards stronger government stewardship and system-wide alignment.

• Strengthened alignment and Government stewardship around the One BHI plan: Participants developed a shared understanding of BHI scale-up priorities, with senior MoH officials clearly endorsing the One BHI Plan as the single framework guiding all programming. This high-level commitment catalysed partner buy-in and signalled a move away from fragmented, partner-led approaches.
• Improved clarity on partner activities, resource flows and progress towards a unified BHI plan/budget: The mapping exercise generated, for the first time, a consolidated overview of partner activities, budgets, and coverage. Eleven partners submitted data in advance, enabling identification of duplication, gaps, and inequities in resource allocation.
• Strengthened governance through stronger commitments towards harmonised implementation and one monitoring and evaluation system: The Ministry enforced a 48-hour deadline for outstanding submissions, demonstrating a shift towards stronger compliance and accountability mechanisms.
• Better planning and equity focus through cross Sector Coordination and Systems Alignment: The updated planning tools and reporting frameworks also support more robust equity analysis. This allows the Ministry to identify gaps affecting internally displaced persons, people with disabilities and remote communities, creating opportunities for targeted SRHR outreach. Commitments to a unified supply chain will help reduce stock outs of SRHR commodities at community level. Given that BHWs often serve as the first point of contact for women and adolescents, improved commodity availability is likely to enhance trust and increase service uptake.

Overall, the workshop laid the foundation for a unified national BHI workplan and budget, enhancing value for money, reducing duplication, and strengthening the delivery of integrated SRHR services across the country.

Challenges identified included fragmented partner coordination and limited compliance with national requirements, weak monitoring and reporting systems, recurring commodity stock outs, the complexity of integrating over 16,000 community volunteers into one national cadre, inconsistent financial data, and uneven subnational capacity. Together, these issues continue to affect alignment, planning and service delivery. In response, the Ministry of Health and partners agreed on stronger accountability measures, unified systems, phased integration, improved budgeting processes, and targeted technical support to strengthen implementation.

This story highlights the value of strong government leadership, practical planning tools, and inclusive stakeholder engagement in addressing fragmentation within complex health systems. The One BHI Plan approach shows that bringing partners together under a single national framework can strengthen coordination, improve accountability, enhance efficiency, and support more equitable service delivery.

The model also provides a promising pathway for scale in other fragile and humanitarian settings. Sustaining this progress will require continued follow-up, stronger compliance mechanisms, and ongoing support to subnational structures so that national alignment is translated into effective implementation.