This study aimed to determine the preference of junior doctors for rural postings in Sudan, and to estimate how much they are willing to trade off from their salaries for nonmonetary incentives. Through this study, the first of its kind in Sudan, it should be possible to recommend policy options to support retention of physicians in rural postings. Methods Study setting Medical graduates undergo supervised training for one year (houseman/ internship) in recognized hospitals in rural or urban settings, in addition to another year of

Antenatal care is shown to be a cost-effective intervention for reducing rates of maternal mortality. However, utilization of maternal health services in Sudan remains low and maternal deaths high. This study aims to investigate why Sudanese women do not attend antenatal care, satisfaction with services and views on improving uptake. Focus group discussions took place, with 30 women who had delivered in the past year, in five areas in Khartoum. Themes in transcripts were identified. Factors that can affect a woman’s choice to attend antenatal care extend beyond physical barriers and include misconceptions of it’s use, conflict between faith and modern medicine and dissatisfaction with previously used services. The care provider’s perceived lack of empathy, unpunctuality and lack of health promotion can also contribute to underutilization.

Background Seeking care from traditional healers for injury is a common practice in low- and middle-income countries, including Sudan. As little is known about specific patterns of the practice in the country, we aimed to investigate associated factors and the role of professional injury care availability. Methods We used Sudan Household Health Survey 2010 data from a national stratified multistage cluster sample of 15 000 households. A multivariable Poisson regression (PR) model with robust variance was used to test potential associations of receiving care from a traditional healer in the first week after injury with age, gender, urban/rural residence, wealth index, educational attainment, cause of injury, time of injury occurrence and state-level injury-care bed density. Results Of 1432 injured participants who sought some form of healthcare, 38% received care from a traditional healer. A significant negative association was found with educational attainment, age and wealth. The association between injury-care bed density and receiving care from a traditional healer was consistently evident only when the injury was caused by a road traffic accident (PR = 0.90, 95% CI 0.85 to 0.96). Conclusions Merely increasing the affordability or availability of injury care facilities may not impact reliance on traditional healers for all causes of injury. Therefore, injury care policies need to consider the role of traditional healers as part of the healthcare system.

The findings imply more potential for separate cooking facilities in preventing burns among children in Sudan than does a change in cooking fuel, although more evidence needs to be gathered, particularly around safety practices.

Although many breastfeeding peer support projects have been initiated, evaluating their cost-effectiveness is difficult as a result of a paucity of data and relevant literature. However, from a review of the limited data it can be shown that breastfeeding peer support programmes can, by increasing the number of babies who are breastfed, make significant savings to the NHS. Other areas that could offer long-term savings to the NHS, but have not been fully analysed, include potential reductions in pre-menopausal cancers in mothers who have breastfed, childhood obesity, urinary tract infections and necrotizing enterocolitis. Consideration of the value-added benefits that peer support workers offer to the mothers and the community highlights the special value of breastfeeding peer support programmes.