Socio-spatial Disparities in the Provision
of Medical Services in the Sudan
GALAL EL DIN EL TAYEB, SIDDIG AHMED AWADALLA, EL FATIH ZEIN EL ABDIN
This chapter attempts to shed some light on the spatial distribution of and social accessibility to medical services in the Sudan. It is based on data compiled by the Ministry of Health. The chief contention is that planning for medical services is an integral part of the general planning process, and reflects the major socioeconomic characteristics of the Sudan as a peripheral capitalist country.
As in other developing countries, the status of the Sudan's national economy is significant for the distribution of medical facilities in at least three ways. First, the crops produced and the level of productivity and economy of an area in general are indicative of the levels of nutrition and related diseases. For example, the fruit and vegetable gardens along the Nile and in the Jebel Marra area enrich the diet of these people in contrast to that of the nomads for whom fruits and vegetables are exotic and hardly known, but who rank first in milk consumption. Where and when production of foodstuffs is low, the status of nutrition also tends to be low, for example, in northern Kordofan, northern Darfur and some pockets in the south. Second, regional variations in the type of economic activity, for example, industry, intensive irrigated agriculture, rainfed cultivation and nomadism, are associated with similar variations in the prevalence and incidence of some diseases, and therefore call for some different medical services and facilities. For example, injuries by machines and pollution-related diseases are dominant in Khartoum, whereas malaria and bilharzia are most prevalent in the Gezira irrigated scheme. Third, since the national economy depends on rural production, the distribution of medical services should show a bias in favour of rural population.
The geographical distribution of medical services does not in itself ensure that