ORIGINAL ARTICLE Perception of basic package of health services’ impact on health service delivery and mortality among residents of Wulu County, South Sudan Gabriel Omoniyi Ayeni 1 & Oladapo Michael Olagbegi 2 & Ebenezer Obi Daniel 1 & Thayananthee Nadasan 2 & Okwuoma C. Abanobi 3 Received: 20 June 2019 /Accepted: 11 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Aim A populations’ perception of health service delivery is critical to the understanding of the relationship between quality of care and utilization of health services and has been increasingly treated as an outcome of health care delivery. This study aimed to assess the perceived impact of a basic package of health services on health service delivery and mortality in Wulu County, South Sudan. Methods A cross-sectional survey of 396 eligible adults aged 18 years and above who had benefitted from the services of health facilities within communities of Wulu County and equally resided in the community during the years 2014 to 2016 was conducted. A structured questionnaire was used to determine respondents’ perceived mortality and health service delivery ratings. Results Most respondents expressed moderate overall perceptions of health service delivery (62.4%) and mortality (84.1%) during 2014–2016. In 2016 significantly lower (p < 0.05) mortality perception scores and significantly higher perceived scores of health service delivery were recorded than in 2014 and 2015. In 2015, however, significantly lower mortality perception scores were recorded than in 2014. Respondents from the most urban area, Wulu Payam, expressed significantly higher health service satisfaction scores than those from other payams. Conclusions The perception of a basic package of health services provided by health care agencies in South Sudan as expressed by the residents of Wulu County was satisfactory and considered to have achieved a significant reduction in the population’ s mortality rate. However, the rural payams appeared to be lagging behind. Keywords Perception . Satisfaction . Mortality . Service delivery . Healthcare Introduction South Sudan implements a Basic Package of Health Services (BPHS) for all citizens, often contracted to nonstate providers (Howard et al. 2014). The National Ministry of Health (MoH) in South Sudan has decentralized health services into four levels: central, state, county and community (MOH 2012). The National MoH is in charge of the health sector policy, guidelines, regulations and standards development; quality assurance, monitoring and evaluation; health financing and health sector partner coordination at the national level (MOH 2012). It provides stewardship and guidance to the sector, manages the tertiary (teaching) hospitals and plays a supportive role for the State Ministries of Health (SMoH). The SMoH provides leadership for health service delivery and management at the state level. The County Health Department oversees the delivery of primary health care ser- vices in their respective counties. Health system strengthening is extremely challenging in war-torn South Sudan, with fluc- tuation between periods of active conflict and relative peace. The County Model Approach vision is to enable long-term sustainability of the health system and to catalyze the * Oladapo Michael Olagbegi olagbegioladapo@yahoo.com 1 Doctors with Africa CUAMM, Lakes State, South Sudan 2 Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4000, South Africa 3 Department of Public Health Technology, Federal University of Technology, Imo State, Owerri, Nigeria Journal of Public Health: From Theory to Practice https://doi.org/10.1007/s10389-020-01213-2