The Democratic Republic of the Congo
We partner with national and local organizations in the Democratic Republic of the Congo so that women, children, and communities—including those who live in the most fragile settings—can access the health care they need.
MOMENTUM is partnering with nearly 40 countries to accelerate progress and advance USAID’s work to save lives and improve health outcomes for women, children, families, and communities in all of their diversity. MOMENTUM brings together specialized technical and country expertise through six distinct yet integrated awards with the depth and breadth of experience to spur reductions in maternal, newborn, and child mortality and morbidity.
Four MOMENTUM projects–Integrated Health Resilience, Private Healthcare Delivery, Routine Immunization Transformation and Equity, and Safe Surgery in Family Planning and Obstetrics–work closely with the Democratic Republic of the Congo’s (DRC’s) government and national and local organizations to transform health care in 10 provinces across the country. We aim to make it easier for women, children, and families to access high-quality maternal, newborn, and child health, voluntary family planning, and reproductive health services in the private and public health sectors.
Strengthening Resilience and Fighting Infectious Diseases in Fragile Settings
Conflict, natural disasters, epidemics, and the COVID-19 pandemic have made the DRC’s North Kivu province a particularly fragile environment. In collaboration with local partners, MOMENTUM Integrated Health Resilience builds on USAID-funded Ebola response efforts to improve and restore health services in the province. It also supports the DRC’s government and its partners to continue providing those services despite shocks and stressors to the health system. MOMENTUM helps strengthen and enhance the capacity of the province’s health systems to reach key populations and address some of the root causes of poor health and fragility. MOMENTUM also facilitates collaboration between the development health sector and humanitarian aid organizations operating in North Kivu to strengthen community health services.
One of the DRC’s chronic health challenges is its high rate of tuberculosis (TB): 270,000 people in the DRC fell ill with the disease in 2018.1 In North Kivu, the rate of TB is likely even higher than the national rate due to its especially fragile context. MOMENTUM works closely with partners in North Kivu to develop and implement a TB program that strengthens screening, testing, treatment, and counseling at local health facilities.
Learn more about MOMENTUM’s approach to building health resilience, or read the story of Mussa Kachunga Stanis, who worked with MOMENTUM to improve access to health care in the DRC.
Tailored Solutions for Family Planning and Reproductive Health
MOMENTUM Integrated Health Resilience works with local organizations and leaders in North Kivu to adapt family planning interventions and messaging to minimize barriers to local service delivery often rooted in harmful gender norms. At health facilities, we help increase providers’ knowledge and skills and their understanding of a broader range of contraceptive methods, especially long-acting reversible contraceptives. Within the community, trained community health workers are mentored and supervised to deliver community-based contraceptive services, including counseling and self-administered contraceptives like Sayana Press. We also support providers to deliver high-quality counseling, address biases, and adolescent-responsive care.
MOMENTUM Safe Surgery in Family Planning and Obstetrics helps provide respectful, holistic maternity care, including safe surgeries, in the DRC. We collaborate with our partners to reach adolescents, youth, and postpartum and post-abortion women in Kinshasa with long-acting reversible contraception and permanent methods of contraception and to integrate family planning into fistula prevention activities. Additionally, we partner with providers in North Kivu, South Kivu, and Ituri provinces to strengthen their ability to provide counseling and family planning methods that work best for each of their clients. We also partner with local organizations and health providers to increase the availability of and access to a broad range of contraceptive methods.
Check out this collection of 20 essential resources for family planning and reproductive health in fragile settings curated by MOMENTUM Integrated Health Resilience.
Fighting Malnutrition
In the DRC, 43 percent of children under five are too short for their age, also called “stunting,” and 23 percent are underweight for their age—both of which are signs of malnutrition.2 To fight malnutrition, MOMENTUM Integrated Health Resilience works with partners in North Kivu to integrate nutrition services with TB control and reproductive, maternal, newborn, child, and adolescent health services in targeted zones throughout the region. MOMENTUM also works with the Ministry of Health to prevent malnutrition, including assisting vulnerable families in setting up kitchen gardens and supporting local health officials to establish functional community nutrition support groups. In those groups, mothers and pregnant women learn from their peers how to improve infant and young child nutrition, including how to prepare 4-star porridge (a blend of foods that includes at least one starch, one animal protein, one pulse and one fruit or vegetable). The mothers also assist community health workers to ensure that every child under five is screened for acute malnutrition at least once every quarter using mid-upper arm circumference (MUAC) measurement tapes. MOMENTUM also collaborates with public and private health facilities to strengthen their readiness to provide high-quality, person-centered, integrated services.
Dive into the story of Moise, a four-year-old boy in North Kivu who was screened and treated for malnutrition by MOMENTUM Integrated Health Resilience.
Maintaining Access to Maternal, Newborn, and Child Health Care in North Kivu
Conflict, natural disasters, Ebola outbreaks, the COVID-19 pandemic, and other disease outbreaks have repeatedly disrupted access to and the delivery of essential health services in North Kivu. MOMENTUM Integrated Health Resilience helps strengthen the capacity of the DRC’s health system to deliver maternal, newborn, and child health services, helping to sustainably transition the country away from humanitarian assistance. In North Kivu, MOMENTUM collaborates closely with the national and provincial Ministry of Health, international partners, local NGOs, United Nations agencies, and other USAID-funded projects to mobilize community and health facility support to improve and strengthen community health services.
For example, we convene representatives from health facilities, community structures, and NGOs to assess health priorities and trends and create action plans to address these needs. Community health workers who collaborate with MOMENTUM also conduct regular household visits to provide health messaging, identify health needs, and make referrals to local health facilities. MOMENTUM also assists the Ministry of Health in running Integrated Community Case Management sites to bring care closer to children under five. MOMENTUM staff meet regularly with community health workers to discuss their activities and reflect on lessons learned from their experiences. MOMENTUM bolsters partners’ efforts to improve primary health care messaging, referrals, and reporting through these meetings.
We also work with partners to provide a steady supply of quality medications, basic personal protective equipment, and other health products for women, children, and communities in North Kivu.
Improving Access to Quality Fistula Care and Obstetric Surgeries
MOMENTUM Safe Surgery in Family Planning and Obstetrics works with the Government of the DRC and several private hospitals in North and South Kivu and Kinshasa to increase access to holistic care for obstetric fistula, a maternal injury that occurs when obstructed labor leaves a hole in the birth canal. We work with hospitals in Kinshasa, Goma, and Bukavu to help them repair fistula cases, continuing the work of USAID’s Fistula Care Plus program.
MOMENTUM also works with providers, provincial ministries of health, and local professional organizations to strengthen the capacity for surgical obstetric care so that women can access timely and high-quality care for cesarean deliveries and hysterectomies after birth.
Increasing Routine Immunization Coverage
The DRC is one of the most vulnerable countries to vaccine-preventable diseases; only 35 percent of children under age two are fully vaccinated against preventable childhood diseases.3 MOMENTUM Routine Immunization Transformation and Equity partners with the government to implement the Mashako Plan, which aims to increase immunization coverage nationwide by 15 points. As part of our work, we collaborate with local and private sector organizations in Haut-Katanga, Kasaï-Central, Kasaï-Oriental, and Lualaba Provinces to address persistent barriers to equitable immunization coverage and identify high-potential interventions and strategies to overcome these barriers.
MOMENTUM is also working with the DRC’s Ministry of Health to reach children with routine vaccinations, especially those who missed their vaccines during the COVID-19 pandemic and other shocks, using the World Health Organization’s Reaching Every District/Reaching Every Child approach. This includes supporting the DRC’s Expanded Program on Immunization to plan for potential shocks and stressors that may disrupt immunization access.
Read how we’re helping children access the vital vaccines they need.
Rolling Out COVID-19 Vaccines
MOMENTUM Routine Immunization Transformation and Equity assists the DRC in introducing COVID-19 vaccines to communities. In coordination with national and provincial Expanded Program on Immunization (EPI) teams, MOMENTUM provides technical assistance for COVID-19 service delivery planning, communication, logistics, data management, mapping, vaccine access and use, policies, and partnerships.
MOMENTUM also supports the DRC’s Ministry of Health to generate demand for COVID-19 vaccines and improve coverage while integrating it with existing routine immunization services.
Learn how MOMENTUM-trained community health workers are encouraging COVID-19 vaccination in the DRC.
Determining the Cost of Private Health Care
The private sector is an integral part of the DRC’s health system,4 but little is known about the cost of private health care delivery. This information gap makes it challenging for leaders to make informed decisions about allocating resources within the health system. MOMENTUM Private Healthcare Delivery conducted a study to understand the difference between costs in the private and public sectors, especially the cost of family planning services, in Kinshasa and its surrounding areas. The study explored the differences in prices paid for commodities, health staff salaries, supplies and equipment, and other costs related to family planning and maternal health services across public and private sectors. The study’s results will help stakeholders in DRC’s public sector make informed decisions about purchasing family planning and maternal health services in the private sector.
Our Achievements in the DRC
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201 people trained
From October 2021 to September 2022, MOMENTUM Safe Surgery in Family Planning and Obstetrics trained 201 trainers, teachers, coaches, health zone managers, and providers on family planning. MOMENTUM also supplied 190 health facilities with contraceptive products and basic surgical equipment to ensure providers are equipped to address difficult implant removals in Ituri and Kinshasa.
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284,714 children screened
MOMENTUM screened 284,714 children and 25,957 pregnant and lactating women in North Kivu for acute malnutrition between October and June 2023.
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339 fistula cases repaired
From October 2021 to September 2022, 339 fistula cases were surgically repaired (with a 91 percent success rate) in MOMENTUM-supported health facilities.
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48,330 vaccines administered to children under 5
During the 2023 African Vaccination Week from April 24 - 30, 2023, MOMENTUM Integrated Health Resilience supported the Ministry of Health to administer 58,330 doses of vaccines to children under five years old, 7,261 of whom had never received a vaccine.
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182,908 COVID-19 vaccinations
From October 2021 to September 2022, MOMENTUM Routine Immunization Transformation and Equity-supported sites in Kinshasa and Haut Katanga completed 182,908 COVID-19 vaccinations.
MOMENTUM Integrated Health Resilience: DRC Ministry of Health, United Nations Population Fund, Soins de Santé Primaires en Milieu Rural (SANRU), DRC Health Systems Strengthening Program/PDSS (Unité de Gestion du Programme de développement du système de santé – Ministère de la santé publique, hygiène et prévention), Santé Plus, Forcier Consulting, Hub for Research, ASRAMES, MTaPs, Breakthrough Action, UNFPA.
MOMENTUM Private Healthcare Delivery: Avenir Health
MOMENTUM Safe Surgery in Family Planning and Obstetrics: EngenderHealth, Integrated Health Project, Breakthrough ACTION and RESEARCH, Panzi Hospital, Health Education Community Action Leadership (HEAL) Africa Hospital, St. Joseph Hospital, Programme National de Santé de la Reproduction de la RDC (DRC National Reproductive Health Program), Programme National de Santé des Adolescents de la RDC (DRC National Adolescent Health Program), Direction d’Enseignement des Sciences de Santé au Ministre de la Santé (Directorate of Nursing Schools at the Ministry of Health)
MOMENTUM Routine Immunization Transformation and Equity: DRC Ministry of Health, Expanded Program on Immunization (PEV), Bill and Melinda Gates Foundation (BMGF), Breakthrough ACTION, U.S. Centers for Disease Control and Prevention (CDC), U.K. Foreign Commonwealth and Development Office (FCDO), Gavi, GRID3, Kinshasa School of Public Health (KSPH), Integrated Governance Activity (IGA), Integrated HIV/AIDS Project (IHAP), International Federation of the Red Cross (IFRC), Integrated Health Program (PROSANI), Premise Data, Pygma, SANRU, UNICEF, VillageReach, World Bank, WHO, World Relief
Interested in partnering with us or learning more about our work in the DRC? Contact us here or check out our East Africa Regional Brief.
Learn more about USAID’s work in the DRC.
References
- WHO. Democratic Republic of Congo (DRC) – Integrating tuberculosis screening into community-based HIV activities. July 2, 2020. https://www.who.int/publications/m/item/democratic-republic-of-the-congo-integrating-tuberculosis-screening-into-community-based-hiv-activities
- Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP) and ICF International, Enquêtes Démographiques et de Santé (EDS-RDC), 2013-14 (Rockville, MD: MPSMRM, MSP, and ICF, 2014).
- UNICEF. Multiple Indicator Cluster Survey (MICS) 2018-2019. 2020. https://mics.unicef.org/surveys
- World Bank. “The Role of the Private Sector in Improving the Performance of the Health System in the Democratic Republic of the Congo.” October 2018. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/487571539958646859/the-role-of-the-private-sector-in-improving-the-performance-of-the-health-system-in-the-democratic-republic-of-congo
Last updated December 2023.