DR Congo

Family Planning/Reproductive Health Sevices Being Revitalized

The Democratic Republic of Congo (DRC) has experienced serious deterioration in health services over the past decades. The total fertility rate is 6.3, one of the highest in Africa. The maternal mortality rate (MMR) is estimated at 1,100 per 100,000 live births; one of every 29 women dies of causes related to pregnancy and giving birth. Infant mortality in the first year is estimated at 92 per 1,000 and for children under five, it is 148 per 1,000.

According to the 2007 DHS, around 10 million (58% of all) women in union want to space the next birth or have no more births. However, only 6.5% of women use a modern contraceptive method, whereas 16% did in 1990.

DRC’s population of 65 million is expected to double in the next 20 years, creating more pressure on economic, health, and family resources. Rebuilding the health care system and addressing reproductive health and family planning (RH/FP) issues in the DRC is a priority of USAID and other donors.

See below for more information on these C-Change activities:

--Repositioning Family Planning

--Training Relais to use the Family Planning Conversation Tool

--Technical assistance in SBCC to service delivery partners

C-Change Leading Efforts to Reposition Family Planning

C-Change is mobilizing stakeholders, partners, and the government to reposition RH/FP policy and programming in DRC. A national RH/FP meeting was held in DRC in December 2009. The goal was to expand RH/FP efforts and create a cross-sectoral forum of government, donor agencies, and civil society to take forward efforts to elevate programming and policy for family planning and garner resources to do so.

Training Community Health Workers (Relais) to use the FP Conversation Tool

C-Change recently trained 3,000 relais (community health workers) in three eastern provinces--Kasai Oriental, Katanga and Kasai Occidental—in use of the Family Planning Conversation Tool. Relais are key outreach workers, serving as the interface between health centers and the community and important to referral and education. This activity is part of the national social and behavior change capacity building program that C-Chage is carrying out in DRC.

The Tool was developed by C-Change/DRC partner CARE and AED. The tool assists relais as they talk to small and large groups of men and women about issues of family planning (FP), including spacing of pregnancies for the health of the mother and her children, visiting the health clinic for FP counseling and antenatal care, and adopting use of modern contraceptives, i.e., the pill, condoms, and injectables.

The one-day training builds the capacity of relais to use the Family Planning Conversation Tool when making home visits or conducting group discussions in their communities. C-Change has also supported development and broadcast of radio dramas on FP through community radio stations in eight zones of the three provinces. While preliminary, results through June indicate an uptake from 17% to 27% in the percentage of women who have gone to the health center for FP counseling, with greater change expected for September’s report. The Ministry of Health reviewed and approved he Family Planning Conversation Tool and determined that the tool will be used nationally.

C-Change Provides SBCC Technical Assistance

C-Change is supporting health service delivery projects to help mobilize community participation and utilization of health services for family planning and reproductive health, maternal and child health, malaria, and tuberculosis. Two large projects, Leadership Management and Sustainability (LMS) and Project AXxes have been operating for the past two years to rebuild health clinics, train health providers, and ensure that health care commodities are available. C-Change is providing technical assistance and capacity strengthening in behavior change communication to these service delivery partners in four areas in the eastern part of the country. Activities include designing a community participation strategy to increase use of services and improve the health status of communities they serve.