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DRC

Session 3D3

Dr. Marie Louise Mbo, M.P.H

Director of National Reproductive Health

Program - Democratic Republic of congo

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Trends in institutional deliveries :

Institutional deliveries increased from 69,7% in 1998 to74% in 2007

Maternal Mortality (MMR) decreased from1837/100000 live births in 1998 to 549/100000 in 2007

Neonatal Mortality (NMR) increased from 39/1000 livebirths in 2001 to 42/1000 LB in 2007

Institutional deliveries take place in health facilities,both public and private, and are assisted mostly byNurses, Midwifes, and less frequently by GeneralPractitioners and Specialists

Sources: MICS2 2001; Strategic Povert Reduction Document 2006-2008.DHS (Demographic and Health Survey) 2007; Situation analysis of NationalReproductive Health Programme 2007-2010

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Reasons of high rates of institutional delivery:

Behavior acquired since colonial time

Financial accessibility facilitated by family solidarity (birth is a happyevent)

Good availability of staff -even if not qualified-

Impacts of the increase of institutional delivery on the quality ofservice:

Offer has increased but insufficiently so that some women go to facilitiesnot compliant with standards or even quack doctors

Service isnt up to Maternal and Newborn Health standards andprocedures

Current post delivery discharge practices

Average duration of stay is 3 days

Discharge procedures : opinion of medical staff then administrativeauthorization (payment of expenses), discharge with an appointment for afollow-up visit at health facility after 6 days

However the Strategy of " Three 6 " is not followed (1st visit after 6th hour,2nd visit after 6th day, 3rd after 6th week]

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Challenges: Postnatal follow-up remains the big challenge.Even if Postnatal visits increased from 23,8 % to 64 % between2001 and 2010, risk of mortality remains. Furthermore, follow-up visit at home are not part of DRC strategies.

Solutions : National Strategic Plan 2011-2015

Building technical capacities

Increasing financial resources

Strengthening information system

Increasing number of maternity hospitals by bothconstruction & rehabilitation [6000 in 1990 & more than8000 in 2006]

Quality Insurance Plan of reproductive health products Strengthening communication on reproductive Health

Perspectives : Increase coverage / universal access; Improvequality of service ; Increase use of key services of Maternal and

Newborn Health.