Democratic republic of the Congo

In Kinshasa, the capital of the DRC, just 20.9% of women use modern contraceptive methods and three in five pregnancies are unintended, with the majority being terminated by women resorting to unsafe abortions.

Mobilising resources remains critical – the Humanitarian Response Plan in 2021 only raised 44% of the necessary funding.

In a challenging healthcare context, MdM’s work seeks to prevent an increase in mortality and morbidity. We provide access to good quality healthcare to communities affected by intercommunal conflict and to displaced people in eight health areas in the Nyemba health zone and two in the Nyunzu health zone.

In 2021, we:

• provided 143,277 consultations,
• treated 1,941 children for malnutrition,
• provided care to 467 survivors of gender-based violence,
• provided 7,145 women with modern methods of contraception.

After the epidemic had been present in the DRC for a few weeks, it became clear that those most affected were in the 26-55 age group, although 75% of deaths were among the over-50s. Studies revealed that those most at risk were people over the age of 50 and those with pre-existing health conditions such as diabetes or high blood pressure.

In November 2020, in accordance with the national response strategy, Médecins du Monde launched a five-month pilot project to carry out early and proactive testing of vulnerable people at two health centres in the Selembao health zone (previously supported by MdM).

In 2021, we:

• identified and provided information to 12,763 vulnerable people (over 50s and/or with diabetes and/or high blood pressure),
• treated 2,865 people with diabetes or high blood pressure.

At the operational level, two new strategies were consolidated in Kinshasa in 2020: the Sexual and Reproductive Health Rights Strategy (access to safe abortion and advocacy) and an advanced community-level intervention in schools. All the work was carried out with local NGO, Afia Mama, which is very active both at the community level and in terms of advocacy (human rights activism), particularly through the Coalition Contre les Grossesses Non Désirées which campaigns on prevention of unintended pregnancies.

The programme seeks to strengthen the provision of basic health services, using an approach tailored to the needs of young people, community engagement and advocacy. It aims to achieve legal access to family planning services and the effective application of the Maputo Protocol. This is an international agreement which guarantees the rights of women, including their right to participate in the political process, social and political equality with men, greater autonomy in making decisions about their health and an end to female genital mutilation.

Our approach is innovative, with its tactic of working in schools to ensure SRH services are adapted to the needs of young people in the school environment and a harm reduction strategy in relation to illegal abortion.

The aim is to reduce mortality associated with unsafe abortions.

• provided 4,759 consultations on sexual and reproductive health and rights,
• provided 245 abortion and post-abortion consultations,
• distributed 131,645 contraceptives,
• organised awareness-raising and information sessions on sexual and reproductive health and rights for 76,124 young people,
• trained 30 healthcare providers and 30 community workers in maternal and child health.