Democratic Republic of the Congo
After nearly four decades of war and conflict, people living in the Democratic Republic of the Congo (DRC) face numerous barriers to accessing quality reproductive health services. Due to its vast size and poorly developed road and communication systems, family planning and other basic services are extremely limited or altogether unavailable. Poor maternal health care has resulted in high maternal mortality as well as the occurrence of obstetric fistula, a hole in the birth canal that results in chronic leakage of urine or feces, often caused by obstructed labor. Traumatic fistula—the same condition inflicted by sexual violence—is also common, due to the prevalence of gender-based violence in the DRC.
Since 2008, EngenderHealth has worked to improve the quality of and access to fistula care services in the DRC. From 2008 to 2013, we partnered with seven health centers and hospitals to train 44 doctors and 242 nurses in fistula repair surgery and 802 doctors and nurses in fistula counseling and follow-up care. Our work also included the improvement of emergency obstetric care and outreach to rural clinics to ensure that women in need of medical attention were referred to the hospitals for repair.
Today, EngenderHealth continues to tackle fistula care in the DRC with the Fistula Care + Project. As our work expands, we are better able to address the backlog of women living with obstetric or traumatic fistula. We are also increasing the integration of family planning services with fistula and maternal health services as a key component of fistula prevention.
Through the Expand Family Planning Project (ExpandFP), EngenderHealth adds to its portfolio of work in the DRC beyond fistula care, supporting the Ministry of Health to build capacity at provincial health facilities by training providers in administering long-acting reversible contraceptive methods, like implants. The approach is to increase contraceptive access and options by delivering family planning services daily at nine clinics in the greater Kinshasa area, as well as hosting special family planning events that offer services free of charge. These events include free services in the 9 facilities once a month and mobile outreach services which often serve more than 1,000 clients per week.