Preventing Maternal Mortality in the Democratic Republic of the Congo: Effect of the Organizational Model of Health Care

Session: Access to Maternal Newborn Care: Improving Quality, Improving Outcomes

Presenter: Abel Ntambue Mukengeshayi, University of Lubumbashi School of Public Health
Download presentation slides

Background: The Democratic Republic of the Congo (DRC) has the third highest number of maternal deaths (MD) and one of the highest risks of MD (730/100,000 live births) in the world. Reaching Millennium Development Goal 5 (≤138/100,000 live births) in 2015 is out of the question; appropriate care is often not accessible. Poor access is the cause of this lack of progress. This study aimed to determine the impact of different organizational models of mother-child health (MCH) services on maternal mortality (MM).

Methods: Using data on the MM ratio, cause of MM, and MCH services use from the Multiple Indicator Cluster Survey 4 (MICS4), we modeled the reduction in MM as a function of the variation in the level of use of services for the period from 2010-2015. We evaluated scenarios based on the model of service provision: family-based or informal care, community-based care, and clinical care. For each model, the rate of MCH services use was progressively varied between 60 and 90%. This rate was not varied for services for which the use was already above the set threshold.

Results: In 2010, 16,390 maternal deaths occurred in DRC. Strategies based on strengthening of facility-based care are certainly the most effective in the fight against the maternal mortality. However, if universal (>90%) coverage of all types of services, on the continuum, were assured to women over one year, more than 48.5% of these deaths could be avoided.

Conclusion: Cost-effective MCH services are well-known. Universal coverage across the mother-child continuum constitutes the strategy most likely to significantly reduce maternal mortality in DRC. To achieve this level of performance, the entire health care system must be strengthened.