Democratic Republic of Congo-Integrated Health Project (DRC-IHP)

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Despite improvements in child survival in recent decades, children in low- and middle-income countries still suffer from illnesses virtually nonexistent in the industrial world.

Pneumonia is the deadliest of these, responsible for the death of 900,000 children under five worldwide in 2013—more than any other infectious disease.

And more children are killed by pneumonia in Democratic Republic of Congo (DRC) than in any other country except for India and Nigeria. Every year, approximately 148,000 children under five die of pneumonia, accounting for 15 percent of child deaths in the country.

{Photo credit: Warren Zelman, Democratic Republic of the Congo}Photo credit: Warren Zelman, Democratic Republic of the Congo

This post originally appeared on the Frontline Health Workers Coalition blog.

I grew up in a village in northwestern Democratic Republic of the Congo (DRC), and although I’m now a doctor and live in Kinshasa, I remember those days well.

I know what it’s like to live 23 kilometers from the nearest health center and to navigate forests and floods to get there. I know how a lack of something simple like antibiotics can cause a quick death. I’ve lost many peers from the village over the years and a lot of family members.

In fact, that’s why I became a physician.

Mukabaha Ntakwigere (at right) at the General Reference Hospital in Nyangezi, DRC. {Photo credit: MSH staff.}Photo credit: MSH staff.

Tuberculosis (TB) is a leading cause of death in Democratic Republic of the Congo (DRC), partly due to a low case detection rate within the health system, compounded by little knowledge or awareness among patients of the disease’s symptoms. In the province of Sud Kivu, where people have relied on traditional healers for generations, those who were suffering from the persistent, painful coughing that is one symptom of TB were advised by traditional healers that they had been poisoned, and they were not referred to health centers.

In Sud Kivu province, in the health zone of Nyangezi, with a population of roughly 129,000 people, case detection was below 12%, which is the minimum "acceptable" threshold for TB detection.

Medical professionals in Nyangezi realized that they were never going to identify and treat those suffering from TB until they could educate the community about the symptoms and the treatment methods.

A group of young men in Mwene Ditu discuss using a cell phone to access health information. {Photo credit: Overseas Strategic Consulting, Ltd.}Photo credit: Overseas Strategic Consulting, Ltd.

Mobile phones are being used increasingly throughout Africa to improve health. The USAID-funded Democratic Republic of Congo-Integrated Health Project (DRC-IHP) is using mobile phone technology to increase the number of people referred to health centers in the project’s 80 targeted health zones. In Mwene Ditu, project staff observed that low numbers of referrals to health centers would be improved by increasing communication—within the community, between the community and health service providers, and among provincial health officials.

Immaculée, seated, holding her twin boys. Thanks to the intervention of the center’s midwife, at left, both of these babies are now in good health. {Photo credit: IRC.}Photo credit: IRC.

Thirteen newborns die every hour in Democratic Republic of the Congo (DRC). So on July 23, when 25-year old Immaculée went into labor with twins at the Monvu Reference Health Center in the Idjwi Health Zone, and her first twin was born without signs of life, the chances of survival were not in his favor.

The odds are stacked against newborns in the DRC: neonatal mortality hovers around 97 deaths for every 1,000 live births, and has done so for years, explaining the acute need for intervention in this area.

Recognizing this need, the USAID-funded DRC-Integrated Health Project (DRC-IHP), in conjunction with the Church of Latter Day Saints and the Ministry of Public Health, organized a “Helping Babies Breathe” training in Kinshasa in April 2012, to build the capacity of health providers who oversee labor and delivery.

Helping Babies Breathe is an evidence-based neonatal resuscitation approach designed for resource-limited areas, which teaches health workers how to handle newborns’ breathing in their first minute of life, a critical period known as the “Golden Minute.”

A community-based distribution agent discusses family planning options with a family in the DRC health zone of Ndekesha. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted from Frontline Health Workers Coalition.

Evidence of the need to scale up the number of frontline health workers in developing countries abounds throughout sub-Saharan Africa, as described in a recent post on the Frontline Health Workers Coalition blog by Avril Ogrodnick of Abt Associates. Yet training new health workers is not sufficient, in itself, to sustainably address the crisis: governments must also invest in providing management support to harvest the full value of these trainings.

Nehema Bubake, seen recovering here at the Kaziba General Reference Hospital, is full of optimism now that her fistula has been repaired. {Photo credit: MSH.}Photo credit: MSH.

In the Democratic Republic of Congo, many women suffer complications during pregnancy and delivery, including obstetric fistula. Prolonged labor may result in a hole (“fistula”) between a woman’s birth canal and bladder or lower intestine, resulting in chronic leaking of urine or feces. This, in turn, leads to social isolation as the women can’t keep themselves clean, are ashamed of their condition, and withdraw from society. Many women and their families believe that this condition is due to a curse, leading to further separation from the community.

A physician assesses a mother and children for malaria at a health center in Bujumbura, Burundi. {Photo credit: Rima Shretta/MSH.}Photo credit: Rima Shretta/MSH.

Today, April 25th, Management Sciences for Health (MSH) joins the global community marking World Malaria Day. "Sustain Gains, Save Lives: Invest in Malaria" -- the theme of this year's World Malaria Day -- recognizes this crucial juncture in the global fight against malaria.

Significant gains have been made in the last ten years; since 2000, malaria mortality rates have decreased 25 percent globally, and 33 percent in Africa. However, progress could be reversed unless malaria continues to be a priority for global, regional, and national decision-makers and donors.

Burundi, Democratic Republic of the Congo (DR Congo), South Sudan, and Uganda are among several MSH countries commemorating World Malaria Day with malaria awareness activities and events, including health talk sessions at football (soccer) games and drama activities with kids.

"Are family planning methods safe?” wondered Mutombo, a community health worker at the Kawama Village Health Center, in the Democratic Republic of Congo’s Katanga Province. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted on USAID's IMPACT blog.

“Don’t they contain a poison?” he added, directing his question to Isaac Chishesa, a community mobilization specialist with USAID’s Democratic Republic of Congo-Integrated Health Project (DRC-IHP).

Tough question! One Isaac was not expecting, at least not within a discussion among trained community health workers.

An experienced community health professional, Isaac responded with a smile and said, “Thank you, my friend, for sharing your concern,” affirming the participants’ right to ask questions. “Family planning methods are safe,” he reassured the group. “Based on international quality standards, each method is required to go through extensive testing before it is made available to the public.”

The faces of Mutombo and his peers lit up. They sighed, a collective sigh of relief, and burst out laughing to relieve some of the tension. They all recognized that even though they were dedicated to bringing about improvements in health behaviors, they, like most of their fellow community members, harbored misconceptions and rumors about family planning.

It is 5:30 a.m. on a Thursday morning in the town of Mwene-Ditu, located in the Eastern Kasaï Province of the Democratic Republic of Congo. The skies are still dark as the crieur, the town crier, makes his rounds, calling out to the community that today is the start of the three-day national vaccination campaign against polio.

As the local residents begin their day, health workers are finalizing preparations for the massive door-to-door effort to immunize children under age five years old from this crippling disease. One such worker is Evariste Kalonji, a community mobilization specialist with the Integrated Health Project.

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