Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

Abstract

Background: Current facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care (EmONC) were assessed in the Kwango and Kwilu provinces of the Democratic Republic of the Congo (DRC). Methods: This is an analysis of the baseline survey data from an ongoing clinical mentoring program among 72 rural health facilities in the DRC. Data collectors visited each of the facilities and collected data through a pre-programmed smartphone. Frequencies of selected indicators were calculated by province and facility type—general referral hospital (GRH) and primary health centers (HC). Results: Facility conditions varied across province and facility type. Maternity wards and delivery rooms were available in the highest frequency of rooms assessed (>95% of all facilities). Drinking water was available in 25.0% of all facilities; electricity was available in 49.2% of labor rooms and 67.6% of delivery rooms in all facilities. Antenatal, delivery, and postnatal care services were available but varied across facilities. While the proportion of blood pressure measured during antenatal care was high (94.9%), the antenatal screening rate for proteinuria was low (14.7%). The use of uterotonics immediately after birth was observed in high numbers across both provinces (94.4% in Kwango and 75.6% in Kwilu) and facility type (91.3% in GRH and 81.4% in HC). The provision of immediate postnatal care to mothers every 15 minutes was provided in less than 50% of all facilities. GRH facilities generally had higher frequencies of available equipment and more services available than HC. GRH facilities provided an average of 6 EmONC signal functions (range: 2-9). Conclusions: Despite poor facility conditions and a lack of supplies, GRH and HC facilities were able to provide EmONC care in rural DRC. These findings could guide the provision of essential needs to the health facilities for better delivery of maternal and neonatal care.

Improving the quality of maternal and newborn health outcomes through a clinical mentorship program in the Democratic Republic of the Congo: study protocol

“…All healthcare providers who provide MNH care and services in the 72 health facilities are eligible to participate as mentees in this clinical mentorship program. Written consent was obtained to collect data on their performance of routine MNH care [7].…”

“…The baseline survey has been completed and published [7]. All data baseline and endline collection tools/questionnaires for the surveys are available for public access [23].…”

“…Provision of quality of health care and services delivered by appropriately prepared healthcare personnel is a crucial strategy aimed at reducing the high burden of diseases and deaths in LMICs [4–6]. However, LMICs often suffer from a shortage of primary healthcare providers, a lack of opportunity for continued education to improve provider performance (i.e., skills, knowledge, and attitudes), poor facility conditions, a lack of supplies, and compromised sociopolitical environments [7, 8]. One approach to improve the quality care is to address the lack of training and/or continued education through development and implementation of a clinical mentorship program.…”

Social and Economic Consequences of the Cost of Obstetric and Neonatal Care in Lubumbashi, in the Democratic Republic of Congo: Mixed Study

“…However, for households that cannot pay, the mothers and babies are held at the point of care, sometimes without treatment, since they cannot afford care.This study aligns with several other studies within the DRC [6,8,9] and elsewhere [32,[45][46][47] revealing that even the lowest healthcare costs are out of reach for many people. As a result, several social and economic consequences arise at the household level: exclusion from health care, indebtedness and high use of the informal sector [15,39,48].It is true that the presence of quali ed personnel during all deliveries is considered to be one of the most important interventions for safer births because it reduces maternal deaths and increases successful delivery of infants [41,[49][50][51]. On the other hand, as this study and several other studies have demonstrated, in poor countries, women and families who must pay out-of-pocket for the costs of care suffer in terms of their physical, mental and social states, and these distressing repercussions are linked to the unaffordable cost of the care they receive.This issue also raises questions regarding staff motivation, patient-centered care, the renewal of equipment, the supply of drugs to maintain quality, the availability of care and the improvement of conditions in the health infrastructure [52][53][54].…”

Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

“…Two-thirds (66.7%, n=8) of GRH facilities provide six signal functions. Among the facilities that provide six signal functions, all provide antibiotics, anticonvulsants, oxytocin, and cesarean sections (see Supplemental Table 6 for additional patterns of availability 11 ). Among HC facilities, 74.7% were able to provide two to four signal functions.…”