Women’s reproductive health in ongoing humanitarian emergency A case study of the Democratic Republic of the Congo Open Access

Abstract

Background

Developing nations, such as the Democratic Republic of the Congo, struggle with maternal mortality reduction and “by the end of 2015, about 99% of the world’s maternal deaths…with countries affected by a humanitarian crisis or fragile conditions accounting for almost 2/3 cases”(UNFPA, 2015). The combination of post-colonial political instability, corruption, and resource mismanagement all work in the disservice of DRC health infrastructure. Women, who traditionally have worse health outcomes then men, feel the brunt of this unfortunate combination. The DRC’s inadequate healthcare system is largely substantiated by its dearth in qualified and accredited health providers. Healthcare systems are stagnated by inadequate resources to properly train health care providers and the lack of basic medical  equipment.

 

Objective

By examining the potential relationships between the amount of eligible providers per health facility and health indicators including types services provided, advanced educational training, we aim to evaluate whether  increasing number of authorized health providers will positively impact women’s health outcomes.

 

Methods

We will conduct a multivariate linear regression analysis of the number of eligible providers against survey categorical and continuous variables using SAS and Excel. 

 

Results Providers with training in the past 2 years [95%CI 1.18-1.29]  or supervision in the last 6 months [95%CI 1.06-1.33] were strongly associated with the number of overall eligible providers at the FOSA. Significant relationships exist with facilities offering cesarean delivery [95%CI 3.04-4.16].

 

Discussion

Overall, our findings indicate the number of eligible providers in a DRC facility correlates strongly with the types of services provided, variety of service providers, and recent education on medical care.

Table of Contents

Introductory Pages...................................................................................................................... i

Distribution Agreement ................................................................................................................ i

Approval Sheet ............................................................................................................................ ii

Abstract Cover Page ................................................................................................................... iii

Abstract ...................................................................................................................................... iv

Cover Page .................................................................................................................................. v

Acknowledgments ...................................................................................................................... vi

Chapter 1: Introduction

      I.         Project overview............................................................................................................... 1

    II.         Significance of MM in DRC............................................................................................ 1

  III.         Country economic overview............................................................................................ 4

Chapter 2: Review of the Literature 

      I.         Conflict and war .............................................................................................................. 5

    II.         Rape as a weapon............................................................................................................. 7

  III.         Cultural beliefs regarding sexual reproductive health...................................................... 8

 IV.         Shortage of eligible providers ......................................................................................... 9

   V.         Key health indicators for women................................................................................... 11

 VI.         Unmet demand for family planning............................................................................... 12

VII.         Facility infrastructure distribution.................................................................................. 13

VIII.         Figure 1........................................................................................................................... 15

Chapter 3: Methods 

      I.         DHS source overview..................................................................................................... 16

    II.         Procedures...................................................................................................................... 16

  III.         Data analysis model........................................................................................................ 17

 IV.         Explanation of output tables........................................................................................... 18

   V.         Ethical considerations.................................................................................................... 19

Chapter 4: Results

      I.         Table 1............................................................................................................................ 19

    II.         Table 2............................................................................................................................ 19

  III.         Table 3............................................................................................................................ 20

 IV.         Table 4............................................................................................................................ 20

   V.         Table 5............................................................................................................................ 21

Chapter 5: Discussion

      I.         Findings ......................................................................................................................... 22

    II.         Limitations ..................................................................................................................... 25

Chapter 6: Conclusion and Recommendations

  III.         Conclusions and implications......................................................................................... 26

 IV.         Recommendations for future research............................................................................ 27

Appendices

      I.         Regression tables............................................................................................................ 28

    II.         Variable explanations..................................................................................................... 33

  III.         Terminology................................................................................................................... 35

 IV.         Acronyms ...................................................................................................................... 36

   V.         References...................................................................................................................... 37

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	humanitarian emergency
Committee Chair / Thesis Advisor	Roger Rochat, Emory University

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