This blog was authored by Dr. Enock Nzembela, a knowledge management and communications specialist with MOMENTUM Integrated Health Resilience in the DRC.
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As we celebrate World Contraception Day, consider a challenging fact. Just eight countries account for half of the world’s maternal deaths. Of those, the Democratic Republic of the Congo (DRC) ranks fourth behind India, Nigeria, and Pakistan. In the DRC, more than 473 women die from pregnancy complications for every 100,000 live births.
MOMENTUM Integrated Health Resilience, funded by the U.S. Agency for International Development (USAID) and led by Corus organization IMA World Health, helps to combat maternal mortality. The maternal and child health-focused initiative has been working for several years in North Kivu province along DRC’s volatile eastern border. In its early stages, the project specifically targeted health zones that accounted for nearly half (43 percent) of all maternal deaths in the province. A significant portion of these fatalities stemmed from poorly spaced pregnancies, which often lead to serious complications. To address this issue, the project emphasizes the importance of providing information on voluntary family planning and ensuring access to contraceptive methods for communities in North Kivu.
MOMENTUM Integrated Health Resilience reached Kavira Mutondirwa, a 30-year-old mother of seven living in the Turunga health area of Nyiragongo Health Zone, near Goma, the regional capital. She stated that she never wished to have a large family but did not have a choice because of misconceptions.
"Most people I met in the past had warned me that taking contraceptives to space my pregnancies would lead to illnesses, such as cancer. I was often pregnant and sick and barely had time to care for myself," explained Kavira. She also noted how the repeated pregnancies negatively impacted the quality of her family’s life, "My children were often born small and weak. My husband and I had tough times making both ends meet, and could barely afford tuition for our kids at school.’’
Kavira’s life changed when she met Kanyere Kabuo, a community health worker trained by MOMENTUM Integrated Health Resilience to raise community awareness on family planning and reproductive health during a home visit. Since MOMENTUM work started in the DRC in 2021, the project has trained 646 community health workers.
“I am very happy to have received Sayana Press, an injection I have been trained to administer myself every three months to avoid getting pregnant,” said Kavira. “I began taking the injection a year ago and since then I have not gotten pregnant, and my last child is three years old now. My friends and my children often say that I look healthier now and encourage me not to have other children. It makes me happy, and I owe it all to Kanyere, who is like a mother, and encouraged me to consider using contraceptives.”
Kanyere described how she was able to advise women and men in her community to opt in for contraception. "I received training on contraception methods and how to provide counseling to people on family planning from the health staff that MOMENTUM mobilized. I became an advocate of what I’ve learned when I was convinced that the knowledge I gained through the training can help people have children they can care for. I refer people who chose those methods I cannot administer to nearby health centers.”
With the support of MOMENTUM Integrated Health Resilience, an increasing number of women are choosing long-acting contraceptives that they can administer themselves, particularly subcutaneous injections like those used by Kavira. According to MOMENTUM data, between October and December 2023, the proportion of new contraception users opting for these methods nearly doubled compared to the same period the year before, rising from 10.2% to 19.3%. A key advantage of these methods is that they allow women to self-administer, eliminating the often burdensome trip to a healthcare facility.
Community health workers like Kanyere play a vital role in addressing local needs, including family planning. By supporting women's health and productivity, these initiatives empower communities to improve the overall wellbeing of families.