Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement

Dieudonné Mpunga; JP Lumbayi; Nelly Dikamba; Albert Mwembo; Mala Ali Mapatano; Gilbert Wembodinga

doi:10.9745/GHSP-D-16-00205

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FIGURE 1
Percentage of Health Facilities With Family Planning Services Available by Province, Broken Down by Those With 3+ Methods Available, DRC, 2014 (N=1,555 Health Facilities Nationally)
Abbreviation: DRC, Democratic Republic of the Congo.
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FIGURE 2
Percentage of Health Facilities With Specific Contraceptive Methods in Stock at the Time of the Survey, DRC, 2014 (N=1,555 Facilities^a)
Abbreviation: DRC, Democratic Republic of the Congo.
^a Data are based on the full sample of 1,555 health facilities surveyed, not the subset that had family planning services available as defined by the index of availability.
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FIGURE 3
Percentage of Health Facilities With Family Planning Services Available That Met the Criteria for High Quality, by Element and in Total, DRC, 2014 (N=513 Health Facilities)
Abbreviation: DRC, Democratic Republic of the Congo.
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FIGURE 4
Percentage of Health Facilities With Family Planning Services Available That Were Rated “High” on Service Quality,^a Nationally and by Province, DRC, 2014 (N=513 Health Facilities)
Abbreviation: DRC, Democratic Republic of the Congo.
^a Facilities were assessed as providing high-quality family planning services if they met all 4 criteria of the quality index: (1) availability of at least 1 staff trained in family planning in the prior 2 years; (2) existence of service delivery guidelines in family planning; (3) availability of, at minimum, male condoms, combined oral contraceptive pills, and injectables; and (4) availability of a sphygmomanometer.

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TABLE 1 Percentage of Health Facilities With Family Planning Services, as Defined by the Availability Index,^a DRC, 2014 (N=1,555 Facilities)

	No. of Health Facilities	Family Planning Services Available^a No. (%)	P Value
Total	1,555	513 (33.0)
Type			<.001
Hospitals	433	230 (53.1)
Referral health centers	244	94 (38.5)
Health centers	498	155 (31.1)
Health posts	380	34 (8.9)
Sector			.37
Public	872	296 (33.9)
Private	683	217 (31.8)
Location			.02
Urban	367	140 (38.1)
Rural	1,188	373 (31.4)

Abbreviation: DRC, Democratic Republic of the Congo.
a Index of availability: (1) availability of a room for family planning service provision; (2) existence of staff assigned to family planning services; and (3) evidence of client use of family planning services from service statistics.

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TABLE 2. Quality of Family Planning Services by Health Facility Characteristic, DRC, 2014 (N=513 Health Facilities)

	High Quality No. (%)	Low Quality No. (%)	P Value
Total	103 (20.1)	410 (79.9)
Type			<.001
Hospitals	63 (27.5)	166 (72.5)
Referral health centers	17 (18.1)	77 (81.9)
Health centers	23 (14.8)	132 (85.2)
Health posts	0 (0.0)	35 (100.0)
Sector			.02
Public	48 (16.4)	245 (83.6)
Private	55 (25.0)	165 (75.0)
Location			<.001
Urban	47 (35.1)	87 (64.9)
Rural	56 (14.8)	323 (85.2)

Abbreviation: DRC, Democratic Republic of the Congo.

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TABLE 3 Number of Contraceptive Methods Offered by Type of Health Facility, DRC, 2014 (N=513 Facilities With Family Planning Service Availability)

No. of Contraceptive Methods	Type of Health Facility (%)
No. of Contraceptive Methods	National and Provincial Hospitals^a(n=10)	District Hospitals and Referral Health Centers^a (n=217)	Health Centers and Posts (n=286)	All Health Facilities(N=513)
0	30.0	34.8	67.9	53.4
1–2	20.0	4.6	6.3	5.7
3–4	0.0	5.4	8.8	7.3
≥5	50.0	55.2	17.1	33.6
Mean number	4.7	4.9	1.6	3.0

Abbreviation: DRC, Democratic Republic of the Congo.
↵a In the DRC, hospitals are classified into 3 categories: national, provincial, and district.