Gender inequality contributes to increased health risks of women and girls in the Democratic Republic of Congo (DRC). Socio-cultural norms place women and girls at a lower social status than men, limiting women’s livelihood options and exacerbating power dynamics that favor men. To survive, they may turn to sex work and other forms of informal income that increase the risk of sexual- and gender-based violence (SGBV) and infections such as HIV.

Years of conflict have fostered an environment where SGBV is common in the DRC. According to the most recent DHS survey in the DRC more than half of women have experience physical violence and nearly 60% have experience spousal violence. Many women and girls have become pregnant as a result of rape, while others have been infected with HIV, dramatically altering their futures, livelihoods, and prospects.

Extreme poverty, traditional cultural and social beliefs and practices – such as the importance of marrying a virgin, dowry payments to the bride’s family, and polygamy – put girls at risk for early marriage, which is linked with adverse health outcomes related to maternal morbidity and mortality. On average girls first get married at the age of 16 and 27% of girls aged 15-19 already have a child or one on the way . The adolescent fertility rate is high, explained in part by low usage of modern contraceptives and the barriers to accessing them.

Parents concerned about the value of their daughters’ virginity prior to marriage may decide not to send their daughters to school out of fear that they will be raped or solicited by men. This and other socio-cultural beliefs and practices limit girls’ educational prospects. As a result, the literacy rates among young women lag behind men’s. As long as gender inequity persists in the DRC women and girls will continue to be at risk for sexual and gender-based violence. This is why ASSP views gender issues as essential across all areas of the project.

Our Approach

Women’s needs and access to care were integrated into the design and implementation of ASSP’s gender program. This included lowering cost for women to access health care, designing health facilities to assure they were appropriate for women’s needs, representation in community governance, priorities in access to water, and employment in construction teams.

Key Achievements

  • More than 3,044 women with fistula benefited from restorative surgery from the start of the project with the general success rate of 94%.
  • Most of these women had lived with fistula – ashamed and often isolated from their communities – for more than four years, largely due to barriers to accessing treatment.
  • Although supply challenges hindered progress, ASSP provided 2,832 SGBV survivors with post-exposure prophylaxis (PEP) kits to help protect them from contracting HIV.
  • The community scorecard program continues to give a voice to communities while also being an instrument for improving gender equity in healthcare delivery, as subgroups of women are established to make sure that they have weight in community health care decisions.
  • The project continues to outperform in its provision of family planning services, a key activity in the effort towards gender equity by giving women choice and control over their reproductive schedules. To date, the project is accountable for 1.32 million new acceptors of modern methods of family planning.
  • IMA partnered with the USAID-funded Engage project to focus on behavior change communication surrounding gender issues in a unique way. The Engage project came to IMA in need of help to fulfill their mission of showing the Girl Rising film in DRC. The film, which seeks to encourage girls’ education, has been shown to an estimated 700,000 people.
  • Women have been hired and promoted to supervisory roles. Women are actively participating in ongoing construction sites and represent 10%-30% of all construction workers. Although there is much more work to be done, these types of changes can slowly erode gender inequity over time.

Women in ASSP Construction


Available for Download

Girl Rising, ASSP-ENGAGE Final Report – March 2017 (pdf)

Available Online