Estimates suggest that less than a quarter of the Democratic Republic of Congo’s (DRC) citizens have access to health care. Where facilities do exist, inadequate health infrastructure negatively influences the quality of care.
The lack of health facilities, combined with poorly constructed and equipped health facilities, creates a ripple effect. Clients in ASSP health zones may have to travel dozens of kilometers for care (if they even are able to travel) and then may arrive at a poorly equipped clinic that cannot cater to their health needs, jeopardizing the likelihood that they return. DRC’s poor health infrastructure contributes to some of the highest levels of maternal and child mortality in Africa, as pregnant women cannot access or choose not to access health facilities. ASSP’s goal of improving primary health care is impossible without significant expansion and refurbishment of health facilities.
Several factors contribute to this unfortunate state of infrastructure. Decades of conflict and lack of government funding allocation have halted new construction and left current facilities in disrepair. Well-intended donors now seeking to build new health centers face challenges in procuring quality local materials for construction, finding adequate logistics support, and navigating the challenging tax issues related to construction.
ASSP has completed the construction or renovation of 253 health centers.
1.47 million births have been attended at ASSP health facilities since the start of the project.
ASSP is aggressively improving health care-linked infrastructure given its critical and foundational role in improving access and quality for primary health care improvement. These construction, procurement, and refurbishment activities support ASSP Objective 1: Enhanced health service delivery and quality. Key project objectives under this strategy are:
- Constructing new health centers per PNDS and Ministry of Health (MOH) guidelines to expand access and health care coverage.
- Rehabilitate targeted existing health care structures to improve their durability, functionality, and longevity.
- Identify, form, and train local construction teams that can provide future maintenance to health facilities.
To date, ASSP has completed 253 health centers, including 79 new construction and 174 completed renovations. These achievements make the infrastructure work of ASSP one of the largest (if not the largest) infrastructure development projects in DR Congo in many years.
Facility utilization is increasing with the improvements in health infrastructure. ASSP had observed a 35% increase in the number of new consultations after the construction completion of BakuaManga Health Center (Demba Health Zone, Kasai Central Province), 30% at Kamandalena Health Center (Demba Health Zone, Kasai Central Province) and 34% increase at Kabeya Lumbu Health Center (Kalonda Ouest Health Zone, Kasai Province) when compared to the three quarters prior to construction completion with three quarters after construction completion in 2016 and 2017.
The number of births by a skilled attendant is also increasing due to infrastructural improvements in maternity wards. ASSP had observed an average of 45% increase in the number of births attended by a skilled worker in the three quarters after construction completion at BakuaMasanga, Bena Kadiebue and Kabeya Lumbu health centers in Demba and Kalonda Ouest health zones in the Kasai province.
2,094 qualified technicians have been trained in high quality, durable construction methods.
ASSP had a goal to equip 50% of assisted health facilities, or 9 health clinics per health zone, with solar refrigerators in order to reinforce the EPI program, reduce budgetary costs of kerosene and decrease carbon emissions. The project has surpassed its cumulative target of 510, reaching 540 units including refrigerators installed in hospitals for blood banks and drugs warehouses.
Map of completed and in-progress health facilities as of year 5, quarter 2
The numbers of births attended by skilled personnel has steadily increased since the start of the project.