Abstract
BackgroundDespite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Antenatal care (ANC) service is a cost-effective intervention for reducing the maternal mortality ratio in low-income countries. This study aimed to identify the intervention effect of the maternal and child health care (MCH) project on the use of four or more (4+) ANC services.MethodsThe MCH project was implemented using the three delays model in Kenge city by the Ministry of Public Health (MoPH) of the DRC with technical assistance from Korea International Cooperation Agency (KOICA) and the Yonsei Global Health Center from 2014 to 2017. Furthermore, Boko city was selected as the control group. A baseline and an endline survey were conducted in order to evaluate the effectiveness of this project. We interviewed 602 and 719 participants in Kenge, and 150 and 614 participants in Boko in the baseline and endline surveys, respectively. We interviewed married reproductive-aged women (19–45 years old) in both cities annually. The study instruments were developed based on the UNICEF Multiple Indicator Cluster Surveys. This study used the homogeneity test and the binary logistic regression difference-in-differences method of analysis.ResultsThe odds of reproductive-aged women’s 4+ ANC service utilization at the intervention site increased 2.280 times from the baseline (OR: 2.280, 95% CI: 1.332–3.902, p = .003) as compared to the control site.ConclusionsThis study showed that the KOICA MCH project effectively increased the 4+ ANC utilization by reproductive-aged women in Kenge. As the 4+ ANC services are expected to reduce maternal deaths, this project might have contributed to reducing maternal mortality in Kenge. In the future, we expect these findings to inform MCH policies of the MoPH in the DRC.
Highlights
Despite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa
This study showed that the Korea International Cooperation Agency (KOICA) maternal and child health (MCH) project effectively increased the 4+ antenatal care (ANC) utilization by reproductive-aged women in Kenge
Plain English summary The maternal mortality ratio (MMR) in the Democratic Republic of Congo is the sixth-highest in the world
Summary
Despite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Despite efforts to achieve the MDGs and SDGs, the MMR in the Democratic Republic of Congo (DRC) was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa [4, 5]. Obstetrical complications such as bleeding, eclampsia, sepsis, and unsafe abortions accounted for nearly 80% of the cases of MMR, and the remaining 20% were caused by underlying diseases [6]. According to the results of studies from 2016, the MMR can be reduced by regular visits to health facilities that provide antenatal care (ANC) [8]
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