DRC has some of the highest maternal and child mortality ratios in the world; women have an average of 6.6 children; and 42 percent of women aged 15-19 years are mothers or pregnant with their first child. For every 1,000 children born, 58 die before their first birthday and 105 die within the first five years of life. Chronic malnutrition affects 43 percent of children under five, one of the worst rates in the world. These poor health outcomes are linked to low levels of effective coverage of high-impact reproductive, maternal, newborn, child and adolescent health (RMNCAH) services, particularly low quality antenatal and delivery care and low capacity for emergency obstetric care.
DRC’s investment framework was derived from the priorities of the National Health Development Plan 2016-2020.
It describes high-impact priority interventions to provide long-term results to improve RMNCAH-N. The programmatic framework identifies priority interventions, focusing on the underfunded areas of family planning, nutrition, adolescent health, and civil and vital statistical reporting. The framework budgets these interventions using the "ONE HEALTH" tool, which presents the implementation framework and the role of different stakeholders. The monitoring and evaluation framework to monitor implementation will be that of the National Health Development Plan 2016-2020.
Priorities identified in the investment case include:
- Expand an integrated RMNCAH-N package of services, including provision of medical and psychosocial services to support victims of sexual and gender-based violence.
- Improve reproductive and adolescent health.
- Increase coverage and improve quality of nutrition services through a multisectoral approach.
- Accelerate access to safe water and utilization of improved sanitation and hygiene.
- Use results-based financing.
- Follow a community-based approach.
- Strengthen the supply chain.
- Improve the geographic distribution and quality of human resources.
- Improve the fiscal space for, the efficiency of, and financial access of the poor to RMNCAH-N services.
- Strengthen governance.
- Strengthen health information systems: create link between DHIS2, a health management data platform and civil registration and vital statistics.
- Establish a functional civil registration and vital statistics system.
How the GFF partnership works in DRC
The GFF’s efforts to help prioritize high-impact interventions in provinces with the lowest health indicators was only made possible with the leadership of the government and support of many partners with long-standing RMNCAH-N experience in DRC. The Ministry of Health, with representatives from civil society organizations, focused on defining RMNCAH-N priorities; UNICEF conducted a health system bottleneck analysis; WHO provided support in costing the investment case; and the GFF Secretariat helped with the resource mapping exercise with the support of the government and several donors.
The GFF contributed to boosting alignment and financing for the essential package of health services. by pooling resources from the World Bank (IDA), the GFF, USAID, and the Global Fund. Gavi, the Vaccine Alliance, The Global Fund, UNFPA, UNICEF, and the governments of Canada and the United States (USAID) provide complementary financing aligned with the GFF investment case in DRC.
While the GFF platform focused on provinces with the weakest health and socioeconomic indicators, many donors—including the World Bank, UNICEF, the European Union, the Global Fund, Gavi, and many others—make a substantial contribution outside the investment case’s provinces to reach universal health coverage through RMNCAH-N funding.
Financing DRC’s priority investments
Partners that contribute to financing DRC’s priorities include Gavi, the Vaccine Alliance, The Global Fund, UNFPA, UNICEF, and the United States (USAID).