At 846 deaths per 100,000 live births in 2014, Democratic Republic of Congo has one of the highest maternal mortality ratios in the world. Women have an average of 6.6 children, and 42 percent of women in the poorest wealth quintiles, aged 15-19 years, are mothers or pregnant with their first child. The contraceptive prevalence rate is 8 percent and population growth is 3 percent. 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. In 2015, per capita health spending was US$ 22 in the Democratic Republic of Congo, one-sixth of the average in Sub-Saharan Africa and one-fourth of the amount necessary to provide basic health services to the population (McIntryre and Meheus, 2014). Households bear 40 percent of total health expenditures, 93 percent of which is made of out-of-pocket expenditures while donors are another key driver of total health expenditures, funding 40 percent of it. Public health spending is only 12 percent of the total health expenditure and is inefficiently allocated to population health needs. 

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