Assessing the Accessibility and Healthcare Quality of Maternal and Child Health Services in Health Facilities of Kasai Province in the Democratic Republic of the Congo: A Cross-Sectional Study

Abstract

Background: The Democratic Republic of the Congo (DRC) is among the five countries with the highest global maternal mortality ratio (MMR) and the highest under-five mortality rate (U5MR) worldwide. One of the 14 provinces in the DRC that have high U5MR and MMR is Kasai. Despite this overriding concern, assessment of the maternal and child situation in this province remains poorly reported. Objectives: this study aimed to assess the accessibility, availability, and quality of maternal and child health services in Kasai province. Methods: A total of 49 health facilities (HFs) in 18 health zones in Kasai province participated in our cross-sectional survey. To collect quantitative and qualitative data, we conducted documentary review, interviews, and direct observation of HFs. Furthermore, the relationship between variables was analyzed by Pearson’s chi-squared test. Results: Nearly 54% of the population in surveyed HFs had geographical access to maternal and child health services, and most of the medical services were unaffordable. Only 11.8% and 7.6% of the HFs offered basic and comprehensive emergency obstetric care (EmOC), with no high-quality level of care. The low availability and quality of EmOC were caused by the insufficiency of necessary inputs and personnel for maternal and child health services in the majority of HFs. Conclusions: The situation of maternal and child health services is extremely precarious in Kasai province in the DRC. Rehabilitation of infrastructure, dotation of equipment, regular supply of medicines, and strengthening of human resource capacity are required to improve the EmOC coverage.