EMPOWERMENT BUILDS CAPACITY FOR STRONGER, HEALTHIER COMMUNITIES

FINAL REPORT OF THE INTEGRATED HEALTH PROJECT PLUS IN THE DEMOCRATIC REPUBLIC OF CONGO 2015–2018

Integrated Health Project Plus in the Democratic Republic of Congo Published: July 31, 2018

Project Name: Integrated Health Project Plus in the Democratic Republic of Congo Cooperative Agreement Number: AID-OAA-A-1100024 Subagreement Number: OAA-A-11-00024-01-MSH

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This product describes the work of the Integrated Health Project Plus, which was made possible by the generous support of the United States Agency for International Development (USAID), the United States President’s Malaria Initiative (PMI), and the United States President’s Emergency Program for AIDS Relief under Subagreement Number OAA-A-11-00024-01-MSH under USAID Cooperative Agreement Number AID-OAA-A-11-00024. The contents are the responsibility of the Democratic Republic of Congo Integrated Health Project Plus and do not necessarily reflect the views of USAID or the United States Government.

Cover Photo: Champion Community meeting. Photo by Lynn Lawry, OSC Report Design: Erin Dowling Design EMPOWERMENT BUILDS CAPACITY FOR STRONGER, HEALTHIER COMMUNITIES

FINAL REPORT OF THE INTEGRATED HEALTH PROJECT PLUS IN THE DEMOCRATIC REPUBLIC OF CONGO 2015–2018

Integrated Health Project Plus in the Democratic Republic of Congo

CONTENTS

EXECUTIVE SUMMARY...... 1 Country context...... 1 Project performance...... 2 Key achievements ...... 4 PROJECT BACKGROUND...... 7 INTERMEDIATE RESULT 1. Access to and availability of minimum package of activities (MPA) and complementary package of activities (CPA) services and products increased...... 10 1.1 Facility-based health care services and products in target health zones increased. . . . . 12 Utilization of health care services ...... 12 Availability of health services ...... 13 Number of health centers implementing minimum package of activities ...... 15 Availability of medicines, commodities, and equipment...... 15 1.2 Community-based health care services and products in target health zones increased. . . 23 Integrated management of newborn and childhood illness ...... 23 i-CCM sites...... 24 Evidence-based WASH activities...... 27 1.3 Provincial management more effectively engaged with health zones and facilities to improve service delivery ...... 32 Leadership Development Program...... 32 INTERMEDIATE RESULT 2. Quality of key family health care services increased...... 36 2.1 Clinical and managerial capacity of health care providers increased ...... 38 Maternal, neonatal, and child health ...... 38 Expanded Program on Immunization...... 45 Family planning...... 49 Nutrition ...... 52 Malaria ...... 59 HIV...... 63 Tuberculosis ...... 72 Sexual and gender-based violence...... 81 Fistula...... 84 2.2 Minimum quality standards for health facilities and services developed and adopted. . . . 87 Results-based financing...... 87 2.3 Primary health care referral system for prevention, care, and treatment improved. . . . 91 INTERMEDIATE RESULT 3. Knowledge, attitudes, and practices to support health-seeking behaviors increased...... 92 3.1 Health sector community outreach linkages ...... 94 Community mobilization campaigns ...... 94 3.2 Health advocacy/Community mobilization organizations...... 97 Champion Communities...... 97 3.3 Social and behavior change campaigns ...... 100

Deborah Ndema’s baby was born not breathing. IHPplus had provided training in Helping Babies Breathe techniques at Hospital. Midwives used these techniques to revive Deborah’s baby. Photo by Rebecca Weaver. v INTERMEDIATE RESULT 4. Health sector leadership and governance improved...... 104 4.1 Health sector policy alignment...... 106 4.2 Evidence-based strategic planning and decision-making...... 106 Improved data for decision making...... 106 4.3 Community in