Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Avenue Michombero No. 02, Bukavu, Democratic Republic of Congo.
School of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.
Health Res Policy Syst. 2024 Apr 30;22(1):55. doi: 10.1186/s12961-024-01138-2.
Maternal and neonatal mortality remains a major concern in the Democratic Republic of Congo (DRC), and the country's protracted crisis context exacerbates the problem. This political economy analysis examines the maternal and newborn health (MNH) prioritization in the DRC, focussing specifically on the conflict-affected regions of North and South Kivu. The aim is to understand the factors that facilitate or hinder the prioritization of MNH policy development and implementation by the Congolese government and other key actors at national level and in the provinces of North and South Kivu.
Using a health policy triangle framework, data collection consisted of in-depth interviews with key actors at different levels of the health system, combined with a desk review. Qualitative data were analysed using inductive and then deductive approaches, exploring the content, process, actor dynamics, contextual factors and gender-related factors influencing MNH policy development and implementation.
The study highlighted the challenges of prioritizing policies in the face of competing health and security emergencies, limited resources and governance issues. The universal health coverage policy seems to offer hope for improving access to MNH services. Results also revealed the importance of international partnerships and global financial mechanisms in the development of MNH strategies. They reveal huge gender disparities in the MNH sector at all levels, and the need to consider cultural factors that can positively or negatively impact the success of MNH policies in crisis zones.
MNH is a high priority in DRC, yet implementation faces hurdles due to financial constraints, political influences, conflicts and gender disparities. Addressing these challenges requires tailored community-based strategies, political engagement, support for health personnel and empowerment of women in crisis areas for better MNH outcomes.
孕产妇和新生儿死亡率仍然是刚果民主共和国（DRC）的主要关注点，该国长期的危机局势使问题更加严重。本政治经济学分析考察了刚果民主共和国孕产妇和新生儿健康（MNH）的优先事项，重点关注北基伍省和南基伍省受冲突影响的地区。目的是了解促进或阻碍刚果政府和其他国家一级和北基伍省、南基伍省关键行为者优先制定和实施母婴健康政策的因素。
使用卫生政策三角框架，数据收集包括对卫生系统不同层次的关键行为者进行深入访谈，并结合案头审查。使用归纳和演绎方法对定性数据进行分析，探讨影响母婴健康政策制定和实施的内容、过程、行为者动态、背景因素和与性别相关的因素。
研究强调了在面临竞争的卫生和安全紧急情况、有限资源和治理问题的情况下优先制定政策的挑战。全民健康覆盖政策似乎为改善获得母婴健康服务的机会带来了希望。结果还揭示了国际伙伴关系和全球金融机制在制定母婴健康战略方面的重要性。它们揭示了母婴健康部门在各级存在巨大的性别差距，需要考虑文化因素，这些因素可能对危机地区母婴健康政策的成功产生积极或消极的影响。
MNH 在 DRC 是一个高度优先事项，但由于财政限制、政治影响、冲突和性别差距，实施面临障碍。应对这些挑战需要制定针对特定社区的战略、政治参与、支持卫生人员以及在危机地区赋予妇女权力，以实现更好的母婴健康结果。
