Mentorship to strengthen health system leadership: A case study of the Walungu rural health zone in the eastern Democratic Republic of Congo.

From 2015 to 2019, the "RIPSEC" program launched a mentorship program, transforming the Walungu health zone, in eastern crisis-affected Democratic Republic of Congo, into a "Learning and Research Zone" (LRZ). As part of the program, a local university was tasked with strengthening the LRZ manager's leadership capacities, including efforts to troubleshoot challenges related to the proliferation of informal healthcare facilities (IHFs). IHFs are unregulated healthcare structures operating on the fringes of the law, and claiming to offer cheaper, higher-quality care to the local population.

Prioritization of maternal and newborn health policies and their implementation in the eastern conflict affected areas of the Democratic Republic of Congo: a political economy analysis.

Background: 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.

Family planning in the Eastern Democratic Republic of the Congo: personal beliefs, intimate partner negotiations and social pressure.

The Democratic Republic of the Congo (DRC) has a low prevalence of family planning use. Recent studies have highlighted the significant role that socio-cultural factors play in the decision to use family planning or not. This qualitative study explored barriers to women's use of family planning methods in an ongoing conflict region, South-Kivu, DRC.

Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo.

Background: Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics.

Methods: We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo.

Engaging men in women's empowerment: impact of a complex gender transformative intervention on household socio-economic and health outcomes in the eastern democratic republic of the Congo using a longitudinal survey.

Background: In the Democratic Republic of the Congo, women in (peri-)urban areas are commonly engaged in small trade, which allows them to meet the basic needs of their families. Microsaving approaches are a low-risk option to obtain financing for economic activities. A project combining men's sensitization on gender equity and women's empowerment through village savings and loan associations were implemented in North and South Kivu to raise the household economic level.

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Background: Biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it and integrate it into the health system, the community dynamic also remains to be taken into account for its support. The objective of this study is to understand the community's perceptions of the concept of integrated health care management according to the biopsychosocial approach (BPS) at the Health Center of a Health District and its evaluation in its implementation.

Ensuring leadership at the operational level of a health system in protracted crisis context: a cross-sectional qualitative study covering 8 health districts in Eastern Democratic Republic of Congo.

Background: This study examines how leadership is provided at the operational level of a health system in a protracted crisis context. Despite advances in medical science and technology, health systems in low- and middle-income countries struggle to deliver quality care to all their citizens. The role of leadership in fostering resilience and positive transformation of a health system is established.

Association between severe acute malnutrition in childhood and hematological disorders in adulthood: the Lwiro follow-up study in the Eastern Democratic Republic of the Congo.

Background: Despite growing evidence on the short-term deleterious effects of severe acute malnutrition (SAM) in childhood on hematopoiesis, little is known about the long-term hematological effects of SAM in low-income countries (LICs). Our study explored the association between childhood SAM and hematological disorders in adults 11 to 30 years after post-SAM nutritional rehabilitation.

Methods: This follow up study investigated 97 adults (mean age 32 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007.

Violence against health care workers in a crisis context: a mixed cross-sectional study in Eastern Democratic Republic of Congo.

Background: Health Care Workers (HCWs) in conflict zones face high levels of violence while also playing a crucial role in assisting the population in distress. For more than two decades, the eastern provinces of the Democratic Republic of the Congo (DRC), have been wracked by conflict. This study aims to describe the state of violence against HCWs and the potential prevention mechanisms in eastern DRC.

Association between diagnostic criteria for severe acute malnutrition and hospital mortality in children aged 6-59 months in the eastern Democratic Republic of Congo: the Lwiro cohort study.

Background: Few studies have assessed the relationship between weight-for-height (WHZ) and mid-upper arm circumference (MUAC) with hospital mortality considering confounders. The particularity of MUAC for age (MUACZ) is less documented.

Objective: This study aims to investigate this relationship in a region endemic for severe acute malnutrition (SAM).

Profile of health care workers in a context of instability: a cross-sectional study of four rural health zones in eastern DR Congo (lessons learned).

Background: The crisis in human resources for health is observed worldwide, particularly in sub-Saharan Africa. Many studies have demonstrated the importance of human resources for health as a major pillar for the proper functioning of the health system, especially in fragile and conflict-affected contexts such as DR Congo. However, the aspects relating to human resources profile in relation to the level of performance of the health districts in a particular context of conflicts and multiform crises have not yet been described.

Barriers to family planning use in the Eastern Democratic Republic of the Congo: an application of the theory of planned behaviour using a longitudinal survey.

Objective: In the Democratic Republic of the Congo, there is a low adherence of the population to the use of family planning (FP) due to various social barriers. This study aimed to understand the drives from social barriers to the use of FP in women in the Kivu, a region particularly affected by poverty and many years of conflicts. A theory of planned behaviour (TPB) using a generalised structural equation modelling has been applied to understand the complex sociocultural drivers to the intention and the ultimate decision to use FP.

Cash-like vouchers improve psychological well-being of vulnerable and displaced persons fleeing armed conflict.

The psychological burden of conflict-induced displacement is severe. Currently, there are 80 million displaced persons around the world, and their number is expected to increase in upcoming decades. Yet, few studies have systematically assessed the effectiveness of programs that assist displaced persons, especially in settings of extreme vulnerability.

Psychopathological states among Congolese health workers during the first wave of COVID-19 pandemic: links with emotion regulation and social support.

Unlabelled: The COVID-19 pandemic is an unprecedented stressor for frontline healthcare workers, notably increasing acute stress disorder and depression rates. Emotion regulation and social support could be major protective factors against such psychopathological states, but their role has not been explored outside Western contexts. To assess the association between emotion regulation, social support, acute stress disorder, and depression among healthcare workers directly confronted with the first wave of COVID-19 pandemic in the eastern Democratic Republic of the Congo.

Risk of Chronic Disease after an Episode of Marasmus, Kwashiorkor or Mixed-Type Severe Acute Malnutrition in the Democratic Republic of Congo: The Lwiro Follow-Up Study.

Background: Long-term impact of different forms of severe acute malnutrition (SAM) in childhood on the emergence of noncommunicable diseases (NCDs) is poorly known. Aim: To explore the association between subtypes of SAM during childhood, NCDs, and cardiovascular risk factors (CVRFs) in young adults 11 to 30 years after post-SAM nutritional rehabilitation. Methods: In this follow-up study, we investigated 524 adults (mean age 22 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007.

Association between post-traumatic stress disorder and hypertension in Congolese exposed to violence: a case-control study.

Background: Numerous risk factors have been involved in the pathogenesis of hypertension. The contribution of psychological factors, including post-traumatic stress disorder, remains largely underexplored, despite their potential role in hypertension.

Objectives: We compared the prevalence of trauma, post-traumatic stress and other psychological disorders between hypertensive and normotensive patients from Bukavu (Democratic Republic of Congo), a 25-year war-exposed city.

[Contrat unique, une approche innovante de financement du niveau intermédiaire du système de santé en République Démocratique du Congo : processus et défis de mise en œuvre].

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Background: Universal health coverage should allow countries to establish a financing strategy in order to guarantee the health of the population.

Aim: Our objective was to describe the process and preliminary results of the implementation of the basket fund approach as a mode of financing the intermediate level (provincial health divisions) of the Congolese health system.

Prevalence, risk factors and adverse pregnancy outcomes of second trimester bacterial vaginosis among pregnant women in Bukavu, Democratic Republic of the Congo.

Background: Bacterial vaginosis (BV) is the most common gynecological condition in women of reproductive age and associated with adverse pregnancy outcomes. In the Democratic Republic of the Congo (DRC), neonatal mortality rate is as high as 2.8 percent with preterm birth (PTB) and low birth weight (LBW) as leading causes.

The use of health facility data to assess the effects of armed conflicts on maternal and child health: experience from the Kivu, DR Congo.

Background: In conflict-affected settings, data on reproductive, maternal, newborn and child health (RMNCH) are often lacking for priority setting and timely decision-making. We aimed to describe the levels and trends in RMNCH indicators within Kivu provinces between 2015 and 2018, by linking conflict data with health facility (HF) data from the District Health Information System 2 (DHIS2).

Methods: We used data from the DHIS2 for the period 2015-2018, the 2014 Demographic and Health Survey, the 2018 Multiple Indicators Cluster Survey and the Uppsala Conflict Data Program.

Association between severe acute malnutrition during childhood and blood pressure during adulthood in the eastern Democratic Republic of the Congo: the Lwiro cohort study.

Introduction: Little is known about the long-term outcomes of Severe Acute Malnutrition (SAM) during childhood. As such, this study aims to explore the association between childhood SAM and blood pressure (BP) in adulthood in a context without nutrition transition.

Methodology: We identified 524 adults (Median age: 22 years) who were treated for SAM during childhood in Eastern DRC between 1988 and 2007.

Barriers and facilitators in the implementation of bio-psychosocial care at the primary healthcare level in South Kivu, Democratic Republic of Congo.

Background: In the Democratic Republic of Congo (DRC), healthcare services are still focused on disease control and mortality reduction in specific groups. The need to broaden the scope from biomedical criteria to bio-psychosocial (BPS) dimensions has been increasingly recognized.

Aim: The objective of this study was to identify the barriers and facilitators to providing healthcare at the health centre (HC) level to enable BPS care.