Association of Intimate Partner Violence (IPV) and Current Contraceptive Use in the Democratic Republic of Congo (DRC): a secondary data analysis of the Demographic Health Survey (DHS) II 2013-2014

Abstract Objective To characterize the association between intimate partner violence (IPV) and current contraceptive use among married or partnered women in the Democratic Republic of Congo (DRC). Methods A secondary data analysis of Demographic Health Survey II data collected during 2013-2014 in the DRC was conducted. After restricting the sample to women who were married or partnered and had answered all questions of interest, 4,038 women remained. Descriptive bivariate analysis was conducted to investigate prevalence of chosen confounders: rural/urban residence, polygamous marriage, woman's education, and partner's education. Multivariate logistic regression was then used to model the association between IPV and contraceptive use while controlling for confounding. Results No statistically significant association between IPV and current contraceptive use was found (OR: 1.08, 95% CI: [0.92, 1.27], p = 0.357). Rural residence halved the odds of currently using contraceptives (OR: 0.55, 95% CI: [0.46, 0.66], p = 0.000). The strongest predictor of current contraceptive use was a woman's educational attainment, with secondary and post-secondary education significantly increasing odds of use (OR: 2.66, CI: [2.01, 3.52], p = 0.000 and 3.76 95% CI: [2.05, 6.88], p = 0.000). Partner's educational attainment followed a similar pattern, increasing odds of contraceptive use by 1.77 (CI: [1.12, 2.81], p = 0.014) and 2.31 (CI: [1.35, 3.97], p = 0.002) times for those with secondary and post-secondary education, respectively. Conclusions for practice This study confirms a previous finding of a lack of association between IPV and current contraceptive use in the DRC. Further research is warranted to determine the association among unmarried women. Keywords Intimate partner violence IPV Contraceptive use Democratic Republic of CongoMaster of Public Healt

Infant feeding practices and determinants of poor breastfeeding behavior in Kinshasa, Democratic Republic of Congo: a descriptive study

Abstract Background Although breastfeeding is almost universally accepted in the Democratic Republic (DR) of Congo, by the age of 2 to 3 months 65% of children are receiving something other than human milk. We sought to describe the infant feeding practices and determinants of suboptimal breastfeeding behaviors in DR Congo. Methods Survey questionnaire administered to mothers of infants aged ≤ 6 months and healthcare providers who were recruited consecutively at six selected primary health care facilities in Kinshasa, the capital. Results All 66 mothers interviewed were breastfeeding. Before initiating breastfeeding, 23 gave their infants something other than their milk, including: sugar water (16) or water (2). During the twenty-four hours prior to interview, 26 (39%) infants were exclusively breastfed (EBF), whereas 18 (27%), 12 (18%), and 10 (15%) received water, tea, formula, or porridge, respectively, in addition to human milk. The main reasons for water supplementation included “heat” and cultural beliefs that water is needed for proper digestion of human milk. The main reason for formula supplementation was the impression that the baby was not getting enough milk; and for porridge supplementation, the belief that the child was old enough to start complementary food. Virtually all mothers reported that breastfeeding was discussed during antenatal clinic visit and half reported receiving help regarding breastfeeding from a health provider either after birth or during well-child clinic visit. Despite a median of at least 14 years of experience in these facilities, healthcare workers surveyed had little to no formal training on how to support breastfeeding and inadequate breastfeeding-related knowledge and skills. The facilities lacked any written policy about breastfeeding. Conclusion Addressing cultural beliefs, training healthcare providers adequately on breastfeeding support skills, and providing structured breastfeeding support after maternity discharge is needed to promote EBF in the DR Congo

Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo

The World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. However, the effect of EBF on malaria risk remains unclear. In the present study, 137 EBF infants and 358 non-EBF infants from the Democratic Republic of the Congo were assessed for fever and malaria infections by polymerase chain reaction, at 6 months of age. EBF was associated with a reduced risk of clinical malaria (odds ratio = 0.13; 95% confidence interval = 0.00–0.80), suggesting a protective effect of EBF against malaria

Antenatal and delivery services in Kinshasa, Democratic Republic of Congo: care-seeking and experiences reported by women in a household-based survey

Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo

Implementation and Operational Research: Maternal Combination Antiretroviral Therapy Is Associated With Improved Retention of HIV-Exposed Infants in Kinshasa, Democratic Republic of Congo

Programs to prevent mother-to-child HIV transmission (PMTCT) are plagued by loss to follow-up (LTFU) of HIV-exposed infants. We assessed if providing combination antiretroviral therapy (cART) to HIV-infected mothers was associated with reduced LTFU of their HIV-exposed infants in Kinshasa, DR Congo

Temporal changes in the outcomes of HIV-exposed infants in Kinshasa, Democratic Republic of Congo during a period of rapidly evolving guidelines for care (2007–2013)

Guidelines for prevention of mother-to-child transmission of HIV have developed rapidly, yet little is known about how outcomes of HIV-exposed infants have changed over time. We describe HIV-exposed infant outcomes in Kinshasa, Democratic Republic of Congo, between 2007 and 2013

Conditional cash transfers and uptake of and retention in prevention of mother-to-child HIV transmission care: a randomised controlled trial

Novel strategies are needed to increase retention in and uptake of prevention of mother-to-child HIV transmission (PMTCT) services in sub-Saharan Africa

Fertility desires, unmet need for family planning, and unwanted pregnancies among HIV-infected women in care in Kinshasa, DR Congo

Abstract Introduction: we assessed the fertility desires, utilization of family planning (FP) methods, and incidence of pregnancies among HIV-infecte

Les grèves de médecins en République Démocratique du Congo : quels repères éthiques généralisables?

Depuis plusieurs années, la République Démocratique du Congo est le théâtre de grèves menées par les médecins du pays. Les revendications des grévistes en question sont essentiellement financières et statutaires, et visent à faire pression sur le gouvernement. Dans ce pays, comme c’est le cas presque partout dans le monde, les grèves médicales sont autorisées. Tout travailleur a le droit de dénoncer par la grève des conditions de travail jugées inacceptables. Mais les médecins sont-ils des travailleurs comme les autres? N’ont-ils pas des obligations morales particulières liées aux spécificités de leur profession? Pour éclairer ces questions, les auteurs de cet article proposent trois repères moraux essentiels généralisables à des situations de grèves médicales ailleurs dans le monde. Le premier porte sur la reconnaissance du droit de grève pour les médecins, y compris pour des motifs strictement financiers. On ne peut demander à des professionnels de santé d’exercer leur métier dans des conditions de travail inhumaines ou sans un salaire permettant de faire vivre leur famille. Le deuxième repère estime que l’on ne peut pas accepter que ce droit de grève s’exerce en sacrifiant les patients les plus fragiles et en niant ainsi l’essence même de la profession médicale. Un troisième repère vient complexifier la réflexion en rappelant que l’extrême délabrement du système de santé congolais rend impossible l’organisation d’un service minimum de qualité en cas de grève. Pour sortir de ces difficultés, nous proposons une alliance thérapeutique nationale entre les médecins et les citoyens pour replacer les patients au centre des préoccupations du système de santé