Speaking at the 2015 CCIH Annual Conference, Dr. Hélène Mambu-ma-Disu, MD, MPH, Senior Program Officer for the Sustainable Immunization Financing Program of the Sabin Vaccine Institute for DRC and SANRU Board Member describes how the faith community is intrinsically involved in delivering vaccines in the DRC.

1. CCIH 29TH ANNUAL CONFERENCE
IMMUNIZATION
AND THE FAITH
COMMUNITY IN DRC
Dr Helene MAMBU-MA,DISU
Senior Program Officer, Sabin Vaccine Institute

2. Public vs. Private Sectors
Public Sector
Not-for-Profit
Private Sector
For-Profit
Church-Managed
Health Services
??
In many countries Church-
managed health services are
considered private sector
competitors to the MOH.

3. Public vs. Private Sectors
Public Sector
Not-for-Profit
Private Sector
For-Profit
Church-Managed
Private Sector
Not-for-Profit
In Congo, the MOH often
delegates the management of
many health zones to Church-
managed health services.

4.  Primary Health Care
 Decentralized Health Zones
 Collaboration with churches in
providing PHC and HZ management
 Projects to implement the above
Principles for Sustainable Health Systems
Development in DR Congo
(established in 1975)

5. NATIONAL HEALTH DEVELOPMENT PLAN
1980-1984
 Health zone (HZ): operational structure for planning,
implementing and evaluating health activities.
 National territory to be divided in HZs (306 to begin with)
 Health Zone not necessarily equal to administrative Zone
 HZ to be developed around existing hospitals, (many of which
were faith-based) (medical officer)
 HZ to be divided into health areas covered by existing health
centers or to be developed (many of the existing health areas
were faith-based) (qualified nurse)
 Health promotion activities from the village up
 Preventive activities from health center up

6. EXPANDED PROGRAM ON IMMUNIZATION IN DRC
 1978 after smallpox eradication
 Fixed, outreach and mobile
strategies from existing hospitals
and health centers.
 Mobile strategy in the rest of
the national territory
 Cold chain often provided by
faith-based communities.
 1980, external evaluation
recommended integration of
immunization activities in the
basic health services.

7.  First EPI 4 year operational plan (1982 – 1986)
◦ Decentralize cold chain at provincial and sub provincial levels:
creation of EPI antennas (21 to begin now 44)
◦ Health zone: operational structure to implement immunization
program; but many existing health zones not operational
enough to correctly implement EPI
 First training course for health zone medical officers
◦ 15 medical officers trained (60% from church hospitals)
◦ Kangu (cath), Kimpese (prot), Kisantu (cath), Bikoro (cath), Vanga (prot),
Karawa (prot), Bwamanda (cath), Nyankunde (prot), Wembo Nyama (prot),
Kaniama (state), Kasongo (state), Katana (state), Walungu (NGO), Near
Goma (state), Morocco
EXPANDED PROGRAM ON IMMUNIZATION IN DRC
(Continued)

8. Plusieurs ZS d’accès difficile
Taux de mortalité infanto juvénile:
104 pour 1 000 NV (EDS 2013)
Pays décentralisé avec 11 provinces et
516 zones de santé (ZS)
Interruption de la circulation du PVS
depuis 3 ans
Context

9. Year
Functional
HZ
FBO/NGO
Managed HZ
Nbr Nbr %
1981 8 6 75%
1982 41 32 78%
1983 64 44 69%
1984 87 61 70%
1985 112 74 66%
1987 ~220 ~130 39%
1990 179 117 65%
2000 ~100 ~60 60%
The creation of Congo’s
health zones around
functional hospitals was
a bottom-up process that
was pioneered by FBOs.

10. FBO-managed Health Zones (1990)
In 1990 50% of
DR Congo’s
306 health zones
were managed
with FBOs/NGOs

11. EPI AT PROVINCIAL LEVEL
COORDINATION
ANTENNA 1 ANTENNA 2 ANTENNA 3 ANTENNA 4
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé
Zone
de
santé

12. Buta Isiro
Aru
Lokutu
Kisangani
Bunia
Butembo
Goma
Uvira
Bukavu
Kindu
Kalemie
Likasi
Lubumbashi
Kamina
Kolwezi
Gbadolite
Gemena
Bumba
Lisala
Mbandaka
Boende
Inongo
Bandundu
Kenge Kikwit Kananga
Tshikapa
Luiza
Luiza
Lodja
KabindaMBJ
MueneD
Boma
Mbanza Ng
Matadi
Dépôt
Central
Kinshasa
Dépôt Central
Dépôt Provincial avec CF
Dépôt Antenne
Antennes servies par dépôt provincial
Dépôt central vers Dépôt provincial
Déplacement des Intrants par avion
Déplacement des Intrants par Véhicule
Dépôt central vers Dépôt Antenne
Dépôt provincial vers les Antennes
Improving the Availability of Vaccines

13. FBO-managed Health Zones (2015)
In 2915 40% of
DR Congo’s
516 health zones
are managed
with FBOs/NGOs

14. Contributions of Faith-Based Communities to the
improvement of immunization coverage in DRC
 Provision of cold chain equipment for good
quality vaccine storage
 Support to community health workers for
social mobilization
 Provision of immunizations free of charge
 Social mobilization during church services
 Provision of incentives to health personnel

15. Thank You!