In DR Congo, pregnant women face rising costs in maternity care • FRANCE 24 English

Key Concepts

• Maternal Healthcare Access: The availability and affordability of medical care for pregnant women and during childbirth.
• M23 Conflict: The ongoing armed conflict in the Democratic Republic of Congo (DRC) involving the M23 rebel group, backed by Rwanda.
• Free Healthcare Program (DRC): A government initiative implemented in 2023 to provide free maternal healthcare, subsequently cancelled in North Kivu.
• Maternal Mortality: Deaths related to pregnancy and childbirth.
• North Kivu: A province in eastern DRC significantly impacted by conflict and economic hardship.

The Deteriorating State of Maternal Healthcare in Eastern DRC

The situation in eastern Democratic Republic of Congo (DRC), specifically in areas like GMA, is creating a crisis for pregnant women. Ernestine Balke, six months pregnant, exemplifies this struggle, expressing deep concern about her ability to afford childbirth due to widespread unemployment and the recent cancellation of a vital healthcare program. Her statement, “When I go into labor, I wonder where I will find the money. We don't have jobs. What's more, there is no longer any free healthcare. I don't know how I'm going to manage,” highlights the desperation faced by many.

Impact of Conflict and Economic Crisis

The ongoing conflict between the M23 rebel group (backed by Rwanda) and the Congolese army is a primary driver of this crisis. The fighting has disrupted the delivery of essential medical supplies and led to the collapse of critical infrastructure. This disruption is compounded by a growing economic crisis and widespread unemployment, making even basic maternal care unaffordable for many women.

The Rise and Fall of the Free Healthcare Program

In 2023, the Congolese government implemented a free healthcare program specifically for pregnant women. This initiative proved highly successful, with medical workers reporting a doubling of attendance at maternity wards. This demonstrates the significant demand for, and reliance on, accessible maternal care. However, the program was subsequently cancelled by the M23 in North Kivu province, beginning in June.

Shift to Home Births and Increased Risk

The cancellation of the free healthcare program has resulted in a concerning trend: an increasing number of women in North Kivu are choosing to give birth at home. This decision isn’t based on medical preference, but rather on financial necessity. As a medical worker stated, “It was a good project for us because it helped women give birth at the health center without difficulty. They knew that at the hospital, everything would be provided for free.” Home births significantly increase the risk of preventable complications and, consequently, maternal mortality. This represents a direct and dangerous consequence of the conflict and the economic downturn.

Logical Connections & Synthesis

The transcript establishes a clear causal link: the M23 conflict disrupts healthcare delivery and exacerbates economic hardship, leading to the cancellation of a successful free healthcare program. This, in turn, forces women to resort to riskier home births due to financial constraints, ultimately increasing the threat of maternal mortality. The story of Ernestine Balke serves as a poignant illustration of this interconnected crisis. The data point of maternity ward attendance doubling with the program’s implementation underscores its effectiveness and the devastating impact of its removal. The core takeaway is that conflict directly undermines public health initiatives and disproportionately affects vulnerable populations, particularly pregnant women, in eastern DRC.