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Table 8 Examples of RMNCAH+N services that proved particularly challenging to be implemented in North and South Kivu, as reported by study informants

From: Health services for women, children and adolescents in conflict affected settings: experience from North and South Kivu, Democratic Republic of Congo

FactorsChallenging serviceEfforts to overcome the challenge
Socio-cultural factors• Family Planning
• Abortion and post-abortion care
• Care for survivors of sexual violence
• Child health (services beyond vaccination such as growth monitoring or regular checks for early detection of conditions)
• Increase demand through awareness activities and build trust in the provider
• Using family planning counselling as entry point for other sexual, reproductive or maternal services
• Engage with difference audiences (youth, men, women, religious groups, midwives, teachers, etc) and work with champions
• In communication messages, focus on the health risks for women and children (for example: the four “Too”: too many/ too early/ too close/ too late pregnancies)
• Free care or input distribution
Health Service Delivery
Lack of equipment/ ambulance• Neonatal resuscitation
• Referral
• Strengthen providers skills for early detection of complications
• Anticipate delivery complications by admitting pregnant women weeks before due date in maternity waiting homes (binyola)
Lack of trained human resources• Mental health for GBV victims
• Maternal mortality surveillance
• Strengthen providers’ skills
Essential Medicines• STIs, HIV
• Undernutrition
• General child and maternal health
• Improving procurement capacity to prevent stockouts
• International procurement (by INGOs)
• Resort to local pharmacies
Emergency context• Adolescent health
• Reproductive health
• Ensuring that MISP is included in all emergency programs