Women and Children’s health: Economic Impact
André Omatete is Stats Congo leading Health Economist Contributor, based in Kinshasa, Democratic Republic of Congo (DRC).
The Democratic Republic of the Congo (DRC), a sub-Saharan African country, has one of the highest rates of maternal death in the world, with 22,000 maternal deaths in 2015 (1). Progress in the fight against maternal mortality remains steady. According to recent global health statistics, this rate decreased from 930 to 690 maternal deaths per 100,000 live births between 1990 and 2015 (2). Leading causes of maternal mortality in the country include, but are not limited to, widespread economic mismanagement and political instability and conflicts; both issues have increased the DRC’s poverty rate. These issues contribute to the lack of adequate care and resources needed to reduce current maternal, newborns, and child mortality rates.
In 2016, a total of 304,000 children died before their fifth birthday, and the neonatal mortality rate was 30% (3). The World Bank estimated that 6 million children were malnourished in the DRC (4). Such alarming figures highlight the issue of malnutrition impacting the optimal health of children.
The country ranks among one of the lowest in the Human Development Index, at 0.433, and gross national product at $ 348.5 / inhabitant (5). The poverty rate remains very high with 63.4% of the population living below the $1.90/day poverty line. There is also a wide geographical disparity in terms of access to healthcare; there is a shortage of healthcare services in rural areas.
Per capita, health expenditure per year ranged from $1.5 to $4.3 per person from 2008 to 2015 (4). Upin closer look, households constitute the main financing source for healthcare services in DRC. They contribute up to an estimated 42% of total health expenditure, more than 90% of which is through direct payments from individuals.
The Democratic Republic of Congo has very limited resources; the state only allocates around 5% of its total budget to public healthcare (5). This has been the case for more than a decade, which indicates the lack of priority given to the health sector. One suggested approach to tackling this issue is implementing a reasonable, flat rate for medical care, thus making maternal health care fees more affordable. Implementing such an intervention should be followed by a series of other measures, like efficiently using the revenue from this flat rate for the rehabilitation and proper equipment of health care facilities, sensitizing women on prenatal consultation, scaling family planning programs, training staff on updated best practices, and ensuring the availability of safe and effective drugs with the introduction of flowcharts and therapeutic protocols.
Taking into account the low socio-economic level and the purchasing power of the Congolese population today, the scaling up of such interventions will require subsidies to the flat-rate system that would ideally come from the Congolese government, or foreign partners and donors. Success will require a lot of stakeholder engagement from the state, private sector partners, program intervention managers, health zones leaders, and by-in from the general population, particularly from women and children. If the government becomes able to mobilize and contribute substantially to the implementation of this flat rate pricing in the country, then these resources could gradually offset (in a targeted way) maternal healthcare services cost per individual, thus reducing maternal and infant morbidity and mortality.
It should therefore be noted that when women are educated and healthier, they are able to contribute to the economic development of a country by partaking in the job market. As farmers, entrepreneurs, traders and innovators, Congolese women will be able to participate in the formal economy, leading to increased economic growth for the country. This will have a multiplier effect as women invest a larger share of their income on the well-being of other women, thus creating long-term benefits for future generations in a country where the economy is dominated by informal activities.
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