Editing Kinshasa

{{setLocation
|Country=Democratic Republic of the Congo
|City=Kinshasa
}}

[[File:Boulevard du 30 juin, Kinshasa.jpg|400px | thumb|right|]]

'''OVERVIEW''' 

The Democratic Republic of the Congo (DRC) has varying levels of resources available, depending upon the financial means and location of the person seeking care. The most resources are available in Kinshasa, the capital city, and in the private hospitals and clinics. However, many people cannot afford these private facilities, and there are also many people who live in more rural or remote areas. Regarding laws, contraception is legal and available, but most women do not use modern contraceptive methods. Emergency contraceptive pills are legally available over-the-counter in pharmacies. Abortion is only legally available when the pregnancy threatens the life of the pregnant person.

The DRC is a diverse country with over 200 ethnic groups. The majority of the people are Bantu, and French is the official language. In terms of religion, 30% of the country is Roman Catholic and 27% are Protestant. Many of the people in the DRC live in poverty, despite the rich natural resources of the country. There is a large refugee population, including DRC citizens who have been internally displaced and refugees from other countries, such as Rwanda, the Central African Republic, and Burundi. The majority of the population is young, with about 46% between 0-14 years old, 20% between 15-24 years old, and 28% between 25-54 years old. Less than 10% of the population is over 55 years old, as of 2020.<ref name=ciaworldfactbook_drc>[https://www.cia.gov/library/publications/the-world-factbook/geos/cg.html CIA World Factbook: Congo, Democratic Republic]</ref>

==Contraception (Birth Control)==

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

===Laws & Social Stigmas===

Generally speaking, contraceptives are used by some women in the DRC, but many do not use them. The country has the second lowest modern contraceptive usage rate in sub-Saharan Africa (about 8% of women of reproductive age) and the second highest fertility rate (6.6 children per women), according to a 2017 report.<ref name="drc_ecawareness">[https://www.jstor.org/stable/10.1363/43e4417#metadata_info_tab_contents Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo]</ref> About 59% of women (ages 15-49) reported that their most recent pregnancy was unintended, according to 2015 data.<ref name=":0" /> 

In the DRC, the most common forms of contraception are the rhythm method (about 8% of women), withdrawal (5% of women), and condoms (4% of women). Other methods are not commonly used, such as injectables (about 1% of women), implants (less than 1% of women), female sterilization  (less than 1% of women), pills (less than 1% of women), and the vaginal barrier method (less than 1% of women).<ref name="unreport_contraceptives2015">[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref> In Kinshasa, the most common methods are condoms, pills, and injectables, which were used by 63% of married women and and 83% of unmarried women who use modern contraceptive methods (2015 data).<ref name=":0">https://www.sciencedirect.com/science/article/pii/S0010782417303943</ref>

In 2015, it was estimated that about 23% of women in the DRC (who were married/in unions and between the ages of 15-49) were using any form of contraception, including traditional methods. This was comparable to the Central African average (about 23% of women). Furthermore, it was estimated that about 27% had unmet family planning needs, which was slightly higher than the Central African average (26% of women). However, it should be understood that modern contraceptive methods are not very popular, with only 9% of women using modern methods, on average. 

For many women in the DRC, the biggest hurdle regarding contraceptive use isn't access. Many women, including in rural areas, have access to clinics, which provide information and services. However, there are religious, social, and economic reasons why women may not opt for modern contraceptives. About half the population is Roman Catholic (50%).<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/cg.html CIA World Factbook: DRC]</ref> The Catholic Church promotes large families and opposes modern contraceptives. For this reason, women typically rely on natural and traditional methods, such as the rhythm method. Furthermore, it has been reported that some women opt to forego contraception and have larger families, as they worry that not all of their children will survive, due to the ongoing conflict in the country.<ref>[https://globalpressjournal.com/africa/democratic-republic-of-congo/faith-family-planning-odds-catholic-families-drc/ Faith and Family Planning At Odds for Catholic Families in DRC]</ref> Finally, traditional values often rank women with many children as possessing higher social and economic standing.<ref name="drc_ecawareness" />

===What to Get & Where to Get It===

* Private sector pharmacies are one of the most common ways to access contraception in Kinshasa.<ref name=":0" /> There are an estimated 5000 small pharmacies and informal drug stores (known as ligablos) in Kinshasa, according to a 2017 report.<ref name=":0" />
* [https://mariestopes.org/where-we-work/democratic-republic-of-the-congo/ Marie Stopes - The Democratic Republic of Congo]: "Marie Stopes DRC has begun its mission to expand access to quality family planning for Congolese women in the capital Kinshasa and the neighbouring province of Tshopo, with the aim to expand to further provinces as the programme grows. Services are initially focused on mobile outreach, with teams of midwives and nurses travelling by road and river to bring contraception to women in remote areas and urban slums. The programme also provides services through a network of MS Ladies, trained healthcare providers (usually nurses, midwives or community health workers) who work within the local community to increase access to high quality family planning services and advice." Address: Marie Stopes DRC, Consession Safricas, Rue Sergent Moke n° 14, Quartier, Socimat, Commune Ngaliema,, Kinshasa. Phone: +243 82 899 72 25
* [https://www.dktinternational.org/country-programs/democratic-republic-of-congo/ DKT International - The Democratic Republic of Congo]: They distribute condoms and other forms of contraception, train health care providers, and conduct outreach in clinics. Call +243 971 014 205. Email: info@dkt-rdc.org.

===Costs===

==Emergency Contraception (Morning After Pill)==

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

===Laws & Social Stigmas===

Emergency contraceptive pills (also known as morning after pills) are available in the DRC. The law states that they are available by prescription only,<ref name=":1">[https://www.cecinfo.org/country-by-country-information/status-availability-database/countries/congo-democratic-republic-kinshasa/ Congo, Democratic Republic (Kinshasa)]</ref> but it appears that it can be purchased without a prescription (based on testimony in reports).<ref name="drc_ecawareness" /> 

Emergency contraceptive pills are not commonly used, with only about 1.9% of married women and 4.3% of unmarried women ever using it, according to a 2015 study.<ref name=":0" /> Emergency contraception is not fully integrated into family planning programs, where it is only recommended in cases of rape, incest, or issues of mental incapacity. There is also low awareness of emergency contraception among the local population, with about 22.6% of all women (ages 15-49) ever having heard of the method, according to a 2014 report. There is also limited distribution of emergency contraception in pharmacies, and some pharmacies experience stock-outs.<ref name=":0" /> 

In 2018, a study found that about two-thirds of pharmacists in Kinshasa were knowledgable about the required timeframe, dosage, and side effects of emergency contraception. About 90% were found to be helpful for people who were new to emergency contraception and had basic questions. About 20% provided incorrect information related to the proper timeframe for taking emergency contraception, and about 4% gave incorrect information about its long-term side effects. About 22% of the pharmacists had issues with stock-outs of emergency contraception. Generally speaking, the study found that private pharmacies typically had adequate knowledge among staff members for dispensing emergency contraception.<ref>https://pubmed.ncbi.nlm.nih.gov/28803883/</ref>

The National Strategic Plan for Family Planning (2014-2020) did not include emergency contraception.<ref name=":1" />

===What to Get & Where to Get It===

* Emergency contraceptive pills (also known as morning after pills) can be purchased at pharmacies, health centers, public sector clinics, hospitals, and organizations associated with the International Planned Parenthood Federation.<ref name=":1" />
* Some of the emergency contraceptive brands you can expect to find are Aleze EC, G-Nancy, Levonorgestrel Richter, NorLevo 1.5mg, Pilule S, Planfam, Revoke 1.5, Revoke 72, Secufem.<ref name=":1" />
* It is important to note that some brands sold in the DRC have been approved by stringent regulatory authorities, like the WHO, FDA, or European Medicines Agency, but not all of them have. If you want to be on the safe side, you can look up a medication before purchasing it to ensure it has been approved by a large regulatory agency.<ref name=":1" />

===Costs===

* In Kinshasa, the median price for LNG emergency contraception was $1.21 in the public sector and $1.43 in the private sector, as of September 2016. The price was higher in Katanga at about $3.30 in the private and public sectors during the same time period.<ref name=":1" />

==Sexually Transmitted Infections (STIs/STDs)==

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

===Laws & Social Stigmas===

There are known travel restrictions related to HIV/AIDS. This means that, if you travel to the DRC, you will not be asked for a medical certificate or proof of your HIV status.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=52 CONGO (KINSHASA) - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>

Generally speaking, the DRC has a lower rate of HIV infection than many other African countries, and the country has made progress in reducing the infection rate. In 2018, it was estimated that about 45,000 people, which is less than 1% of the adult population, in the DRC were living with HIV. Between 2010-20, the HIV infection rate dropped from about 31,000/year (in 2010) to 19,000/year (in 2020). Furthermore, there was a 60% drop in the number of AIDS-related deaths, going from about 34,000 deaths/year (in 2010 to about 13,000 deaths/year (2020). In 2018, it was estimated that about 62% of people with HIV in the DRC knew their status, and about 57% of HIV people were on treatment. However, it is important to understand that women are especially at risk for HIV infection in the DRC. The HIV infection rates among young women (ages 15-24) are about 4 times those of young men.<ref name=undaids_drc>[https://www.unaids.org/en/regionscountries/countries/democraticrepublicofthecongo UNAIDS: Democratic Republic of the Congo]</ref>

Some people access HIV treatment from Postes de distribution communautaire d'ARV, also known as PODIs. In 2015, 2300 people living with HIV received treatment from PODIs in Kinshasa.<ref>https://www.msf.org.za/sites/default/files/publications/dissemination_of_three_novel_approaches_piloted_by_msf_-_copy.pdf</ref>

===Testing Facilities===

* Kinshasa has some community centers, which are run by HIV+ people, that provide HIV testing and support. You can read more about them [https://reliefweb.int/report/democratic-republic-congo/hiv-kinshasa-we-patients-had-find-solutions-ourselves here].

===Support===

* Postes de distribution communautaire d'ARV or PODIs: Community anti-retroviral (ARV) distribution points.
* National des Organisations d’Assise Communautaires (RNOAC): A Congolese network of people living with HIV.

===Costs===

==Medications & Vaccines==

===Laws & Social Stigmas===
There are an estimated 3,000-3,500 users of PrEP (pre-exposure prophylaxis) in the DRC (as of 2021).<ref>https://www.prepwatch.org/country/democratic-republic-congo/</ref>

===What to Get & Where to Get It===

===Costs===

==Menstruation==

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

===Laws & Social Stigmas===
In Kinshasa, the menstrual options vary considerably, depending on the person's wealth and independence. The main types of menstrual products used by women in Kinshasa are sanitary pads (84.2% of women), other materials such as tampons, toilet paper, foam, natural materials (22.3% of women), cloth (7.7% of women), and cotton wool (2.3% of women, according to 2017 data.<ref name=":2">https://www.pmadata.org/sites/default/files/data_product_results/PMA2020-DRC-Kinshasa-R1-MHM-Brief-EN.pdf</ref> About 18% of women reported washing and reusing their menstrual products and 92% said their reused products were dry when they used them.<ref name=":2" /> 

A large percentage of women in Kinshasa (57%, according to a 2021 study) reported a lack of privacy to deal with their menstrual hygiene.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967348/</ref> The main locations that women in Kinshasa use for menstrual hygiene are their sleeping areas (66% of women), the main sanitation facility in their homes (22.3% of women), other sanitation facilities in their homes (5.3% of women), sanitation facilities at school, work, or public facilities (5%), and either a backyard or no facility at all (1.8% of women), according to 2017 data.<ref name=":2" /> 

===What to Get & Where to Get It===

===Costs===

==Gynecological Exams==

===Laws & Social Stigmas===

The quality of gynecological care in the DRC varies greatly, depending on the economic means and geographic location of the patients. Below, we have provided a list of some of the medical facilities and ob/gyns available in Kinshasa, but some may be too expensive for some people. For more information on the options available in the DRC, we also recommend you check out this [http://mamacongo.blogspot.com/2014/05/kinshasa-faqs-doctors-hospitals-other.html blog post] on local health care.

===What to Get & Where to Get It===

====Medical Facilities====

* [https://cmk-cd.org/ Centre Medical Kinshasa]: This is the top and best equipped hospital in Kinshasa. It has various ob/gyns on staff, and it has Centre Privé d'Urgence (CPU) for emergencies. Phone: +243 890 274 713. Email: sec@cmk-cd.org
* [http://www.cliniquediamant.com/ Centre Medical Diamant ("Canadian Clinic")]: This clinic has an ob/gyn department, and it can handle general appointments (no emergencies). They have modern equipment. English translation is available upon request. Reception: 0976000065 or 0817121555. Address:  3642, Suite 101, Future Tower, Boulevard du 30 Juin

====Obstetricians/Gynecologists====
* Dr. Ana Bila: This female ob/gyn speaks English & French. Appointment necessary; office hours at Centre Medical Diamant. She was on the [https://cd.usembassy.gov/u-s-citizen-services/doctors/ list] provided by the US Embassy (accessed March 2020). She has been practicing since 2009. Phone: +243 993 025 355 / +243 099 967 084. Address: 1 O.U.A, Kinshasa, Congo - Kinshasa.
* Dr. Bavi: This male ob/gyn speaks speaks French & some English. He operates from Boulevard Clinique Dentaire Caravella/admits to CHK. He was on the [https://cd.usembassy.gov/u-s-citizen-services/doctors/ list] provided by the US Embassy (accessed March 2020). Phone: +243 999 921 321. Email: davidhroire@yahoo.fr.
* Dr. Mbutuku: This doctor operates out of CMK & was on the [https://cd.usembassy.gov/u-s-citizen-services/doctors/ list] provided by the US Embassy (accessed March 2020). Phone: +243 998 844 404 / +243 818 844 404

===Costs===

==Pregnancy==

===Laws & Social Stigmas===

The maternal mortality rate (MMR) is 693 deaths per 100,000 live births, according to 2015 data. This MMR is ranked 10th in the world, meaning that the DRC has the 10th worst MMR globally. <ref name=“cia_mmr”>[https://www.cia.gov/LIBRARY/publications/the-world-factbook/fields/353rank.html#IC CIA World Factbook - Maternal Mortality Rate (MMR)]</ref>

===What to Get & Where to Get It===

===Costs===

==Abortion==

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

===Laws & Social Stigmas===

In the DRC, abortion is generally prohibited. It is only legally permitted when the pregnancy endangers the life of the pregnant person. The abortion laws originally come from the 1867 Penal Code of Belgium, which were then incorporated into the Penal Code of the Democratic Republic of the Congo in the nineteenth century.<ref name="ww_drc">[https://www.womenonwaves.org/en/page/4985/abortion-law-congo Abortion law Congo]</ref>

For information on abortion practices and issues in the DRC, you can check out [https://www.guttmacher.org/fact-sheet/abortion-kinshasa Guttmacher Institute: Induced Abortion and Postabortion Care in Kinshasa, Democratic Republic of Congo Induced Abortion and Postabortion Care in Kinshasa, Democratic Republic of Congo (2018].

===What to Get & Where to Get It===

* According to Women on Waves, Misoprostol (one part of the abortion pill) is available under the brand name Cytotec. It's very expensive for most people in the DRC.<ref name="ww_drc" />

===Costs===

==Advocacy & Counseling==

==LGBTQ+ Resources==

* Note: Homosexuality is legal in the DRC and it is legal to change gender. However, homosexual marriage is not legal and there is no legal protection against discrimination of LGBTQ+ individuals, as of 2021.<ref>[https://www.equaldex.com/region/democratic-republic-of-the-congo Equaldex - Democratic Republic of Congo]</ref>
* [https://www.equaldex.com/region/democratic-republic-of-the-congo Equaldex - Democratic Republic of Congo]: This website provides information on LGBTQ rights and laws in the DRC.
* [https://www.lonelyplanet.com/democratic-republic-of-congo/practical-information/directory/lgbt-travellers/a/nar/25c0380f-97ad-41ba-8688-91a946a61f4e/355218 Lonely Planet: DRC LGBT Travellers]: This website provides information on travel in the DRC for LGBTQ+ travelers.

==Additional Resources==

* [https://minisanterdc.cd/ Ministry of Health]
* [https://www.who.int/countries/cod/en/ WHO - Democratic Republic of Congo]
* [https://drc.unfpa.org/ UNFPA - Democratic Republic of Congo]
* [https://www.mariestopes.org/where-we-work/democratic-republic-of-the-congo/ Marie Stopes DRC]: This international NGO focuses on women's health care access, and they may be able to provide some help or services to people in need. Address: Consession Safricas, Rue Sergent Moke n° 14, Quartier Socimat, Commune Ngaliema, Kinshasa. Phone: +243 82 899 72 25
* [https://www.ippf.org/about-us/member-associations/congo-dem-republic The Association de Bien-Etre Familial – Naissances Désirables (ABEF-ND)]: "The Association de Bien-Etre Familial – Naissances Désirables (ABEF-ND) was founded in 1977, and since then it has worked tirelessly to drive changes which will secure a better future for the country. ABEF-ND offers sexual and reproductive health (SRH) information, education and communication for young people. It offers HIV and AIDS prevention and management services, and community-based distribution of contraceptives. It also advocates strenuously around SRH issues with legislators and health professionals. As such, it’s central to shaping relevant national policies."
* [https://www.womenforwomen.org/where-we-work/democratic-republic-congo Women for Women International - DRC]: "Since 2004, Women for Women International – Democratic Republic of the Congo has served more than 95,000 women through our yearlong program in eastern Congo's North and South Kivu provinces."
* [http://www.familyplanning-drc.net/ Family Planning in the DRC]
* [https://www.familyplanning2020.org/democratic-republic-of-the-congo Family Planning 2020 - Democratic Republic of Congo]

==References==
<references />

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