Health system resilience amid outbreaks: understanding the politics of sexual and reproductive health service adaptation in eastern Democratic Republic of Congo


Partners: Queen Margaret University, International Rescue Committee and Liverpool School of Tropical Medicine


During epidemics women and girls often experience reduced access to non-outbreak related sexual and reproductive health (SRH) services. For example, during the West Africa Ebola outbreak, excess maternal and neonatal deaths exceeded the number of deaths from Ebola, and the current COVID-19 pandemic might have similar effects. While guidance and tools to adapt SRH protocols and programmes to emergencies exist, often SRH services targeting women are dismissed as non-essential despite the mortality risks.


This study examined decision-making dynamics around adaptations to the Minimum Initial Service Package for Reproductive Health in Emergencies in North Kivu in the context of COVID-19. It examined relationships across local civil society organisations, international non-governmental organisations, Health Cluster, UN agencies, national/subnational government, the private sector, and international donors with a view to understanding the politics of SRH service adaptation during an outbreak, what (or who) drives willingness to innovate and adapt, and if possible, what are the repercussions of doing so or not.



Image: DRC: A Trip to the Front Lines of the Fight Against Ebola – Beni, North Kivu. World Bank Photo Collection via Flickr

"ReBUILD for Resilience brings together partners to share experiences, to discuss our contexts, and to create an appropriate model that helps build resilience in health systems across the country and beyond"

Sushil Baral, HERD International