Keywords
Free Maternity Care
Universal Health Coverage
maternal Health
General Referral Hospital
How to Cite
Abstract
In the Democratic Republic of the Congo (DRC), despite reforms in the health sector, maternal mortality remains high. As part of Universal Health Coverage (UHC), a policy providing free maternity care was introduced in 2023 to reduce financial barriers to obstetric care. This study examined the implementation of this policy at the Ndjili General Referral Hospital (HGR) by assessing beneficiary satisfaction levels and identifying challenges encountered. This is a descriptive quantitative study conducted among 20 women who gave birth at the Ndjili General Referral Hospital (HGR) during 2024. Data were collected using a structured questionnaire and analyzed using descriptive statistics and the chi-square test. The sample consisted mainly of married women (60%) with a high school education (60%), with an average age of 27. All participants gave birth at the facility under study. Three to four prenatal visits were reported in 65% of cases, and 20% of deliveries required a cesarean section. Although the policy is generally recognized as effective, 70% of respondents believe it is still accompanied by practical difficulties; 40% report having incurred certain costs during their care. Complete satisfaction remains limited (20%), while the assessment of the quality of care remains generally favorable (90%). The benefits most frequently associated with the program are reduced mortality (35%), lower out-of-pocket expenses (30%), and improved maternal health (20%). The most commonly reported constraints relate to shortages of kits (30%), medications (25%), and incidental costs (20%). Recommendations focus primarily on strengthening supplies (65%), expanding free services (25%), and increasing capacity (10%). No statistically significant associations were found (p > 0.05). Free maternity care promotes access to care, but its consolidation requires improved resource availability and more rigorous oversight of its implementation.
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