Strategies of increasing contraceptive prevalence implemented by nursing staff: Cross-sectional study in clinical base in the Karisimbi health zone, Provincial Division of health North Kivu, DRC.

In the Democratic Republic of Congo, family planning is part of integrated health services. However, often policymakers and service providers are not taking family planning as their priority but focus their attention and resources on other health problems. The result is a 5.8 percent modern contraceptive prevalence rate in the country (although higher in Kinshasa where it is 14.1%).In addition, according to the magazine of the DSRP of the Republic. Democratic Congo on 8 and 9 March 2010 the health, the total fertility rate remains high at 6.3 in 2007 against 7.1 in 2001 and will remain always high for a number of years according to the estimated calculations of the projection of the fertility rate. The low use of contraceptive methods, particularly modern methods, can be mentioned as one of the factors that explain the high fertility in the country. The use of maternal health services seems to have significantly improved in recent years. However, there are still serious problems in the quality of services and the promotion of good governance in family planning program.

This study had as objectives to identify and describe strategies for increase in contraceptive use implemented by the nursing staff and promote information, education and community Communication for change of behavior(CCCB) of the population in terms of family planning, work with Community initiatives and advocacy with leaders and administrative decision-makers for more support and resources to the program of Family planning in the Karisimbi health zone, Province of North Kivu in the Democratic Republic of the Congo.

On a non-probabilistic sampling by choice reasoned eighteen training facilities incorporating family planning of 57 interviewees including 36 staff members, including two by training health centers: namely, the head of the sanitary training and family planning provider, to which a survey questionnaire was administered, for the quantitative data; interview with three key informants, the load of family planning to the UNFPA/Goma, the Provincial Coordinator of the National program of Reproduction Health and physician at area, using an interview guide and animation of a Focus Group Discussion with eight users of family planning in the General Reference of Virunga hospital for qualitative data.

About institutional strategies, surveyed, or 100%, all has the family planning service, what have also stated the Coordinator Provincial of the program National of Reproductive health; the majority of respondents (75%) has been trained in family planning, and 55.6% of respondents revealed that they receive one to three visits of supervision per year. Family planning is not yet officially established in the private health facilities. Regarding medical strategies, three safe methods are available in 77.7%. The majority of respondents (94.4%) recorded side effects among them, 53% refer cases which exceed in the Virunga General Reference Hospital where works, but 29.4% nowhere refer secondary effects. For community based strategies, the respondents or caregivers, 66, 7% promoting methods to long duration of action. Assumption that have statistically measured by khi-square (χ²) and cross tabulated with tab.n° 31, (χ² computedχ²,400 withdl = 1 at 5% Less than χ² on the table = 3,8415) having rejected the alternative hypothesis and confirmed the assumption stipulated that institutional strategies such as training and motivation of personnel of Family planning has a negative effect in promoting contraception by nursing staff in Karisimbi health zone.

The hypotheses of this study have been confirmed, so institutional, medical and community strategies are being implemented in the Karisimbi ZS, but to varying degrees, with the support of UNFPA and Save the Children; Apart from the support of sterility which is not subsidized like other components of family planning. No input from the Government with regard to the supply of contraceptives. The biggest challenge to family planning in the Democratic Republic of the Congo is the sustainability of the activities because the supply of inputs of family planning and the training of personnel depend almost exclusively on the donors and NGOs due to the lack of good governance.