Advancing Primary Health Care in Eastern Congo

About the Project

From 2006-2011, IMA World Health led Project AXxes, a large USAID-funded health systems strengthening and service delivery program targeting eight million people in post-conflict areas of eastern Democratic Republic of Congo (DRC).

The main objective was to improve the availability, quality, and capacity of overall health care, using the appui global  or “global assistance” strategy of the Ministry of Health (MOH), in 57 rural health zones adversely affected by years of civil war, neglect, and relative isolation.

Approximately two-thirds of the health zones were nonfunctional or had limited services at project startup. The project’s assistance focused foremost on the MOH priority package of primary health care (PHC) interventions including reinforcement of vaccination services, provision of pharmaceuticals and supplies to hospitals and health centers, delivery of a full complement of maternal and child health services including family planning, and newborn and postpartum care.

Led by IMA, the consortium of implementing partners included the Protestant Church of Congo (Eglise du Christ au Congo, or ECC), World Vision and Catholic Relief Services.

Project Objectives

  • Increase access to, quality of, and demand for multi-sectoral, integrated PHC
  • Increased capacity of the health zone and the referral system
  • Increased capacity of national health programs and provincial and district offices

Key Achievements

  • Rehabilitation of 217 health facilities and construction of 130 facility incinerators
  • Cumulative training of more than 33,000 health workers at all levels
  • Attainment of a 44% curative care utilization rate (up from < 30% in year one)



Timeframe: 2006-2011

Funding level: $60 million (US)

Donor: USAID


IMAs Role: Lead Agency

Implementing Partners:

Technical Partners:

  • 1,276 fistulas repaired in projects years two, three and four
  • More than 1,000,000 antenatal visits (331,649 in year four versus 189,632 in year one)
  • 661,839 pregnant women received Intermittent Preventive Treatment for malaria (212,896 in year four vs. 112,511 in year one)
  • Distribution of more than 1 million ITNs through prenatal and growth monitoring clinics
  • 618,500 women received assisted delivery with Active Management of the Third Stage of Labor(AMSTL) protocol (282,948 in year four vs. 7,094 in year one)
  • Integration of SGBV interventions into the package of primary health care activities in health facilities throughout all 57 supported health zones
  • 849,306 new acceptors of a new method in family planning (283,166 in year four vs. 26,074 in year one)
  • More than 200,000 pregnant women received HIV counseling in 137 PMTCT clinics
  • Prevention of HIV mother-to-child transmission in 983 HIV + women
  • 13,555 partners/husbands of pregnant women received HIV counseling and testing and received results (7,783 in year four versus zero in year one)
  • 818,368 children vaccinated for measles (251,343 in year 4 vs. 123,638 in year one)
  • Detection of 37,823 cases of Tuberculosis
  • 310 community care sites established and functioning at year‟s end vs. 25 in year three (the first year of that initiative)
  • Construction of 629 spring caps, 196 facility latrines and 6,313 community latrines.
  • Procurement, importation, and delivery of more than 100 air and sea freight shipments via Kinshasa, Bukavu and Lumbumbashi.