Primary Health Care in Rural DR Congo


IMA’s first major health systems strengthening project, SANRU III strengthened the capacity of approximately 60 NGO-managed health zones for priority primary health care interventions and health zone support systems. The target population was 8.9 million persons, making it one of the largest USAID sponsored service delivery projects in the world at the time.

Priority interventions included a basic package of services including HIV/AIDS and STIs, malaria, nutrition, re-emerging diseases such as tuberculosis, and water and sanitation. SANRU III also managed three WHO-supported APOC onchocerciasis projects. Support systems included planning and management, training and supervision, supply line and cost recovery, infrastructure rehabilitation and equipment; and information and surveillance systems.

Launched on the heels of a prolonged armed conflict, SANRU III was designed to address the alarming rates of morbidity and morality, particularly of children under five, stemming from weakened infrastructure, fragile economy and severe poverty.

There was an emphasis on including primary health care for all children and women in the childbearing age range, with services including prenatal care, immunizations, preventive treatment of malaria, and distribution of insecticide-treated nets, prevention of mother-to-child transmission of HIV, desirable births and community-based integrated management of childhood illnesses.



  • Distributed over 1 million tablets of Ivermectin to over 500,000 people living in nine high risk health zones; trained a large corps of community-directed distributors in drug administration & data collection; and development and distribution of  IEC materials throughout the three project areas.
  • Increase in use of prenatal services from 73% (2001) to 85% (2005).
  • Well baby services increased from 78% (2001) to 95% (2005).
  • Decrease in the incidence of low birth weight children, neonatal mortality and maternal mortality by 6%, 8% and 9% respectively.
  • Increase in detection and cure rates for Tuberculosis from 41% and 69% respectively to 70% and 85%.
  • By 2006 68% of the population in the 56 HZs had access to potable water, up from 33% five years earlier.
  • Provided training opportunities for health care personnel within the managed health zones. Between 2001 and 2005; 74 Heath Zone Medical Directors, 66 Managers/Administrators, 226 Trainers/Supervisors/Nursing Instructors, 106 Water & Sanitation Coordinators, 32 Lab Technicians, 1232 Health Center Nurses, and 683 Health Workers were trained. All targets for training except for Lab Technicians were exceeded.
  • Successful grant issuance and management to a wide variety of implementing and technical assistance partners.



Funding Level: $26.6 million

Donor: USAID


Timeframe: 2001-2006


IMA’s Role: Lead

Key Partner: Eglise du Christ au Congo (ECC)

Implementing and Technical Partners:
  • Advance Africa
  • American Baptist Church (USA)
  • APOC
  • Axios
  • BD
  • BNLO
  • Catholic Relief Services
  • CBM
  • Church World Service
  • CURE
  • DOCS
  • DFID
  • Environmental Health Project (EHP)
  • Fometro
  • Georgetown University
  • Global Fund
  • Johns Hopkins University
  • Johnson & Johnson
  • Making Cities Work
  • Memisa
  • Mennonites
  • Merck
  • Mission Aviation Fellowship
  • Partners for Health Reform (PHR Plus)
  • Pfizer
  • Presbyterian Church (USA)
  • PSI
  • University of North Carolina