Workforce

 

WORKING PERSONNEL IN FAMILY PLANNING


Despite manpower development in the past few decades, large sections of the health sector suffer from grave staff shortages. Staff underpayment and mismanagement combined with the unavailability of equipment and essential commodities make it difficult, particularly for the MOH, to attract and retain health workers, especially in hard to reach areas. Salaries that the government pay to its civil servants, including health professionals are not commensurate with the cost of living. Remunerations are far lower than most other African countries.

Number of Health Professionals in the DRC in 2011:

Category Number Agents per citizen
Physicians 3,116 20,143
Pharmacists 331 189,623
Pharmacy Assistants 270 232,464
Nurses (All Categories) 43,021 1,459
Radio Technicians 212 296,063
Lab. Technicians 870 72,144
Source : MOH, PNDS 2011-2015

TYPES OF FP HEALTH WORKERS RESPONSIBLE FOR THE DELIVERY OF FP SERVICES


1. Physicians
  • Provide oversight to FP service delivery, in their role as Médecin Chef de Zone (the chief medical officer for the health zone, responsible for all health services provided by the zone)
  • Relatively few are involved in FP service delivery to clients, except to perform an occasional female sterilization (often for medical reasons rather than desire of the woman/couple to avoid further pregnancies)
2. Nurses
  • Provide the vast majority of clinical service delivery in health centers, including counseling of clients, selection of contraceptive methods, application of the methods (insertion of implants or IUDs, injection of Depo-Provera), management of side effects.
  • Fill out clinic registries that provide the raw data for service statistics.

3. Community Extension Workers (Relais Communautaires)
Volunteers that live in the village and are chosen by the people of this village to serve as the bridge between households and health care services; therefore, the relais communautaire agrees to devote part of his time to the interests of the community and to work for sustainable development goals in his village.

  • There are two types of relais communautaires:
    • Relais de Sites (RS; Relay of Sites): worker that receives formal training to enable him to care for sick children in the community
    • Relais Promotionnel (RP; Special Relay): worker trained to conduct outreach activities on health and mobilize in the community; he or she is primarily concerned with information, education, and communication
  • In relation to family planning, relais communautaires:
    • Create awareness of FP methods among members of the community
    • Distribute condoms, cyclebeads, and pills to interested members of the community
    • Refer interested persons to the hospital or health centers for clinical methods
4. Community-Based Distributors (CBD, volunteers that work on behalf of a particular organization)
  • Create awareness of FP methods among members of the community
  • Distribute condoms, cyclebeads, and pills to interested members of the community
  • Refer interested persons to the hospital or health centers for clinical methods
    • Congolese and International NGOs that rely on community-based distributors in the DRC:
      • ABEF
      • WWF
      • MSH
      • Jane Goodall Institute
      • Pathfinder International
      • CARE
      • DKT RD Congo
5. Animateur Communautaire de la Zone de Santé (Community Facilitator of the health zone)
  • He or she is responsible for all health zone activities

6. Pharmacists
The number of pharmacies has increased since 1998, when it was determined that there were only 121 registered pharmacists in the whole country. The majority of these pharmacists get their supplies from local suppliers and the remaining have international sources of supply. Pharmacies are a main source of modern contraceptives in the DRC, particularly for health zones and health facilities that are not supported by local or international partners.

TRAINING OF PERSONNEL WORKING IN FAMILY PLANNING


Strides made in the last decades in the domain of education have resulted in a large development increase in manpower. In 2006, about 11,000 physicians were registered by the Ordre National des Médecins (the DRC Medical Association), 3116 were on the government payroll, 2,000 were practicing in South Africa and many more had emigrated elsewhere. DRC has improved its ratio of health workers to population.

Doctors and nurses may get a cursory introduction to contraceptive service delivery as part of medical/nursing school, but it is not sufficient to provide them with sufficient knowledge and mastery for clinical service delivery.

The PNSR developed a 12-day training module that covers the basics of clinical service delivery. It includes six days of theory, followed by one day of practice on pelvic models, and five days of supervised practice with actual clients.

The PNSR has resisted efforts to reduce the length of training, given that the current course was shortened from a longer version given in the past. However, some NGOs have found it impractical to require staff to be away from other duties for 12 days and have shortened the content.

The PNSR considers it its mandate to do a training needs assessment at the provincial level each year. However, given the lack of budget for this purpose, no recent assessment has been done. PNSR reports that some FP groups at the provincial level may approach the branch offices to give their staff training in FP service delivery, without the central offices being informed. The training module is supposed to be available at the provincial level, and partners can have access to those modules where available.

Training Conducted by the PNSR in 2011

In 2011, PNSR lead or coordinated the following trainings:
  • PNSR supported the activities of other partners:
    • UNFPA (20 persons trained in the logistics software CHANNEL)
  • PNSR conducted four sessions of training of trainers:
    • Two with the International Rescue Committee (IRC)
    • Two with the International Reproductive Health (IRH)
In total, 73 persons were trained in 2011.

Please see:
2008 PNSR Family Planning Service Provider Training Module

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