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Case Study

Vitamin Angels Increases Coverage in the Democratic Republic of Congo

Vitamin Angels partners with the national government and local organizations to improve nutrition policy and expand service delivery of vitamin A supplementation, deworming treatment, and UNIMMAP MMS.

Published: April 2023

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Our Annual Reach in THE DRC*

Pregnant Women & Babies

600,000 with UNIMMAP MMS

Children Under 5

12.4 million with vitamin A and deworming treatment

Extensive Coverage

100 partners across 19 of 26 provinces

*Reach is based on Vitamin Angels’ shipments that were largely distributed in 2023.

Our Team

  • Mulamba Diese, MD, PhD, Senior Program Manager DRC
  • Davidson Mamboleo, MD, Program Coordinator
  • Molly Russ, MPH, Senior Program Officer, Africa

A Confluence of challenges

In the DRC, the fragmented health system, lack of resources, poor infrastructure, difficult geography, and ongoing conflict, result in an inequitable distribution of critical health and nutrition services.

Public Health Challenges

CHILD HEALTH

1 in 10 children die before reaching age 5, and 6 million children suffer from undernutrition or stunting.[i]

MATERNAL HEALTH

42% of women of childbearing age are anemic, and there is a high maternal mortality rate of 437 per 100,000 live births.[ii]

Since 2015, Vitamin Angels has worked with the national government and a growing number of local organizations to increase coverage among low-resource populations nationwide.

Vitamin Angels is building capacity and expanding coverage of essential nutrition interventions

Together with the government and local organizations, we are reaching pregnant women, infants, and young children across the DRC in underserved communities. These communities include rural and indigenous populations, those living in urban slums, internally displaced populations, and refugees from neighboring countries.

Today, Vitamin Angels works with more than 100 program partners, in 19 of the 26 provinces across the DRC, providing life-saving vitamin A supplementation and deworming (VAS+D) for children under five years of age, and UNIMMAP MMS for pregnant women (United Nations International Multiple Micronutrient Antenatal Preparation, Multiple Micronutrient Supplements: a specific formulation of the supplement commonly known as prenatal vitamins and minerals). In 2021, Vitamin Angels and its partners provided UNIMMAP MMS to over 600,000 pregnant women, and VAS+D to 12.4 million children under five.

By partnering with the government at the national, provincial, and local levels, and providing trusted non-governmental organizations (NGOs) with advisory services and technical assistance, Vitamin Angels helps build an enabling environment for improved nutrition policy and service delivery while increasing the availability of and demand for vital nutrition interventions.

Country Overview

Located in Central Africa, The Democratic Republic of Congo (DRC) is the largest country in Sub-Saharan Africa.[iii] It is home to the 14th largest population in the world at about 102 million people.[iv]

Building MMS Demand Through Advocacy and Capacity Building

When Vitamin Angels began working in the DRC, the Ministry of Health had an existing MMS policy but lacked the resources for implementation. To help move from policy to practice, Vitamin Angels conducted a landscape analysis in partnership with the government to better understand the current antenatal care system and paths to improve service delivery for communities most in need. Following this analysis, Vitamin Angels partnered with the Ministry of Health to convene and facilitate a workshop that brought together key stakeholders working on nutrition, including governmental institutions, UN agencies, and NGOs. These groups agreed to update existing antenatal care guidelines to include MMS, strengthen the MMS supply chain, and conduct implementation research to ensure MMS programming is data-driven, context-specific, scalable, and effective.

At the community level, Vitamin Angels provides resources and skills training courses to service providers. Program partners highly value these critical learning opportunities, sometimes sending representatives many miles on foot or motorbike to attend. Vitamin Angels also worked to address barriers, including a lack of awareness of nutrition services and misunderstandings about nutrition interventions and practices. Using a variety of communication methods that are trusted sources of health information and news, including the radio, Vitamin Angels and its partners share important health announcements with hard-to-reach, remote communities.

The program is paying off, with community-driven demand for MMS growing rapidly in the DRC. In 2021 Vitamin Angels reached 600,000 pregnant women with MMS products, with demand exceeding Vitamin Angels’ supply.

Overcoming Extreme Poverty

Though rich in natural resources, the Democratic Republic of Congo (DRC) is one of the poorest countries in the world, with more than 70% living on less than $1.90 a day.[v]

Mulamba Diese, MD

We must make sure that the health of pregnant women is taken care of. So, we continue to improve and also extend and scale up this program to increase the coverage, especially for MMS. My hope for my community is to see more people accessing this service. And slowly but surely, the country will experience all the benefits of improved nutrition.”

Mulamba Diese, MD, PhD, Senior Program Manager DRC

Expanding coverage in underserved areas through local partnerships

In some cases, Vitamin Angels and their local partners are the only service providers in certain communities, in large part due to insecurity, poor transportation systems, and the high cost of reaching those areas. Ongoing violence perpetrated by approximately 120 rival armed groups plagues eastern Congo.[vi] But women and children in these areas still need critical care and services.

In areas of high insecurity, including the Fizi territory, Beni, and the Ituri Province, partnership with local groups is essential. In these areas, Vitamin Angels worked with local, neutral NGOs with in-depth knowledge of the areas to bring VAS+D and MMS to pregnant women and children. Their knowledge of the areas and relationships with the local populations allowed them to provide security and navigate the complex logistical task of getting products to these communities. Vitamin Angels worked with a local logistics and transport group that is one of just a few willing and able to move goods throughout the country. The DRC has many rivers and a poor network of roads and bridges, so moving the products often requires a combination of aircraft, trucks, boats, and motorbikes.

Vitamin Angels is continuing to support the government as it moves through the phases of implementation research to build and scale up effective nutrition programming throughout the DRC, including initiating a study to explore community-driven MMS and VAS+D distribution via Village Health Volunteers. Currently, Vitamin Angels is conducting a coverage study to
evaluate how its work in the DRC with program partners is addressing coverage gaps supporting the most vulnerable people and communities.

Our Continuing Efforts

Vitamin Angels is working to create an environment for improved nutrition policy and service delivery by building consensus among policymakers, training and supporting our partners, and identifying and reducing barriers.