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CASE STUDY

National government and local organizations partner with Vitamin Angels to increase VAS+D and MMS coverage in the Democratic Republic of Congo

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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.[i]

Many challenges, including a fragmented health system, lack of resources, poor infrastructure, difficult geography, and ongoing conflict, result in an inequitable distribution of critical health and nutrition services. As a result, 1 in 10 children die before reaching age five, and six million children suffer from undernutrition or stunting.[ii] Additionally, there is a high prevalence of undernutrition and anemia among pregnant women, and a high maternal mortality rate of 473 per 100,000 live births.[iii]

In 2015, Vitamin Angels began collaborating with the government and local organizations in the DRC to build capacity and expand coverage of essential nutrition interventions to pregnant women, infants, and young children in underserved communities. This includes 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.

Infographic titled "Malnutrition in the Democratic Republic of Congo (DRC)" with statistics about infant and mother health in the DRC.

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.

Joseph Musangu, Vitaimin Angels facilitator and VAS+D distributor.

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.[iv] 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.