Advocacy as a Tool for Advancing Family Planning in the Democratic Republic of the Congo: A Case Study.

The national strategic plan for family planning (FP) in the Democratic Republic of the Congo (DRC) calls for an increase in modern contraceptive prevalence in 2025. The DRC's size and weak health infrastructure pose significant challenges to programming in all areas of primary health care, including FP. Notwithstanding, in the past decade, a group of advocates organized to undertake a series of activities to improve the policy environment for FP in the DRC. We outline the 4 major accomplishments to date: revitalizing a multisectoral FP stakeholder group at the national and provincial levels, obtaining the repeal of the Law of 1920 in the form of a new Public Health Law passed in 2018, soliciting public statements favorable to FP from political figures including 2 presidents, and securing the disbursement of government funds for the purchase of contraceptives. We reveal the work behind the scenes needed to obtain these advocacy wins. Given that the field of advocacy does not lend itself to rigorous evaluation using randomized trials or quasi-experimental design, it is important to document and analyze how such advocacy wins can be attained.

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

CONTEXT: Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. METHODS: Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. RESULTS: Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. CONCLUSIONS: Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.