Background: A nutritious and healthy diet during pregnancy is essential for the health of both mother and baby. Inadequate dietary intake during pregnancy contributes to maternal malnutrition and can have lifelong effects on the health of the child. Maternal malnutrition is common in many low-income countries, including the Democratic Republic of Congo (DRC). Kwango province, DRC, has a high prevalence of malnutrition among all population groups, including macro and micronutrient deficiencies among pregnant women. The study aimed to explore the dietary knowledge and practices of a pregnant woman in this area. Methods: This study adopted a qualitative approach using in-depth interviews (IDIs) with pregnant women and key informants, and focus group discussions (FGDs) with fathers and grandmothers in the community, to explore women’s knowledge and practice about diet during pregnancy. Data were collected between January and April 2018. IDIs were conducted with pregnant women who were recruited at antenatal clinics during their second and third trimesters. IDIs were undertaken with selected key informants, who were health workers providing care to pregnant women, and included doctors, nurses, nutritionists, and community health workers. All IDIs and FGDs were audio-recorded, transcribed verbatim, and translated to English. The triangulation method and thematic analyses were used. Results: Overall, women showed good general knowledge about nutrition and the need for increased and varied foods during pregnancy, but little technical knowledge about nutrients and sources of nutrition. Healthcare facilities, media, NGOs, and family members were the main sources of nutritional information. However, women were unable to put this knowledge into practice, primarily due to poverty and poor access to a variety of foods. The Popokabaka community accessed food from farming, fishing, and the market, although purchasing food was frequently unaffordable. Cassava flour was the most common daily food. Food taboos, traditional practices, and late ANC attendance were identified as factors that influenced dietary practices. Conclusions: Various social, economic, and environmental factors within the local community influenced dietary practices among pregnant women in rural DRC. A comprehensive approach is required to improve nutrition, and address food insecurity, cultural practices and improve the health outcomes of both mother and child.

Vaccination against COVID-19 has been the main strategy used by most countries to limit the spread of the virus. However, vaccine uptake has been low in Africa, leading to the implementation of several interventions in order to improve vaccine coverage. This study was conducted due to the lack of information about COVID-19 vaccine coverage and the factors associated with vaccine hesitancy. This cross-sectional study was carried out in Kinshasa city using multi-stage random sampling. A total of 2160 households were included in this study. The data were analyzed using Stata 17 software. The means and standard deviations were computed for continuous data that followed a normal distribution, whereas proportions together with their 95% confidence intervals (CIs) were computed for categorical variables. The connections between dependent variables and each independent variable were tested using either Pearson's chi-square test or Fisher's exact test. The logistic regression method was employed to determine the factors that are linked to hesitation in obtaining the COVID-19 immunization. The majority of respondents were aged between 25 and 34 and 35 and 49 (28.9%). During this study, 15% (95% CI [13.25–17.9]) of respondents had received at least one dose of the COVID-19 vaccine. The prevalence of vaccine hesitancy was 67% (CI95%:64.9–69.1). Among the reasons given for refusing to be vaccinated, most respondents cited concerns about the vaccine being unsafe or causing adverse reactions (45%). Among the reasons given for accepting the vaccine, 26% thought that the vaccine prevented superinfection. The factors associated with hesitancy toward the COVID-19 vaccine were female gender, an age of less than 35 years, and living in non-slum households. Despite the interventions implemented across the country, the reluctance to be vaccinated remains a problem; this could lead to poor health outcomes, especially among the elderly and those with pre-existing conditions. It is important to step up awareness-raising campaigns in the community in order to increase the uptake of vaccination.

Introduction: Food insecurity is a vital issue, especially in places such as Kinshasa. Additionally, food insecurity has been worsened by the COVID-19 pandemic, particularly in low- and middle-income countries. Thus, this study examined food insecurity in Kinshasa after the peak of the pandemic to understand the impact of post-pandemic recovery efforts as well as the heterogeneity of this problem according to the residence of respondent (slum vs. non-slum areas). Methods: Grounded in the four key dimensions of food security (availability, access, vulnerability, and utilization), this cross-sectional study was conducted in Kinshasa with a representative sample of 2170 households selected from 62 enumeration areas. We used a questionnaire to interview participants about their food situations. Interviews were conducted with the head of each household or their designated representative by 150 master’s students using tablets powered by the SurveyCTO application. Household food security status was evaluated using the Household Food Insecurity Access Scale. A logistic regression model was developed to assess household risk factors associated with food insecurity. Results: Most people we talked to were over 40 years old, and many lived in households with fewer than six people. About a third of the households were overcrowded. The prevalence of food insecurity was 76.5% (95%CI: 74.6–78.3). Factors associated with food insecurity included being a household head aged over 50 years, insufficient living space, lower socioeconomic status, and residing in slum areas (AOR: 1.38; 95% CI: 1.06–1.79). Conclusions: Vulnerable groups, such as slum residents, older adults, and informal workers are more likely to be affected by food insecurity. Addressing these challenges requires the government to develop targeted strategies that bolster resilience and mitigate household vulnerability during crises.

Several routine immunization (RI) strengthening efforts have been implemented in the Democratic Republic of the Congo (DRC) in the last decade. However, there has been no assessment of national or provincial-level trends in inequalities in RI coverage since the implementation of these programs. In this analysis, we aimed to describe trends in childhood vaccination coverage and inequalities from 2017 to 2023 at the national and provincial levels and to compare these trends among groups of provinces where two initiatives have been in place: the Mashako plan and a provincial level public-private partnership using a memorandum of understanding (MOU) approach. We used population-based surveys including the Multiple Indicator Cluster Survey (MICS) - Palu 2017-2018 survey and four annual vaccination coverage surveys conducted from 2020 through 2023. We described vaccination coverage (three doses of pentavalent vaccine (Penta3) and at least one dose of a measles containing vaccine (MCV1)) and assessed relative and absolute inequalities in vaccination coverage by maternal education and household wealth at each time point. Analyses were conducted at the national level and within two groups of provinces: those initially included in the Mashako plan in 2018 and those initially included in the MOU approach. Inequality estimates were pooled across province groups using a random effects DerSimonian and Laird estimator for meta-analysis. From 2017 to 2023, national Penta3 coverage increased by 9.9 percentage points (47.7 % to 57.6 %) while MCV1 declined by 6.7 percentage points (58.9 % to 52.2 %). As of 2023, substantial wealth and education-related inequalities in childhood vaccination coverage remained: at the national level, children from wealthier households were 2.23 times more likely to receive Penta3 compared to children from poorest households (95 % Confidence Interval (CI) 2.16-2.31). Between 2017 and 2023, absolute and relative wealth-related inequalities appear to have declined, but differences were not statistically significant. Education-related inequalities have improved less than wealth-related inequalities. Though differences were often not statistically significant, reductions in inequalities were generally larger in provinces initially included in the Mashako plan and the MOU approach than in provinces not initially included in either initiative. Initial improvements in coverage and inequality between 2017 and 2020-2021 have largely stagnated at the national and sub-national levels in 2022 and 2023. Efforts remain needed to reach RI coverage and equity targets in the DRC. Routine monitoring of inequalities in RI coverage should be performed regularly to track progress. A more explicit equity focus in RI strengthening initiatives in the DRC may be necessary to accelerate progress in reducing existing inequalities.

Introduction: Food insecurity is a vital issue, especially in places like Kinshasa. Additionally, food insecurity has been worsened by the COVID-19 pandemic, particularly in low- and middle-income countries. Thus, this study examined food insecurity in Kinshasa after the peak of the pandemic to understand food insecurity in post-pandemic recovery efforts and the possible implications for public health policies for future pandemics similar to COVID-19. Methods: This study was conducted in Kinshasa with a representative sample of 2,160 households selected from 36 enumeration areas. We interviewed participants from different areas and used a questionnaire to ask them about their food situation. Interviews were conducted with the head of each household or their designated representative by 150 master’s students using tablets powered by the SurveyCTO application. Household food security status was evaluated through the Household Food Insecurity Access Scale. A logistic regression model was developed to assess household risk factors associated with food insecurity. Results: Most people we talked to were over 40 years old, and many lived in households with fewer than six people. About a third of the households were overcrowded. Factors associated with food insecurity included being a household head aged over 50 years, insufficient living space, lower socioeconomic status, and residing in slum areas (AOR: 1.38; 95% CI: 1.06–1.79). In 2022, 12,627,424 individuals faced food insecurity in Kinshasa, including 8,829,820 individuals who experienced severe food insecurity. Conclusion: Living conditions play a significant role in food insecurity. Governments need to do more to help people, especially those living in crowded areas. To combat economic restrictions that lead to food insecurity during crises, policymakers and implementing partners should enhance food assistance programs, such as cash transfers and food supply initiatives, focusing on overcrowded households and the informal job sector. Key Messages: What is already known on this topic: This study emphasizes the multifaceted nature of food security, defined as the continuous access to sufficient, safe, and nutritious food, comprising availability, accessibility, utilization, and stability. Food insecurity, resulting from unmet needs in any of these dimensions, correlates with poor health outcomes and increased mortality. The global COVID-19 pandemic exacerbated food insecurity, particularly in low- and middle-income countries, with rates exceeding 50%. Factors such as poverty, living conditions, low income, lack of livestock, large household size, and psychological factors contribute significantly. While prior studies in the Democratic Republic of the Congo exist, they are limited, often focusing on specific groups. This study aims to comprehensively assess household food security in Kinshasa during the post-COVID-19 period, identifying associated factors for a more nuanced understanding. What this study adds: This study adds to the existing literature by investigating the prevalence and determinants of food insecurity during a global health crisis, employing the Household Food Insecurity Access Scale for assessment. It contributes novel insights by examining the prevalence and severity of food insecurity in Kinshasa, the Democratic Republic of the Congo, offering a unique context for understanding the impact of a global health crisis on household food security. How this study might affect research, practice, or policy: The study recommends implementing cash transfer strategies for vulnerable households, particularly those with informal jobs and young children, based on significant associations between lower socioeconomic status and food insecurity during the COVID-19 pandemic. Another recommendation is to expand food assistance programs for overcrowded households and the informal job sector, addressing the high prevalence of food insecurity in slum areas. Other social and structural determinants of food security, such as women’s empowerment and access to water and electricity, should be further researched.

BACKGROUNDA nutritious and healthy diet during pregnancy is essential for the health of both mother and baby. Inadequate dietary intake during pregnancy contributes to maternal malnutrition and can have lifelong effects on the health of the child. Maternal malnutrition is common in many low-income countries, including the Democratic Republic of the Congo (DRC). Kwango province, DRC, has a high prevalence of malnutrition among all population groups, including macro and micronutrient deficiencies among pregnant women. The study aimed to explore the dietary knowledge and practices of pregnant woman in this areaMETHODSThis study adopted a qualitative approach using in-depth interviews (IDIs) with pregnant women and key informants, and focus group discussions (FGDs) with fathers and grandmothers in the community, to explore women’s knowledge and practice about diet during pregnancy. Data was collected between January and April 2018. IDIs were conducted with pregnant women who were recruited at antenatal clinics during their second and third trimester. IDIs were undertaken with selected key informants, who were health workers providing care to pregnant women, and included doctors, nurses, nutritionist and community health workers. All IDIs and FGDs were audio-recorded, transcribed verbatim and translated to English. Triangulation method and thematic analyses were used.RESULTSOverall, women showed good general knowledge about nutrition and the need for increased and varied foods during pregnancy, but little technical knowledge about nutrients and sources of nutrition. Healthcare facilities, media, NGOs and family members were the main sources of nutritional information. However, women were unable to put this knowledge into practice, primarily due to poverty and poor access to a variety of foods. The Popokabaka community accessed food from farming, fishing and from the market, although purchasing food was frequently unaffordable. Cassava flour was the most common daily food. Food taboos, traditional practices, and late ANC attendance were identified as factors that influenced dietary practices.CONCLUSIONSVarious social, economic and environmental factors within the local community influenced dietary practices among pregnant women in rural DRC. A comprehensive approach is required to improve nutrition, and address food insecurity, cultural practices and improve health outcomes of both mother and child.