DRC SURVEY: An Overview of Demographics, Infrastructure, Health, and Financial Services in the Democratic Republic of Congo

Transcription

1 3/14/17 DRC SURVEY: An Overview of Demographics, Infrastructure, Health, and Financial Services in the Democratic Republic of Congo Naughton B, Abramson R, Wang A, Kwan-Gett T

2 Agenda Agenda Introduction Methodology Findings Demographics & Infrastructure Health System & Outcomes Financial Wellbeing Conclusion 03/14/17 2

3 Introduction 03/14/17 3

4 Introduction Contextual Review Challenges: Violence and instability Nearly collapsed & overburdened health system Crippled infrastructure Humanitarian crises Persistent conflict particularly in Eastern region There are promising trends however, and further targeted investments could have a large and lasting impact 03/14/17 4

5 Introduction Contextual Review Data Concerns Data quality has been questioned in the literature Concerns anecdotally corroborated by experts at UW, PATH, and IHME Particular skepticism of government-produced statistics on health sector outcomes In 2015, World Bank granted $45 million to strengthen National Statistical System to support accurate and accessible data 03/14/17 5

6 Introduction Added Complication: New Province Boundaries 03/14/17 6

7 Work Order START Team Work Order & Deliverables Identify trends and indicators across DRC including demographics, infrastructure, health outcomes, and financial well-being Deliverables: Summary report Presentation All sources used Editable database that can be updated 03/14/17 7

8 Methodology 03/14/17 8

9 Methodology Project Overview 03/14/17 9

10 Methodology Sources & Database All sources are stored and organized according to theme with a common naming system for easy access The editable database can be updated over time, and identifies both referenced and un-referenced sources for each theme Screenshot DRC Documents Database 03/14/17 10

11 Primary Findings 03/14/17 11

12 Primary Findings Thematic Areas Trends and indicators will be highlighted across the three main thematic areas Demographics & Infrastructure Health System & Outcomes Financial Well-Being 03/14/17 12

13 Primary Findings: Demographics & Infrastructure 03/14/17 13

14 Demographics & Infrastructure Demographics Figure Source: CIA Factbook 03/14/17 14

15 Demographics & Infrastructure Demographics: Education of Girls Overall, an estimated 52% of girls in DRC have less than a complete primary education, however the figure ranges dramatically among provinces (28.4%-75.4%) % 75.4% Data source: DRC-DHS Survey , 1: Statistics associated with prior provincial boundaries. % girls with incomplete primary education 03/14/17 15

16 Demographics & Infrastructure Demographics: Modern Contraception Overall, 8% of married women in DRC report use of modern contraception method, ranging from a low of 4-5% in central areas compared to 19% in Kinshasa % 19.0% Data source: DRC-DHS Survey , 1: Statistics associated with prior provincial boundaries. % married women using modern contraception 03/14/17 16

17 Demographics & Infrastructure Demographics: Fertility Rate DRC has an overall fertility rate of 6.6 children per woman, however the rate varies through the country. (range: children/woman) Data source: DRC-DHS Survey , 1: Statistics associated with prior provincial boundaries. Average children/woman 03/14/17 17

18 Demographics & Infrastructure Infrastructure: Electricity, Water, & Sanitation 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 42% 0.40% UTILITIES 85% 32% Urban Households Rural Households 21% 17% Electricity Improved Water Source Improved Sanitation Facilities Data source: DRC-DHS Survey /14/17 18

19 Demographics & Infrastructure Infrastructure: Information & Communication Technology Per 100 people MOBILE PHONE & INTERNET ACCESS Mobile phone subscriptions 53 (2015) Internet Users 3.8 (2015) Data source: World Bank World Development Indicators 03/14/17 19

20 Demographics & Infrastructure Infrastructure: Transportation Source: Map No Rev. 11 United Nations, May /14/17 20

21 Primary Findings: Health System & Outcomes 03/14/17 21

22 Health System & Outcomes Health Service Delivery Source: Muyembe et al /14/17 22

23 Health System & Outcomes Key Health System Challenges Little Accountability Leads to poor planning, implementation, corruption Fragmentation of Health Services Disparate and disconnected providers Weak Supply Chain Parallel systems and stock outs Health Workforce Inconsistent salaries, poor training User Fees Unpredictable and unregulated End-User Challenges Patients presenting with advanced disease 03/14/17 23

24 Health System & Outcomes Health Challenges: Outbreaks & Non-Communicable Diseases (NCDs) Infectious disease outbreaks are recurring and detrimental In particular: malaria, TB, measles, yellow fever, and cholera Weak/non-existent surveillance systems Poor laboratory capability Fragmented and inconsistent roll-out of systematic vaccinations NCDs are rising with epidemiological transition Increasing rates of NCDs are being identified Increasing reports of complications related to hypertension, including stroke and chronic kidney disease 03/14/17 24

25 Health System & Outcomes Mortality Trends : The Rise of NCDs NTDs and Malaria Neonatal Disorders Nutritional Deficiencies Cardiovascular Diseases Neoplasms Diabetes Chronic Respiratory Diseases Maternal Disorders Source: IHME /14/17 25

26 Health System & Outcomes Under-Five Mortality: Indicative of Health System Challenges Almost half of the deaths in the country are children under age 5 U5M in Central Africa and Great Lakes Countries Diarrhea, acute lower respiratory infections and malaria account for more than 50% of the deaths of children under five in the country Stark differences rural to urban Children from urban areas 2x as likely to be immunized than those in rural areas 03/14/17 26

27 Health System & Outcomes Nutrition Challenges Particularly for Women & Children DRC Urban Rural Children under age five who are stunted (%) Children under age five who are wasted (%) Children under age five who are underweight (%) Children age 6-59 months who are anemic (%) Women age who are anemic (%) Men age who are anemic (%) Source: 2013 DHS 03/14/17 27

28 Financial Wellbeing 03/14/17 28

29 Financial Wellbeing Focus Areas Microfinance Banking System Economic Overview Credit Services Mobile Money 03/14/17 29

30 Financial Wellbeing Banking System Low infrastructure coverage Lack of regulation Microfinance Banking System Economic Overview Credit Services Mobile Money 03/14/17 30

31 Financial Wellbeing Banking System: Remains Small and Underdeveloped Sources: IMF, World Bank, Central Banks, European Investment Bank, /14/17 31

32 Financial Wellbeing Mobile Money Microfinance Banking System Economic Overview Credit Services Lagging adoption despite rising mobile phone subscription Mobile Money 03/14/17 32

33 Financial Wellbeing Mobile Money: Increasing Usage but with Bottlenecks 03/14/17 33

34 Financial Wellbeing Credit Services Microfinance Banking System Economic Overview Credit Services Mobile Money High growth Remains a scarce, expensive, and highly concentrated resource 03/14/17 34

35 Financial Wellbeing Credit Services: Less Reliance on Formal Institutions Sources of Credit in the DRC Percentage of those who reported using credit A financial institution A private lender An employer A family or friend Store credit Source: Demirguc-Kunt and Klapper /14/17 35

36 Financial Wellbeing Microfinance Microfinance Lack of regulation and supervision Not profitable or sustainable Banking System Economic Overview Credit Services Mobile Money 03/14/17 36

37 Financial Wellbeing Microfinance: Rapid Recent Growth 1 million 143 Institutions 208 Branches Source: IMF, as of end 2012 Source: World Bank 03/14/17 37

38 Financial Wellbeing Microfinance: Risk Mitigation 03/14/17 38

39 Financial Wellbeing Overview Low infrastructure coverage Lack of regulation Microfinance Lack of regulation and supervision Not profitable or sustainable Banking System Economic Overview Credit Services Lagging adoption despite rising mobile phone subscription Mobile Money High growth Remains a scarce, expensive, and highly concentrated resource 03/14/17 39

40 Financial Wellbeing Access to Financial Services by Gender ACCESS TO FINANCIAL SERVICES IN DRC Female ( percent aged 15+) Male (percent aged 15+) DEBIT CARD IN OWN NAME USED AN ACCOUNT TO MAKE TRANSACTIONS VIA A MOBILE PHONE USED INTERNET TO PAY BILLS OR MAKE PURCHASES USED AN ACCOUNT TO RECEIVE WAGES MOBILE ACCOUNT USED TO SEND MONEY MOBILE ACCOUNT USED TO PAY BILLS MOBILE ACCOUNT Source: Gender Stats Database, WDI, /14/17 40

41 Conclusion 03/14/17 41

42 Conclusion Promising Trends Mortality rates have been falling Life expectancy has been increasing Economic recovery is expected to start in 2017 Financing for government investments is increasing Further investments targeted at the key catalysts of development will be crucial for health, financial, and physical security 03/14/17 42

43 Conclusion Though the DRC still ranks near the bottom of most global indicators, identifying trends and ongoing challenges could reveal opportunities for partnerships and innovative programs that lead towards the ultimate goals of improved governance, better health, and greater financial wellbeing. 03/14/17 43

44 Thank you 03/14/17 44

45 Appendix Appendix 03/14/17 45

46 Appendix DRC Health Zones 03/14/17 46