- Marked disparities in MNH working conditions by sex, age, and professional cadre in North and South Kivu.
- Female providers face fewer promotions, limited continuing professional development, and higher workplace and personal discrimination than male counterparts.
- Younger staff report more patient violence and fewer salary supplements; doctors receive more non-monetary incentives such as leave and uniforms.
Int J Womens Health. 2026 Jul 30;18:621089. doi: 10.2147/IJWH.S621089. eCollection 2026.
ABSTRACT
BACKGROUND: Maternal and neonatal health (MNH) indicators remain poor in the Democratic Republic of Congo (DRC), despite the high rates of facility-based childbirth. Working conditions of MNH providers, particularly in conflict-affected eastern DRC, remain poorly documented. This study examines disparities in working conditions among MNH providers in North and South Kivu by sex, age, and professional category.
METHODOLOGY: A cross-sectional survey was conducted among MNH providers in 28 health facilities across North Kivu (October 2023) and South Kivu (February 2023). A structured questionnaire collected information on working conditions, compensation, professional development and workplace violence. Data were entered into RedCap and analyzed using Stata 17. Differences by sex, age, and professional cadre (nurses/midwives vs medical doctors) were assessed through bivariate comparison analysis, with statistical significance set at p<0.05.
RESULTS: A total of 220 MNH providers participated (116 in North Kivu, 104 in South Kivu), 76% were women, the median age was 38.5 years and 79% were nurses/midwives. Women experienced fewer promotion opportunities (p = 0.001), limited access to continuing professional development (p = 0.029), and higher levels of workplace (p = 0.038) and personal-life discrimination (p = 0.019) than men. Men experienced more verbal or physical aggression from patients or their relatives. Providers younger than 35 years reported more patient-related aggression (p = 0.021) and fewer salary supplements (p = 0.015). Doctors were more likely than nurses to receive non-monetary incentives, including leave and uniforms.
CONCLUSION: Significant disparities in working conditions exist by sex, age, and professional cadre among MNH providers in eastern DRC. Equity-oriented human resource policies that strengthen professional development, workplace protection, and staff welfare are needed to improve provider well-being and quality of maternal and neonatal care in conflict-affected settings.
PMID:42549288 | PMC:PMC13431457 | DOI:10.2147/IJWH.S621089
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