[PPT] - DRC SURVEY: An Overview of Demographics, Infrastructure, Health, PowerPoint Presentation

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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

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 Introduction  Methodology  Findings

Demographics & Infrastructure
Health System & Outcomes
Financial Wellbeing

 Conclusion Agenda

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Agenda

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Introduction

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฀ 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 Contextual Review

Introduction

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฀ 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

utcomes

฀ In 2015, World Bank granted $45 million to strengthen National Statistical System to support accurate and accessible data

Contextual Review – Data Concerns

Introduction

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Added Complication: New Province Boundaries

Introduction

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 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

START Team Work Order & Deliverables

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Work Order

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Methodology

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Project Overview

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Methodology

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฀ 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 Sources & Database

Methodology

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Screenshot DRC Documents Database

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Primary Findings

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Trends and indicators will be highlighted across the three main thematic areas

Thematic Areas

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Primary Findings

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Demographics & Infrastructure Health System & Outcomes Financial Well-Being

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Primary Findings: Demographics & Infrastructure

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Demographics

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Demographics & Infrastructure

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Figure Source: CIA Factbook

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Demographics: Education of Girls

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Data source: DRC-DHS Survey 2013-2014, 1: Statistics associated with prior provincial boundaries.

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%). 1

28.4% 75.4% % girls with incomplete primary education Demographics & Infrastructure

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Demographics: Modern Contraception

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Demographics & Infrastructure

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Overall, 8% of married women in DRC report use of modern contraception method, ranging from a low

f 4-5% in central areas compared to 19% in Kinshasa. 1

Data source: DRC-DHS Survey 2013-2014, 1: Statistics associated with prior provincial boundaries.

3.9% 19.0% % married women using modern contraception

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Demographics: Fertility Rate

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Demographics & Infrastructure

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Data source: DRC-DHS Survey 2013-2014, 1: Statistics associated with prior provincial boundaries.

4.2 8.2 Average children/woman

DRC has an overall fertility rate of 6.6 children per woman, however the rate varies through the country. (range: 4.2-8.2 children/woman) 1

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Infrastructure: Electricity, Water, & Sanitation

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Demographics & Infrastructure

03/14/17 Data source: DRC-DHS Survey 2013-2014

42% 85% 21% 0.40% 32% 17% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Electricity Improved Water Source Improved Sanitation Facilities

UTILITIES

Urban Households Rural Households

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Infrastructure: Information & Communication Technology

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Demographics & Infrastructure

Data source: World Bank World Development Indicators

Mobile phone subscriptions 53 (2015) Internet Users 3.8 (2015)

10 20 30 40 50 60

Per 100 people

MOBILE PHONE & INTERNET ACCESS

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Infrastructure: Transportation

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Demographics & Infrastructure

03/14/17 Source: Map No. 4007 Rev. 11 United Nations, May 2016

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Primary Findings: Health System & Outcomes

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Health Service Delivery

Health System & Outcomes

Source: Muyembe et al. 2013.

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Key Health System Challenges

Health System & Outcomes

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

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฀ 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 Health Challenges: Outbreaks & Non-Communicable Diseases (NCDs)

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Health System & Outcomes

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Mortality Trends 1990-2015: The Rise of NCDs

Health System & Outcomes

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Source: IHME 2015

NTDs and Malaria Neonatal Disorders Nutritional Deficiencies Cardiovascular Diseases Neoplasms Diabetes Chronic Respiratory Diseases Maternal Disorders

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Almost half of the deaths in the

country are children under age 5

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

Under-Five Mortality: Indicative of Health System Challenges

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Health System & Outcomes U5M in Central Africa and Great Lakes Countries

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Nutrition Challenges – Particularly for Women & Children

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Source: 2013 DHS

DRC Urban Rural Children under age five who are stunted (%) 43 33 47 Children under age five who are wasted (%) 8 5 9 Children under age five who are underweight (%) 23 14 26 Children age 6-59 months who are anemic (%) 60 59 60 Women age 15-49 who are anemic (%) 38 41 37 Men age 15-49 who are anemic (%) 23 21 24

Health System & Outcomes

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Financial Wellbeing

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Focus Areas

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

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Banking System

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

Low infrastructure

coverage

Lack of regulation

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Banking System: Remains Small and Underdeveloped

Financial Wellbeing

Sources: IMF, World Bank, Central Banks, European Investment Bank, 2013 03/14/17 31

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Mobile Money

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

Lagging adoption

despite rising mobile phone subscription

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Mobile Money: Increasing Usage but with Bottlenecks

Financial Wellbeing

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Credit Services

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

High growth
Remains a scarce,

expensive, and highly concentrated resource

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Credit Services: Less Reliance on Formal Institutions

Financial Wellbeing

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5 10 15 20 25 30 35

A financial institution A private lender An employer A family or friend Store credit Percentage of those who reported using credit

Source: Demirguc-Kunt and Klapper 2012

Sources of Credit in the DRC

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Microfinance

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

Lack of regulation

and supervision

Not profitable or

sustainable

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Financial Wellbeing

143 Institutions 208 Branches

Source: IMF, as of end 2012 Source: World Bank 03/14/17 37

Microfinance: Rapid Recent Growth

1 million

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Microfinance: Risk Mitigation

Financial Wellbeing

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Overview

Financial Wellbeing

Economic Overview

Banking System Mobile Money Microfinance Credit Services

Low infrastructure

coverage

Lack of regulation
Lagging adoption

despite rising mobile phone subscription

High growth
Remains a scarce,

expensive, and highly concentrated resource

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Lack of regulation

and supervision

Not profitable or

sustainable

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Access to Financial Services by Gender

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Financial Wellbeing

7.43 0.15 0.99 1.41 2.1 0.9 2.09 11 0.99 2.93 5.98 3.27 2.89 4.55

M OBI L E ACCOUNT M OBI L E ACCOUNT US E D TO P AY BI L L S M OBI L E ACCOUNT US E D TO S E ND M ONE Y US E D AN ACCOUNT TO RE CE I V E W AGE S US E D I NTE RNE T TO P AY BI L L S OR M AKE P URCHAS E S US E D AN ACCOUNT TO M AKE TRANS AC TI ONS V I A A M OBI L E P HONE DE BI T CARD I N OW N NAM E

ACCESS TO FINANCIAL SERVICES IN DRC

Female ( percent aged 15+) Male (percent aged 15+)

Source: Gender Stats Database, WDI, 2014

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Conclusion

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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

Promising Trends

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Conclusion

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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.

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Thank you

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Appendix

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DRC Health Zones

Appendix

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