Papers by Félicité Langwana
Research Square (Research Square), Mar 15, 2024
Background The National Expanded Program on Immunization in the Democratic Republic of the Congo ... more Background The National Expanded Program on Immunization in the Democratic Republic of the Congo started using geospatial data at scale in 8 Provinces to strengthen the planning and implementation of vaccination services with a focus on the identi cation and immunization of zero-dose children, children who have not received the rst dose of diphtheria-tetanus-pertussis containing vaccine (DTP1). Methods The study used a mixed-methods research design including survey tools, in-depth interviews and direct observation to document the uptake, use, and perceived impact of georeferenced immunization microplans in the intervention provinces of Haut-Lomami and Kasai and in the control province of Kasai Central. A total of 113 health facilities in 98 Health Areas in 15 Health Zones in the three provinces were included in the study sample. A gender intervention in select Health Zones and Health Areas in Kasai Province was also evaluated through a targeted qualitative study. A secondary analysis of immunization coverage survey data was conducted to assess the associated effects on immunization coverage, especially for rates of zero-dose children. Results This research study shows that georeferenced microplans are well received, utilized, and led to changes in routine immunization service planning and delivery with perceived improvements in identi cation and reaching zero-dose children. In addition, the gender intervention is perceived to have led to a signi cant change in the approaches taken to overcome sociocultural gender norms and engage communities to reach as many children as possible, leveraging the ability of women to engage more effectively to support vaccination services. The quantitative analyses showed that georeferenced microplans may have contributed to a dramatic and sustained trend towards high immunization coverage in the intervention site of Haut Lomami, which rose dramatically from 8.9% in 2020 to 76.8% in 2021 and to 92% in 2022 for Pentavalent 3 antigen, while the DPT1-DPT3 drop-out rate changed little from 1% in 2020 to 1.7% in 2021 and 1.6% in 2022 after three years of implementation. Conclusion The overall study identi ed positive contributions of the georeferenced data in the planning and delivery of routine immunization services. It is recommended to conduct further analyses in Kasai in 2024 and 2025 to evaluate the effects of the gender intervention on immunization coverage and equity outcomes.
Journal of Globalization Studies, Nov 29, 2023
approach. However, we critically explained the reasons why the DRC might find itself in a 'comple... more approach. However, we critically explained the reasons why the DRC might find itself in a 'complex dilemma', based on different learned insights and perspectives gathered and illustrated in numerical illustrations via figures and statistical tables. After analysis and discussion, the results of this paper clearly show that, beyond the different possible imaginations and strategic opportunities offered by the confrontation between the B3W and the BRI following to the 'conservative-progressive competition,' the DRC, like some developing countries, is in the prey of this 'complex dilemma' due to its different assets, weaknesses and problems. This is due to a number of fundamental reasons: its strategic character in the eyes of both 'conservatives' and 'progressives'; its pronounced dependence on both China and the Western world; and its fragility due to problems of leadership and political governance. To conclude, this paper reasoned that it is up to the DRC to prepare and preserve itself and learn from its past mistakes in order to better redefine the fundamental strategic options for its best survival. It is also up to the DRC to reshape its political model, in particular by strengthening its political governance, but above all by working towards the formation of an innovative leadership capable of capitalizing on the opportunities arising from such a confrontationwhile at the same time trying to contain, limit, and even prevent the possible risks.
Contraception and Reproductive Medicine
IntroductionWomen who use contraceptive methods sometimes stop early, use methods intermittently,... more IntroductionWomen who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.MethodsWe conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.ResultsIn total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-...
Open Access Journal of Contraception
To address the high unmet need for postpartum family planning (PPFP) in resourcelimited settings,... more To address the high unmet need for postpartum family planning (PPFP) in resourcelimited settings, particularly in sub-Saharan Africa, this study aimed to identify PPFP-related barriers and catalysts to inform policies and programs to increase access to postpartum contraception. Methods: Using qualitative methodology, we explored the perspectives of women, adolescent girls, men, religious and community leaders, service providers, and decision makers from three rural communities in Burkina Faso and three rural-urban communities in the Democratic Republic of Congo. Both countries have high unmet need for PPFP and are priority countries of the French Muskoka Fund for Maternal and Child Health. Results: Perceived catalysts included negative traditional views on the consequences borne by closely spaced children and their mothers; a 6-week postpartum visit dedicated to PPFP (albeit poorly attended); political will and enabling policies for FP; and support from certain religious leaders and men. Main reported barriers were the lack of male engagement; out-ofpocket copayment for contraceptives; reliance on amenorrhea for pregnancy prevention without knowing its limits; misconceptions about modern contraceptives, including prerequisites for the lactational amenorrhea method; sexual abstinence supported by religious and traditional norms for up to 3-6 months, although women reported earlier resumption of sexual activity; low prioritization of scheduled postpartum visits by women; and limited availability of readily accessible methods, PPFP counseling materials, and clinic days and scheduled visits dedicated to contraceptive services. Conclusion: Based on results found to be most actionable, the following interventions have the potential to optimize access to PPFP services: counseling women on postpartum-pregnancy risks and options at different points in time before and after childbirth through the use of appropriate information, education, and counseling materials; integrating PPFP services into existing maternal and child health visits; making contraceptives readily available and affordable; and meaningfully engaging male partners.
BMC Women's Health
Background: The YAM DAABO study ("your choice" in Mooré) takes place in Burkina Faso and the Demo... more Background: The YAM DAABO study ("your choice" in Mooré) takes place in Burkina Faso and the Democratic Republic of Congo. It has the objective to identify a package of postpartum family planning (PPFP) interventions to strengthen primary healthcare services and determine its effectiveness on contraceptive uptake during the first year postpartum. This article presents the process of identifying the PPFP interventions and its detailed contents. Methods: Based on participatory action research principles, we adopted an inclusive process with two complementary approaches: a bottom-up formative approach and a circular reflective approach, both of which involved a wide range of stakeholders. For the bottom-up component, we worked in each country in three formative sites and used qualitative methods to identify barriers and catalysts to PPFP uptake. The results informed the package design which occurred during the circular reflective approacha research workshop gathering service providers, members of both country research teams, and the WHO coordination team. Results: As barriers and catalysts were found to be similar in both countries and with the view to scaling up our strategy to other comparable settings, we identified a common package of six low-cost, low-technology, and easilyscalable interventions that addressed the main service delivery obstacles related to PPFP: (1) refresher training of service providers, (2) regularly scheduled and strengthened supportive supervision of service providers, (3) enhanced availability of services 7 days a week, (4) a counseling tool, (5) appointment cards for women, and (6) invitation letters for partners. Conclusions: Our research strategy assumes that postpartum contraceptive uptake can be increased by supporting providers, enhancing the availability of services, and engaging women and their partners. The package does not promote any modern contraceptive method over another but prioritizes the importance of women's right to information and choice regarding postpartum fertility options. The effectiveness of the package will be studied in the experimental phase. If found to be effective, this intervention package may be relevant to and scalable in other parts of Burkina Faso and the DRC, and possibly other Sub-Saharan countries.
Patient education and counseling, Oct 2, 2018
Postpartum family planning (PPFP) is essential for maternal and newborn health but is often not s... more Postpartum family planning (PPFP) is essential for maternal and newborn health but is often not systematically addressed before or after childbirth. This article describes the development and field-testing of a PPFP counseling tool to support providers and women. Participatory action research involving women, men, providers, policymakers, researchers, and contraceptive experts from Burkina Faso and the Democratic Republic of Congo. The tool consists of an A4-size flipchart with illustrations on the client side and clinical information and counseling tips on the provider side, and can be used during visits of the antenatal-delivery-postnatal care continuum. Qualitative results suggest that the tool is easily understandable, user-friendly, relevant, and useful with regard to providing PPFP information to clients, and respectful of clients' rights and choices. It may have a positive influence on clients' attitudes towards PPFP and their decision to use contraception. The tool h...
The Lancet. Global health, 2020
BACKGROUND In rural Burkina Faso, a package of six low-technology, post-partum contraceptive inte... more BACKGROUND In rural Burkina Faso, a package of six low-technology, post-partum contraceptive interventions (ie, refresher training for providers, a counselling tool, supportive supervision, daily availability of contraceptive services, client appointment cards, and invitation letters to attend appointments for partners), aimed at strengthening existing primary health-care services and enhancing demand for them, doubled the use of modern contraceptives at 12 months post partum (ie, 55% uptake in intervention recipients vs 29% in routine-care users). This study assessed the effect of a similar package but in urban settings of Kinshasa province, Democratic Republic of the Congo, in an effort to reduce the unmet need for post-partum family planning. METHODS Yam Daabo was a multi-intervention, single-blinded, cluster-randomised controlled trial done in six primary health-care centres (clusters) in Kinshasa. Centres were randomly allocated to receive the six-component intervention or stan...
Drafts by Félicité Langwana
by Benjamin Mwadi Makengo, Joseph Mimbale, Gracien Mwadi Kapita, ESPOIR L U K A U MATEZO, scheel mutombo, CHRISTEL MPONGO NZIAZI, Willy Kalala Kankonde, Félicité Langwana, Patience Kamanda, Théo-Macaire Kaminar, Patrice Mukulu Nduku Bénis, Patrice Mukulu Nduku Bénis, Richard Kakesa, Jean-Marie Mbutamuntu, and Germain Kuna Maba Mambuku Preprint, 2022
This article seeks to explain why the confrontation between the "Build Back Better World" [B3W] v... more This article seeks to explain why the confrontation between the "Build Back Better World" [B3W] versus the "Belt and Road Initiative" [BRI] might well place Democratic Republic of Congo (DRC), as the case for many other developing countries, in a "complex dilemma". The latter is understood here as a situation in which, faced with a choice between two paths to follow, it appears not only difficult to go in one direction against the other, but also to manage to balance the two at the same time, without taking a position [neutrality or third path] and without creating pronounced imbalances between the blocks of the "conservatives" and the "progressives"represented here respectively by the United States and China. The complexity of this dilemma is viewed in the strategic choice to be made and the possible costs in the aftermath of its choice for its survival. By using secondary data extracted from international and national sources, the methodology used in the elaboration of this document is essentially qualitative, based on the strategic analytical approach. However, we privileged not only purely theoretical analyses explaining the reasons for this "complex dilemma", but also numerical illustrations via figures and statistical tables. After analysis and discussion, the results that emerge from this paper clearly show that beyond the different possible opportunities presented by the confrontation between B3W and BRI following to the "conservative-progressive competition", due to its different assets, weaknesses and problems, DRC-as the case for certain developing countries, is in the prey of this "complex dilemma". This is due to a number of fundamental reasons: its strategic character in the eyes of both "conservatives" and "progressives"; its pronounced dependence on both China and the Western world; and its fragility due to problems of leadership and political governance. To conclude, this paper reasoned that it is up to DRC to prepare, preserve itself and learn from its past mistakes in order to better define the fundamental strategic options for its best survival. It is also up to DRC to reshape its political model, in particular by strengthening its political governance, but above all by working towards the formation of an innovative leadership capable of capitalizing on the opportunities arising from such a confrontation-all the while trying to contain, limit, and even prevent the possible risks.
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Papers by Félicité Langwana
Drafts by Félicité Langwana