Development of an integrated community-based tool for reproductive health monitoring: a sequential mixed-methods participatory study with local stakeholders in the health zone of N’djili, Democratic Republic of the Congo
DOI:
https://doi.org/10.51168/je4rgn18Keywords:
Reproductive Autonomy, Community Monitoring, Contraceptive Methods, Community Participation, Mixed Methods, N’DjiliAbstract
Background:
Reproductive autonomy and responsive contraceptive follow-up remain important public health concerns in the Democratic Republic of Congo (DRC). In N’djili Health Zone, routine monitoring mainly relies on aggregate indicators and provides limited documentation of women’s experiences, perceived side effects, and community preferences.
Objective:
To co-develop an integrated community-based reproductive health monitoring tool with women, health providers, community actors, and local stakeholders in N’djili.
Methods:
A sequential mixed-methods participatory community-based study was conducted in N’djili Health Zone. The quantitative component included 400 women aged 15–49 years selected by stratified sampling; the qualitative component included 15 purposively selected participants interviewed until information saturation. Data were collected using a structured questionnaire, semi-structured interviews, community observation, participatory workshops, and reproductive-health monitoring records. Quantitative data were analysed descriptively using frequencies and percentages, while qualitative data underwent inductive thematic analysis. Standardized procedures, interviewer training, triangulation, double coding, member checking, and confidentiality procedures were used to reduce potential bias. Missing quantitative data were identified during data cleaning and reported as missing when not sufficiently complete for analysis.
Results:
Among 400 women, 51.0% were aged 20–29 years, 48.0% had secondary education, and 70.0% were married or in a common-law union. Perceived contraceptive side effects were reported by 200 women (50.0%). Regarding willingness to participate in the proposed tool, 134 women (33.5%) answered “yes”, 133 (33.3%) “no”, and 133 (33.3%) “maybe”. Qualitative findings highlighted sociocultural and religious influences, preferences for trusted and accessible advisors, and expectations regarding understandable information, confidentiality, local-language accessibility, and community-leader involvement.
Conclusion and Recommendations:
The participatory process identified locally relevant requirements for an integrated monitoring tool. Future implementation should combine community dialogue, confidential reporting, provider referral, and clearly defined clinical or biological monitoring components. Further evaluation is needed before assessing effectiveness or generalizability beyond N’Djili.
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Copyright (c) 2026 Bertine Mbongopasi Ekeni, Gérard Eloko Eya Matangelo, Emmanuel Kitete Mulongo, Koto-Te- Nyiwa Ngbolua, Baholy Robijaona Rahelivololoniaina
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