Continued high maternal and perinatal mortality in cities in sub-Saharan Africa is an excellent example of a “complex and intractable” problem in healthcare. It is happening despite increasing availability of resources and health facilities, and relatively short geographic distances between women and health facilities. There are many factors contributing to the eco-system of maternal health in cities beyond healthcare provision; including infrastructure, security, national policies, and international financing and global health priorities. The effects of the many factors at play are subtle, frequently unappreciated and unmeasured, and non-linear. To improve the survival and wellbeing of pregnant women and their babies, we urgently need a model of how these various meso and macro factors operate and interact. Such model predicting maternal and perinatal mortality would enable a rapid and accurate assessment and comparison of various potential interventions. Looking for the maps of health facilities for the health zones in Lubumbashi? You can find them here in this link.

The main ambition of this project is to develop a city-wide model of the dynamics of maternal healthcare to inform strategies for improving urban maternal health in Lubumbashi, the Democratic REpublic of the Congo (DRC). The ground-breaking nature of this study is the extensive capture and analysis of the three main dimensions contributing to this model: i.) maternal health service provision by the health system, ii.) maternal healthcare use by women and iii.) the complex, non-linear interactions between the provision and use of care within the spatial, social and political eco-system of a city. The main focus of this inquiry is care during labour and childbirth, which is the predominant contributor to poor maternal and perinatal health.