ORIGINAL RESEARCH article

Front. Health Serv.

Sec. Health Policy and Management

Volume 5 - 2025 | doi: 10.3389/frhs.2025.1551131

This article is part of the Research TopicPerspectives and Opinions in Health Services, Volume IIView all 10 articles

Challenges and strategies for maintaining Nutrition Services in the Democratic Republic of Congo during COVID-19: A Qualitative Study

Provisionally accepted
Marc  BosonkieMarc Bosonkie1*Benito  KazenzaBenito Kazenza1Rawlance  NdejjoRawlance Ndejjo2Marie-Claire  MuyerMarie-Claire Muyer1Eric  MafutaEric Mafuta1Ruphin  MbuyiRuphin Mbuyi3Branly  MbungaBranly Mbunga1Paul-Samsom  LusambaPaul-Samsom Lusamba1Olufunmilayo  I FawoleOlufunmilayo I Fawole4Mala  Ali MapatanoMala Ali Mapatano1
  • 1University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • 2Makerere University, Kampala, Central Region, Uganda
  • 3Centre National d'Appui au Développement et à la Participation Populaire, Kinshasa, Democratic Republic of Congo
  • 4University of Ibadan, Ibadan, Oyo, Nigeria

The final, formatted version of the article will be published soon.

Background: The rapid spread of COVID-19 forced governments to urgently implement non-pharmaceutical measures to stop the surge. These restrictions disrupted the provision of nutrition services. This study identified challenges faced by nutrition services using the six components of the health system and preventive strategies that can strengthen nutrition interventions during future outbreaks.Methods: A multiple-case qualitative study was carried out. Purposive sampling was used for recruitment of participants. 57 key informants were selected based on their role in the Nutrition sector at different levels of the health pyramid. The interview guide incorporated nutrition leadership, financing, workforce, infrastructure and commodities, service delivery and information system. Each topic had subtopics on challenges and adaptations. All transcripts were exported to Atlas Ti v22, and thematic analysis was conducted.Results: Initially excluded from the national COVID-19 response, nutrition services were later integrated through advocacy by the National Nutrition Program. Despite limited funding, the government maintained support, and health workers adapted with flexible staffing approaches. Commodity shortages, including Ready-to-Use Therapeutic Food, led to the use of locally produced substitutes. Movement restrictions and fear of infection disrupted essential services such as growth monitoring and immunization. To sustain access, mitigation strategies were implemented, including tailored education, modified weighing methods, and decentralized care. Key innovations included rapid registration with anthropometric protocols, additional service points for child health activities, double-weighing scales to reduce contact, crowd control during Growth Monitoring Promotion, community-based service delivery, and improved digital integration.Conclusions: COVID-19 disrupted all pillars of nutrition services in the DRC but also spurred innovation. Institutionalizing adaptive strategies, securing sustainable funding, and supporting local Ready-to-Use Therapeutic Food production are essential to strengthen resilience and ensure continuity of nutrition services in future health emergencies.

Keywords: COVID-19, Challenges, Solutions, maintaining nutrition services, DRC

Received: 24 Dec 2024; Accepted: 30 May 2025.

Copyright: © 2025 Bosonkie, Kazenza, Ndejjo, Muyer, Mafuta, Mbuyi, Mbunga, Lusamba, Fawole and Mapatano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Marc Bosonkie, University of Kinshasa, Kinshasa, Democratic Republic of Congo

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