Assessment of Policies, Laws, and Regulations Affecting the Contraceptive Needs of Adolescents in the Democratic Republic of the Congo

摘要

Background: Poor regulation is a barrier to adolescents’ accessing family planning (FP) services. We aimed to assess policies, laws, and regulations according to the contraceptive needs of adolescents in the Democratic Republic of the Congo (DRC). Methods: A mixed method study was conducted in 74 structures, including 13 administrative structures and 61 facilities offering FP. Data were collected through semi-structured interviews and document review. Using a health policy analysis framework, we analyzed the types of policies; their availability at the delivery points; the actors and the context of the policy formulation process. The content of policies was analyzed on the basis of WHO recommendations to ensure respect for human rights in the provision of contraceptive information and services. Results: Of the policies targeting the sexual and reproductive health (SRH), 18 were mainly focused on the FP of which 5 were the standards and directives; 5 implementing documents; 3 guidelines; 3 laws and 2 policies. Twelve documents were classified “important” for the FP extension. However, a few targeted adolescents and were translated into operational instructions for providers. Of 9 WHO recommendations, one was fully and two partially integrated into FP policies. Adolescents and FP providers were less involved in the policy formulation process. Conclusion: The FP regulation remains problematic in the DRC. FP policies are unsuitable to adolescents’ expectation; they do not guarantee a secure and unrestricted access to FP services. The ministry of health should put in place evidence-based regulations to improve access to SRH services by adolescents.