• DRC suffered 159 documented attacks against healthcare facilities in 2022. In the case study areas, healthcare facilities cease operations for up to 4 weeks following an attack.

  • Women avoid seeking antenatal and postnatal care in attacked health centers, risking maternal and infant lives.

  • Shortages of medicines and parental fear endanger malnourished children.

  • Local health workers, communities, and local health district management teams are the first to respond to reduce the impact of such an attack. However, critical gaps remain.

  • A multifaceted approach based on collaboration between local, national, and international stakeholders is essential to ensure the continuity of health services for women and children under 5.

A new study by the IRC and ERSP-UCB analyzed attacks on health facilities in DRC. In 2022, 8% of the attacks against health facilities recorded in more than 30 countries in conflict occurred in DRC. This violence seriously compromises access to essential healthcare, particularly for pregnant women and children under the age of 5. The provinces of North and South Kivu, in the east of the country, are among the worst affected by this situation. 

It is against this backdrop that the International Rescue Committee (IRC), with the ERSP-UCB, in partnership with Insecurity Insight and the Researching the Impact of Attacks on Healthcare (RIAH) project, funded by the Foreign, Commonwealth & Development Office (FCDO), has conducted a study to assess the impact of attacks on the healthcare system on service delivery, staff, and affected communities.

Leonie Tax, Health and Protection Data Specialist said, "The study, carried out in three areas in South Kivu and North Kivu, revealed alarming results for women and children under 5. Following an attack, the health facilities either slowed down or stopped operating altogether for between 2 and 4 weeks. The reasons include the fear of providing services at night, a lack of resources and infrastructure to replace those looted or destroyed, as well as a collective fear that reduced overall attendance at health facilities.”

The study has found the attacks have also significantly reduced the number of women attending health facilities for maternal health services, leading to a significant drop in the number of births at health facilities. In the Kirindera site, the number of children born in the health facility dropped from 50 in the month before the attack to less than 10 in the months following the attack. Services for children, such as post-natal consultations, preschool consultations, and vaccinations, have also been severely affected.

Dr Samuel Lwamushi Makali, Public health researcher and Head of the International Cooperation Department, Université Catholique de Bukavu, said, “The study shows how the community, health authorities, and health workers have adopted coping mechanisms to deal with the ongoing violence. Local health teams have organized psychological support for affected health staff, reorganized services with reduced working hours, and mobilized communities to rehabilitate facilities and raise awareness of the need to resume care. However, gaps remain, and humanitarian support and improved security are crucial to the gradual resumption of healthcare activities¨.

Dr Lievin Bangali, Senior Health Coordinator IRC DRC, said, "Violence against the health system in the context of armed conflict in eastern DRC is having a profound and devastating impact on the health of children and mothers, exposing these already vulnerable populations to increased risks of mortality and morbidity.”

To tackle this, the IRC calls for a multifaceted approach, combining capacity-building in health centers, improving access to care for affected populations, and implementing prevention and protection strategies. Collaboration between local, national, and international players is crucial to developing sustainable solutions. It would ensure the safety of healthcare staff, the protection of infrastructures, and the continuity of essential healthcare services. We all have the same goal: safeguarding the lives and well-being of communities affected by conflict.


The IRC has been operating in the Democratic Republic of the Congo (DRC) since 1996. We deliver emergency assistance to individuals affected by recurring crises while fostering social cohesion within communities through collaborative efforts with Congolese institutions. We also provide essential health services, including primary health care, sexual and reproductive health, infection prevention and control, as well as water, sanitation and hygiene. We reinforce violence prevention and support survivors of gender-based violence through comprehensive interventions, including providing psychosocial support, facilitating economic recovery, and ensuring access to essential services (such as legal and medical assistance), particularly in eastern DRC where there is a severe protection crisis. Our approach involves collaboration with communities and their institutions to promote social cohesion aimed at conflict reduction and support to primary and secondary schools. 

Learn more about the IRC’s DRC response.