Bringing care home: How women health entrepreneurs are expanding healthcare access in North Kivu, DRC

Barriers facing women in North Kivu

Lucie’s experience reflected wider barriers for women in North Kivu. Many women wanted to start businesses, but they often lacked access to training, start-up capital, and reliable supply networks. Years of conflict weakened local markets, making it even more difficult to build stable livelihoods.

“Social and cultural norms also restricted women’s economic participation and decision-making power,” Lucie says.

Many women had limited control over household finances, and young women faced even greater restrictions. Young people who leave school early have few economic opportunities and limited access to accurate health information. Violence against women and girls (VAWG) is widespread. When women face complications during pregnancy, many have no access to emergency care. Maternal and newborn deaths remain common — not because solutions don’t exist, but because families cannot access them.

These overlapping challenges left many women like Lucie with the knowledge to help, but not the means to do so.

But in April 2023, Lucie heard about a new initiative called TUMA+. Short for Tuhimizane kwa Mabadikio, TUMA means “mobilizing change” in Kiswahili. The project supports women to become community health entrepreneurs by providing training, start-up capital, ongoing support, and access to health products they can distribute in their communities.

Because of her dedicated volunteer work at Makasi health facility, the Butembo Health Zone selected Lucie for the first training of community health entrepreneurs conducted by partner organization Healthy Entrepreneurs.

The training included health education, entrepreneurship, and customer service, as well as guidance on distributing health products responsibly.

Perhaps most importantly, Lucie gained confidence.

“Before TUMA+, several barriers prevented women in Butembo from becoming health entrepreneurs and earning a decent income,” Lucie explains. “These included limited access to financial resources and start-up capital, insufficient technical knowledge and business skills, and weak linkages with formal health systems and supply chains.”

“This experience inspired me to become a health entrepreneur,” she says.

Bringing healthcare closer to families

Today, Lucie continues to visit families in North Kivu. Now, alongside health education, she can provide guidance on disease prevention, hygiene practices, and reproductive health while helping families access supplies they might otherwise struggle to find. She carries products to help with pain relief, coughs and colds, fevers, infections, reproductive health, menstrual management, and more.

For many households, her new skills and services have made a noticeable difference.

Kyakimwa Neema, a mother of two, says Lucie’s visits help families better understand how to respond to common illnesses.

“Lucie regularly visits us from house to house and raises awareness about different diseases and the appropriate medicines for each illness,” Neema says. “She explains how to use the medicines correctly during treatment. Whenever I feel unwell, I call her and she provides me with the necessary medication.”

For Neema and other families, having a trusted health worker nearby reduces the burden of traveling to distant facilities.

“Her support also makes it easier for us to access basic healthcare quickly,” Neema explains. “Often, we do not have enough money for transportation to reach health facilities, but thanks to the community health worker’s home visits, they reduce the distance and the costs for us by bringing care closer to our homes.”

Since the initiative began, 1,200 women health entrepreneurs have started working across other health zones in North Kivu: Irangya, Katsya, Makasi, Masuli, Vighole, and Vulindi.

Lucie says the presence of these entrepreneurs is improving access to health information in many communities.

“Access to essential health information and services has improved considerably,” she tells us. “Communities are now better informed about key health issues, including maternal and child health, nutrition, hygiene, and disease prevention. As a result, many families are adopting healthier practices.”

The role of women in the community is also beginning to change.

“Women health entrepreneurs are recognized as trusted actors, contributing not only to health improvement but also to local economic empowerment,” Lucie says. “This has enhanced community engagement and confidence in women-led initiatives.”

In her own family, Lucie’s new work has been transformational.

“I earn a minimum daily income which allows me to meet my family’s needs, especially my children’s schooling,” she explains. “Before, my work as a community health worker alone was not enough. Today, the combination of awareness-raising and selling health products has been life-changing.”

Her children are able to attend school regularly. Her family has enough to eat. The constant anxiety about money has eased. More than financial stability, Lucie has gained something she sees as even more valuable: the ability to solve the problems she sees in her community.

A path forward

Lucie hopes more women will have the opportunity to participate in similar programs in the future.

“Investing in women as health entrepreneurs has transformative potential, not only for their own livelihoods but for the broader health and well-being of entire communities,” she says. “When women are supported with the right resources, training, and networks, they become trusted agents of change. Supporting women as health entrepreneurs strengthens health systems from the ground up, fosters economic empowerment, and creates resilient communities. When women thrive, health outcomes improve, and the benefits extend far beyond individual families to entire regions.”

She believes that when women receive training, resources, and support networks, they can help address local health challenges while strengthening their own economic security. She dreams of a day when no mother in Butembo has to watch her child suffer from a preventable illness because basic medicine is out of reach.

Today, when Lucie walks through her community, she no longer just witnesses suffering—she helps prevent it. She is no longer just a volunteer. She is an entrepreneur, a change maker, and a leader.

In North Kivu, against a backdrop of conflict and crisis, women like Lucie are helping build a different future—one household visit at a time.