New health data from the Democratic Republic of the Congo's (DRC) Ituri Province shows a sharp decline in the number of children and women accessing essential healthcare services, including childhood immunizations and births in health facilities, as fear of infection and service disruptions keep families away from care.
Between April and June 2026, the use of essential health services dropped by 42 per cent in the primary outbreak hotspots of Bunia, Mongbwalu, Nizi, and Rwampara. Across Ituri Province, service utilization declined by an estimated 13 per cent.
"The data suggests that fear of infection, combined with disruptions to services, is deterring lots of children and their families from seeking care," said John Agbor, UNICEF Representative in the DRC. "One doctor told our team that before the current outbreak, his facility saw an average of 500 patients a month but that has dropped to almost nothing."
Additional key impacts on children and women (April-June comparison):
- Routine childhood vaccinations fell by more than half across the hotspot areas, including a 69 per cent decline in first-dose measles vaccination in Mongbwalu, the outbreak epicentre.
- Province-wide, follow-up vaccines also declined: the third dose of pentavalent vaccine by 22 per cent and the second measles dose by 18 per cent. Health facilities administered over 23,000 fewer routine child vaccine doses in May and June than in April.
- Maternal health facilities were also affected, with facility-assisted deliveries falling 13 per cent across the province, and by 38 per cent, 30 per cent, and 70 per cent in Bunia, Rwampara and Nizi respectively. First antenatal care visits fell by around 28 per cent in all three hotspots.
- No comparable seasonal decline was observed over the same period in 2025.
Disrupted care is compounding the threat that children already face directly from Ebola itself. As of 2 August 2026, there have been 743 confirmed child cases and 330 child deaths (0-17 years). Although children represent nearly one in four confirmed cases, they account for almost one in three deaths. Young children under five are particularly affected, with a case fatality rate more than double that of adults; over 60 per cent of confirmed cases in this age group result in death, compared with fewer than 30 per cent among adults aged 18 years and older.
This is now the worst Ebola outbreak on record for the country, and the fastest-growing Ebola outbreak ever recorded.
To counteract rising transmission and restore community confidence in essential health services, UNICEF and partners - working closely with the Ministry of Health, WHO and Africa CDC - have trained and deployed around 13,000 frontline community actors and key influencers, reaching more than 2.4 million people with guidance on Ebola prevention and early detection. Teams have also carried out over 505,000 household visits to build trust, dispel misinformation and refer suspected cases for care.
UNICEF has also supplied infection prevention and control materials to eight Ebola treatment centres and equipped 45 health facilities in Ituri with infection prevention and control kits, water, sanitation and hygiene supplies, and entry screening materials. Supply chains for essential medicines, malaria kits, and obstetric supplies have been maintained at priority facilities. Community-based mental health and psychosocial support have reached more than 21,000 people affected by the outbreak, including 5,100 children.
"The Ebola outbreak is severely disrupting the entire health system, with inevitable consequences for cases of malaria, diarrhoea, and other treatable illnesses that are the biggest killers of children," added Agbor. "Ensuring that health posts remain open, safe, and trusted is essential to saving lives today and preventing future outbreaks tomorrow as we invest in a more resilient health system."
To sustain and expand UNICEF's life-saving interventions from 21 to 51 affected and high-risk health zones, UNICEF has revised its six-month appeal to US$113.45 million. With US$23.5 million mobilized to date, a funding gap of US$89.9 million remains, urgently requiring flexible donor support to prevent further disruption to essential services.
