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Background: The Democratic Republic of the Congo (DRC) is classified among the 5 countries with the highest global maternal mortality ratio (MMR) and highest under-five mortality rate (U5MR) in the world. Kasai is one of 14 provinces of the DRC, which have a high U5MR and MMR. Despite this overriding concern, almost no studies have been conducted to assess maternal et child situation in this province. The aim of this study was to assess access, availability, and quality of maternal and child health services in Kasai Province in the DRC. Methods: A cross-sectional survey of 49 Health Facilities (HFs) integrating quantitative and qualitative data collection was conducted in 18 Health Zones in Kasai Province in the DRC. Documentary review, interviews and direct observation of HFs were performed to collect data. Pearson’s chi-squared test was performed to establish the relation between variables.Results: Nearly 54 % of visited HFs population had a geographical access to maternal and child health services and the majority of medical acts were unaffordable. Basic and comprehensive emergency obstetric care (EmOC) were offered respectively by only 11.8% and 7.6% of HF and none provided high quality basic or comprehensive EmOC. This low availability and quality of EmOC are due to the insufficiency of necessary inputs and personal for maternal and child health services in the majority of HFs. Conclusion: The situation of maternal and child health services is very precarious in Kasai Province. The improvement of EmOC coverage will require rehabilitation of infrastructure, dotation of equipment, regular supply of medicines and strengthening of human resource capacity.

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