At the end of our study, it should be remembered that our ambition was to evaluate the financial management autonomy of Performance-Based Financing, then see the reasons and remedies to propose for the improvement of the services offered to the ‘HGR Gemena. In carrying out this work, our main objective is to evaluate the level of management autonomy of the HGR/Gemena in the performance-based financing approach. Through this evaluation, this study will explain the mechanisms likely to guide this institution towards the performance so desired in the Performance-Based Financing approach. To carry out this study, we used the descriptive and documentary method, supported by observation and documentary review for this study it is based on the autonomy of financial management, to collect data on the variables of the study, namely: Human resources management, Material management, Financial management, MEG management and other inputs, Flat rate pricing. To achieve these objectives, it was useful for us to use different techniques to collect data and information, including the documentary review. In the data analysis the following methods were used analytical methods, structural-functionalist method, statistical and dialectical method. Indeed, the results of the present study reveal that the contribution of Performance-Based Financing to the financial management autonomy of the HGR/Gemena takes into account distribution keys in relation to the contract signed by the EUP: drug purchase, performance bonus, investment, operation, social marketing and bank reserve which led to the financial management autonomy of the HGR/Gemena.

DR Congo is among the African countries with a maternal mortality ratio and rate above the African average. A maternal death is not an isolated event but rather the culmination of a process. Many indicators make it possible to assess the state of health of a population and maternal mortality (intra-hospital) is that which has been studied in our work. This study aims to determine the ratio, the proportions and their respective frequencies, by establishing associations with their factors, in each structure (C.U.L., SENDWE, SNCC, KENYA). This is a cross-sectional descriptive study including 9,977 deliveries for 10 maternal deaths during the year 2019 and retained on the basis of the documentary review and supported by a medical audit. The mean age of the deceased women was 29 years (standard deviation 5.6151). The mean distance was 8 km (E-T 3.3665, KCC 14, 3750, p = 0.1566). The RMMIH is 82 deaths per 100,000 NV, with a rate of 0.08. The mean parity was 4.2 (SD 3.1552), with 50% large multiparas (5 and over), and gestity 5.5 (SD 3.5668), with 40% multigests (6 and more). Genital hemorrhages represented 60% of cases (p = 0.06, KCC 3.1250). 90% followed ANC, which was the only highly significant association with the causes of maternal deaths. The mean recovery time interval was 8.5 minutes (E-T 3.4400). 90% were referred (KCC 10.00, p = 0.067). The staff were 100% qualified. We believe that the results obtained in this study will make it possible to understand the importance of the organization of services, not only in a hospital structure, but also in a service and especially in a health system, while knowing that the environmental conditions childbirth also influence the outcome of pregnancy.

The present study was carried out at the Higher Institute of Medical Techniques of Gemena, in the South Ubangi Province in the DRC. The disease is most often unpredictable, it neither advises the time of its onset, nor the time of its departure. It is certain that the expenses it gives rise to cannot be foreseen either in terms of their amount or the period in which they will be incurred. However, health is priceless, but health services come at a cost: «Man can only offer what he has» it is said. Mutual health insurance is a system of solidarity between members of a professional mutual aid group, this organization brings together people of the same category or tendency to belong to. This is how the determination of the factors favoring the organization of the mutual health organization at ISTM Gemena would serve as a prerequisite for access to quality health care for the health of students. This article addressed the «determining aspect of the organization of the mutual health insurance at ISTM Gemena». We have set ourselves the general objective of determining the factors that favor the organization of this system. To achieve this objective, we have set ourselves the following specific objectives: Describe the socio-demographic characteristics of the subjects selected for the study; identify the factors that explain the organization of a mutual health system; Analyze the links between student responses and the various factors identified. The field survey method using a questionnaire and documentary review and interview techniques on a sample of 110 students divided into 7 sections of the ISTM Gemena; after descriptive analysis of the data, we arrived at the following results: 98 or 89.1% of respondents wish to join the mutual insurance company while 12 or 10.9% have the opposite opinion, 100 respondents or 90.9% are willing to contribute while 10 respondents or 9.1% do not have this will, The factors identified in order to promote the organization of the mutual: socioeconomic, demographic, geographical, cultural and organizational, There is no relation between the information received by the students and the importance of the mutual health insurance, therefore the students of ISTM Gemena would not have sufficient knowledge on the importance of mutual health insurance, There is no relationship between the information received by the students and the accessibility to health care. quality, therefore the students of ISTM Gemena would not have access to quality health care, There is a relationship between the information received by the students and the organization of the mutual health insurance, therefore the students of the ISTM Gemena would not have sufficient knowledge on the importance of the mutual, There is no relation between the information received by the students and the accessibility to quality care, therefore the students of ISTM Gemena do not would not have access to quality health care.

It should be pointed out that currently the use of teaching documents remains a real problem and this has direct and indirect implications on the training of learners and even the performance of nationals on the job. In fact, the use of educational materials offers several advantages. This defeated reality motivated us to verify the determinants that would be the cause of this situation which increasingly weakens the training of learners. The general objective of this research is to determine the factors linked to the low use of educational materials. In view of all of the above, we have made the assumptions that: The determinants of the low use of educational documents by teachers are due: - Low staff motivation and poor working condition - Lack of staff training - The poor follow-up of educational documents by school authorities - The low availability of full-time teachers - Non-compliance with; assignment in relation to the teachers' study profile To address the above concerns, the study resorted to the survey method based on the interview technique and document review. The questionnaire was used as a data collection instrument. The sampling technique is probability. The sample size is 120 distributed in 7 schools, ie a population sample, that is to say by exhaustive choice. The results of the study reveal that of the 100% of our sample, there are 92.5% of the male subjects; 55% of subjects aged 41 - 55; 92.5% of married subjects; 81.6% of graduates; 95% of teachers not trained in keeping educational documents; 63.3% of teachers with seniority of 6 - 12 years. Thus, the results of this study confirmed the first four factors of our hypothesis that means that the low motivation of the staff and bad working condition; lack of staff training; the poor follow-up of educational documents by school authorities; the low availability of full-time teachers are the determinants of the low use of teaching documents in other words if we want to obtain a systematic and correct use we must act on these elements on the other hand the last factor is rejected, which means that the non- respect for the assignment in relation to the study profile of teachers has no relation to the low use of teaching documents.

This study is the result of a survey of 344 people in the Bwamanda Health Zone specifically in 8 health areas on the determinants of low affiliation to the Bondeko Health Mutual in the Provincial Division of Southern Ubangi Health. In the Democratic Republic of Congo. We conducted a descriptive retrospective study aimed at improving the conditions for universal access to health care by identifying the factors that may affect affiliation to the health insurance system of developing countries. Considering the contribution and the importance of a mutual health in the accessibility of care in health facilities, this research is based on the observation that Bondeko Health Mutual is one of the oldest in the DRC but also constituted for certain country a model to follow for others including Rwanda. Despite its seniority it turns out that the annual affiliation rate does not believe in relation to the expected population. The results of this research revealed that poverty, discouragement of providers, number of people in the household and high affiliation fees are the determinants of weak community affiliation in this research.

A descriptive study was conducted at the Office of the Provincial Division of Health of South Ubangi to assess the level of knowledge of the agents there affect on health problems related to the computer. The main concern was to determine the level of the agents on the pathologies related to the use of the computer.The survey was conducted with a population of 40 agents, from which we extracted a sample of 35 agents present and having the computer as a working tool and this in the period from January 15 to March 15, 2018. The latter has led the following results: knowledge of health problems related to the use of the computer gave, based on observed frequencies, 36%.This result being lower than our acceptability criterion, led to the conclusion that the agents of the Provincial Division of Health of South Ubangi have little knowledge of health problems related to the use of the computer.

The job market is becoming increasingly competitive and demanding these days. Question of making a judicious choice between one's vocation and social constraints in order to avoid a conflict against oneself (self-satisfaction) but also to meet societal requirements. In the DRC, at least each province has a medical training institution, if not more. Thousands of new students are recruited each year, while hundreds are poured into the job market, which is apparently saturated. A survey of an exhaustive non-probabilistic sample made up of 52 learners from the midwifery sector at the Gemena istm revealed some reefs between vocation and social constraints which govern the choice of option by the learners and to establish a reconciliation between the two. Our life, our professional career is sometimes completely sealed by the choice we make.

his article presents the summary of a transverse exploratory study carried out within the framework of a study led to the General Hospital of Reference of Gemena on 70 professionals of health in this institution in the chief town of the Province of the South-Ubangi in Democratic Republic of Congo; it is a evaluative research in order to improvement of the working conditions of the professionals of health in the hospitals. Considering the impact that the working conditions produce on the employees of a medical institution, this research leaves the report of the fall of the outputs of work by tiredness, the stress, the insufficiency of adequate materials, the bad policy wage, the plethoric manpower of people receiving benefits, the insufficiency of materials of care, the precariousness of hospital hygiene and the modicity of wages and premiums for professionals of health not doctors. The results obtained reveal that the working conditions of professionals of health of the HGR Gemena are less favorable (average 52%). What proves that the "SOCIAL" conditions of work are not taken into account; what bring the demotivation and the dissatisfaction instead of work. By comparing the various categories of the following left again professionals of health some socio-professional characteristics (training areas, sex, age and occupational categories), the study did not reveal any statistically significant difference between the categories observed and expressed at the time of this research.