Introduction: In a national context of increasing urban populations and commitment to universal health coverage, this study aims to analyze the household income and health care expenditure in the city of Goma, Eastern DRC.Methodology: This descriptive cross-sectional study was based on a 2017 survey of a sample of 1,000 households in the urban and suburban areas of the City of Goma on household income and health care expenditures during the last episode of illness. Data was analyzed by SPSS version 23.Results: The median monthly household income was 140 Usd, with 89.9% of households living on less than 1.9 Usd per day. Only 9.1% of households were covered by a health insurance system and 91.6% of households experienced at least one illness episode in the past three months. The use of care were dominated by self-medication by purchasing drugs from the pharmacy (50.7%), with non-care cases (6.8%), and varied by income quartile and gender (p <0.001). The median direct care expenditure was 10.7 Usd (0-2272.5 Usd), with catastrophic expenditures in 42.9% of cases and loss of working days and income, not varying according to income quartile (p> 0.05).Discussion and conclusion: This level of income and catastrophic healthcare expenditure requires progress towards a better thought-out compulsory health insurance system that capitalizes on innovative financing.

Introduction: As part of a comprehensive study aimed at the reorganization of urban health services, this article describes the therapeutic itinerary of the urban patient in Goma city, Eastern Democratic Republic of Congo; the aim of this study was to identify the kind of health services attended by the urban patients. Methods: This descriptive and cross-sectional study was conducted using a random sampling procedure of 1000 household in Goma city in September 2017. The collected data were collected by professionals encoded and analyzed by statisticians using the SPSS version 23 software. Results: In an episode of sickness, more than half of patients (51%) sought from pharmaceutical offices without a prescription or self-medication, 25% used a structure with a doctor and only 7% sought treatment at the health facility of its health area. In addition, 7% of patients did not use any care while 3% of patients look first treatment in traditional pharmacopoeia. Higher levels of non-use of health care and mortality were noted in households with a female household head. On the other hand, there were no significant difference in the type of care, quality and perceptions of direct cost of care (P>0.05) depending on the head household gender. Discussion and Conclusion: The important recourse of the urban patient to self-medication and secondarily to health services with doctors, requires rethinking the organization and regulation of urban health services and pharmaceutical institutions.