[ Enjeux et défis de couverture santé universelle en République Démocratique du Congo: Synthèse critique interprétative de la littérature ]
Volume 66, Issue 1, April 2023, Pages 42–56
Jean-Bosco Kahindo Mbeva1, Mitangala Ndeba Prudence2, Eric Tchouaket Nguemeleu3, Mahamba Nzanzu4, Levis Kahandukya Nyavanda5, and Jean-Roger Syayipuma Kambere6
1 ULB Coopération, PADISS, Bureau de Goma, RD Congo
2 ULB Coopération, PADISS, Bureau de Goma, RD Congo
3 Université du Québec en Outaouais, Québec, Canada
4 ULB Coopération, PADISS, Bureau de Goma, RD Congo
5 Université Libre des Pays des Grands Lacs (ULPGL), Goma, RDC
6 Université Officielle de Ruwenzori (UOR), Butembo, RD Congo
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: In line of the powerful concept of Universal health coverage (UHC) inspired to the Primary Health Care Renewal in 2008 and the Astana Declaration on Primary Health Care and the Sustainable Development Goals, this study analyzes the challenges of universal health coverage (UHC) in the Democratic Republic of Congo (DRC). Methods: The study used a reflective and interpretive synthesis of the literature. The search was conducted using keywords related to universal health coverage, health policies, systems and services and the DRC. Results: The study highlights a strong desire for progress in the DRC towards UHC that contrasts with the legal and organizational framework, governance practices, organization of health services and care delivery. Effects of this limited congruence are illustrated by the low level of integration and performance of health services, and the high level of catastrophic health expenditure and exclusion of the population in access to health care. Discussion and conclusion: In a context where nearly 75% of the population lives on less than USD 1.9 per day and the informal sector, the hybrid legal framework is an obstacle to the real progress towards UHC in the DRC. Changing the legal framework, by integrating a generalized mandatory system, and then structuring a greater raising of funds, including innovative financing, as well as establishing a more coherent and adaptive governance in favor of UHC, are priority avenues to explore to resolutely commit to the path of UHC in the DRC.
Author Keywords: Universal health coverage, DRC, Governance, review.
Volume 66, Issue 1, April 2023, Pages 42–56
Jean-Bosco Kahindo Mbeva1, Mitangala Ndeba Prudence2, Eric Tchouaket Nguemeleu3, Mahamba Nzanzu4, Levis Kahandukya Nyavanda5, and Jean-Roger Syayipuma Kambere6
1 ULB Coopération, PADISS, Bureau de Goma, RD Congo
2 ULB Coopération, PADISS, Bureau de Goma, RD Congo
3 Université du Québec en Outaouais, Québec, Canada
4 ULB Coopération, PADISS, Bureau de Goma, RD Congo
5 Université Libre des Pays des Grands Lacs (ULPGL), Goma, RDC
6 Université Officielle de Ruwenzori (UOR), Butembo, RD Congo
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction: In line of the powerful concept of Universal health coverage (UHC) inspired to the Primary Health Care Renewal in 2008 and the Astana Declaration on Primary Health Care and the Sustainable Development Goals, this study analyzes the challenges of universal health coverage (UHC) in the Democratic Republic of Congo (DRC). Methods: The study used a reflective and interpretive synthesis of the literature. The search was conducted using keywords related to universal health coverage, health policies, systems and services and the DRC. Results: The study highlights a strong desire for progress in the DRC towards UHC that contrasts with the legal and organizational framework, governance practices, organization of health services and care delivery. Effects of this limited congruence are illustrated by the low level of integration and performance of health services, and the high level of catastrophic health expenditure and exclusion of the population in access to health care. Discussion and conclusion: In a context where nearly 75% of the population lives on less than USD 1.9 per day and the informal sector, the hybrid legal framework is an obstacle to the real progress towards UHC in the DRC. Changing the legal framework, by integrating a generalized mandatory system, and then structuring a greater raising of funds, including innovative financing, as well as establishing a more coherent and adaptive governance in favor of UHC, are priority avenues to explore to resolutely commit to the path of UHC in the DRC.
Author Keywords: Universal health coverage, DRC, Governance, review.
Abstract: (french)
Introduction: En lien avec le renouveau des soins de santé primaires prôné par l’OMS en 2008 et la déclaration d’Astana sur les soins de santé primaires, le développement durable et la couverture santé universelle, un concept puissant de santé publique, cette étude analyse les défis de couverture santé universelle (CSU) en République Démocratique du Congo (RDC). Méthodes: L’étude a procédé par une recension réflexive et interprétative de la littérature. La recherche a été effectuée dans les bases de données Pubmed, Medline, Google scholar à partir des mots clés relatifs à la couverture santé universelle, aux politiques, systèmes et services de santé et à la RDC. Résultats: Cette étude met en évidence une volonté forte de progression de la RDC vers la CSU, qui contraste avec un cadre légal et organisationnel de la CSU et des pratiques de gouvernance des services de santé et de prestations des soins questionnables. Le faible niveau d’intégration et de performances des services de santé et le niveau élevé de dépenses catastrophiques pour la santé et d’exclusion de la population dans l’accès aux soins, illustrent les effets de cette congruence limitée. Discussion et conclusion: Dans un contexte de forte paupérisation des populations, faire évoluer ce cadre légal vers un système obligatoire généralisé, structurer une levée plus importante des financements, dont innovants, instaurer une gouvernance plus cohérente et adaptative en faveur de la CSU, constituent des pistes prioritaires à explorer pour accélérer la progression de la RDC sur la voie de la CSU.
Author Keywords: Couverture santé universelle, RDC, Gouvernance, revue des écrits.
How to Cite this Article
Jean-Bosco Kahindo Mbeva, Mitangala Ndeba Prudence, Eric Tchouaket Nguemeleu, Mahamba Nzanzu, Levis Kahandukya Nyavanda, and Jean-Roger Syayipuma Kambere, “Issues and challenges of universal health coverage in the Democratic Republic of Congo: A critical interpretative synthesis of the literature,” International Journal of Innovation and Scientific Research, vol. 66, no. 1, pp. 42–56, April 2023.
