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.

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: The study was about the mapping of health care Organization in urban areas. It aims is to show the apportionment, appurtenance, and profile of the pharmaceutical pharmacies in the Goma city, in eastern DRC. Goma city is served in medicine by the public and private sector. Methodology: The study is cross-sectional and descriptive. It was carried out by an exhaustive census of pharmacies. Data entry and analysis was done using SPSS version 23 software. Results: The inventory of pharmacies is 723 in the city of Goma, whether one pharmaceutical office for 1.314 habitants. Almost 70% of them have set up in the last 5 years, with 31% in 2017 alone. One third of pharmacies have official authorization minutes from the Ministry of Health. All of the pharmacies are private for profit and are supplied by the private sector. More than 90% of pharmacies operate in non-standard premises and are run in 92.1% of cases by healthcare providers. Conclusion: Private pharmaceutical pharmacies play a major role in the supply of medicines in urban areas of Goma. Their functioning far from the standards, seems to indicate a lack of regulation, which exposes the population to the consumption of drugs of a potentially non-optimal quality.

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.