[ Résilience des centres de santé dans la prise en charge du paludisme: Cas de la Zone de santé de Katana en République démocratique du Congo ]
Volume 37, Issue 1, August 2022, Pages 188–200
Hermès Karemere1, Nadine Muhune2, Rosine Bigirinama3, and Samuel Makali4
1 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
2 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
3 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
4 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
Original language: French
Copyright © 2022 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: The Katana Rural Health Zone has experienced several events including looting of health centers, the cessation of funding or the instability of nursing staff, which could have hindered the functioning of its health structures. These structures have continued to operate in this unfavorable context, thus showing themselves to be resilient. This study aims to identify the adaptive mechanisms put in place by the Katana health zone in the face of adverse events. Methodology: The study is a mixed cross-sectional study covering the period from 2014 to 2018. It is based on the identification of events that occurred in the Katana Health Zone, the analysis of the evolution of cases and deaths linked to malaria and the perceptions of key players on the nature of the events, their link with the number of cases. The study used a documentary review and individual interviews targeting 8 key players. Results: The main destabilizing events identified are related to the management of human resources, the use of health services, the breakdown of funding, the availability of curative or preventive inputs, community participation and security and safety issues. Infrastructure. The trend of the evolution of new cases with malaria is similar for all age categories. On the other hand, the evolution of deaths is different. Health services continued to provide care thanks to the coping mechanisms developed. Conclusions: The study demonstrates the precariousness of a health system heavily dependent on humanitarian aid, the interruption of which can generate dysfunction with effects on mortality, including infant mortality; the weak involvement of the government in supporting structures facing the misdeeds of disasters such as the earthquake and looting; the poverty of the population making it inaccessible to health care despite the reduction in prices and the resilience of health centers following the establishment of endogenous adaptation mechanisms..
Author Keywords: Resilience, Health System, Adverse Events, Malaria, Katana, Democratic Republic of Congo.
Volume 37, Issue 1, August 2022, Pages 188–200
Hermès Karemere1, Nadine Muhune2, Rosine Bigirinama3, and Samuel Makali4
1 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
2 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
3 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
4 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
Original language: French
Copyright © 2022 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: The Katana Rural Health Zone has experienced several events including looting of health centers, the cessation of funding or the instability of nursing staff, which could have hindered the functioning of its health structures. These structures have continued to operate in this unfavorable context, thus showing themselves to be resilient. This study aims to identify the adaptive mechanisms put in place by the Katana health zone in the face of adverse events. Methodology: The study is a mixed cross-sectional study covering the period from 2014 to 2018. It is based on the identification of events that occurred in the Katana Health Zone, the analysis of the evolution of cases and deaths linked to malaria and the perceptions of key players on the nature of the events, their link with the number of cases. The study used a documentary review and individual interviews targeting 8 key players. Results: The main destabilizing events identified are related to the management of human resources, the use of health services, the breakdown of funding, the availability of curative or preventive inputs, community participation and security and safety issues. Infrastructure. The trend of the evolution of new cases with malaria is similar for all age categories. On the other hand, the evolution of deaths is different. Health services continued to provide care thanks to the coping mechanisms developed. Conclusions: The study demonstrates the precariousness of a health system heavily dependent on humanitarian aid, the interruption of which can generate dysfunction with effects on mortality, including infant mortality; the weak involvement of the government in supporting structures facing the misdeeds of disasters such as the earthquake and looting; the poverty of the population making it inaccessible to health care despite the reduction in prices and the resilience of health centers following the establishment of endogenous adaptation mechanisms..
Author Keywords: Resilience, Health System, Adverse Events, Malaria, Katana, Democratic Republic of Congo.
Abstract: (french)
Introduction: La Zone de Santé de rurale de Katana a connu plusieurs événements dont des pillages des centres de santé, l’arrêt des financements ou l’instabilité du personnel soignant, qui auraient pu entraver le fonctionnement de ses structures sanitaires. Ces structures ont continué à fonctionner dans ce contexte défavorable, se montrant ainsi résilients. La présente étude vise à identifier les mécanismes adaptatifs mis en place par la zone de Santé de Katana face aux événements défavorables. Méthodologie: L’étude est transversale mixte couvrant la période de 2014 à 2018.Elle est basée sur l’identification des évènements survenus dans la Zone de santé de Katana, l’analyse de l’évolution des cas et décès liés au paludisme et les perceptions des acteurs clés sur la nature des évènements, leur lien avec le nombre de cas. L’étude a recouru à la revue documentaire et aux entrevues individuelles ciblant 8 acteurs clés. Résultats: Les principaux évènements déstabilisants identifiés sont liés à la gestion des ressources humaines, à l’utilisation des services de santé, à la rupture de financement, à la disponibilité des intrants curatifs ou préventifs, à la participation communautaire et à des problèmes sécuritaires et infrastructurels. La tendance de l’évolution de nouveaux cas atteints de paludisme est similaire pour toutes catégories d’âges. Par contre, l’évolution des décès est différente. Les services de santé ont continué à offrir des soins grâce aux mécanismes d’adaptation développés. Conclusions: L’étude démontre la précarité d’un système de santé dépendant fortement de l’aide humanitaire dont l’arrêt peut générer un dysfonctionnement avec des effets sur la mortalité dont celle infantile; la faible implication du gouvernement dans le soutien aux structures confrontées aux méfaits des catastrophes comme le tremblement de terre et pillages; la pauvreté de la population la rendant inaccessible aux soins de santé en dépit de la baisse des tarifs et la résilience des centres de santé à la suite de la mise en place des mécanismes endogènes d’adaptation..
Author Keywords: Résilience, Système de Santé, Evénements défavorables, Paludisme, Katana, République Démocratique du Congo.
How to Cite this Article
Hermès Karemere, Nadine Muhune, Rosine Bigirinama, and Samuel Makali, “Resilience of health centers in the management of malaria: Case of Katana Health Zone in the RD Congo,” International Journal of Innovation and Applied Studies, vol. 37, no. 1, pp. 188–200, August 2022.
