ULB Coopération, PADISS, Bureau de Goma, RDC; Université Officielle de Ruwenzori (UOR) (Butembo, RDC); Université Libre des Pays des Grands Lacs (ULPGL), Goma, Nord Kivu, RD Congo
Introduction: As part of a process to reorganize urban health services, this article analyzes the profile of health services in the eastern DRC city of Goma; the aim is to identify their distribution and level of medicalization. Methods: This descriptive and cross-sectional study conducted a comprehensive survey of health care facilities in the city of Goma in January 2018. Geographical and health data (infrastructure, equipment, human resources, care provided) were collected by professionals. They were encoded and analyzed using SPSS version 20 software. Results: The urban supply of care in Goma is too bloated with one facility for 8,794 inhabitants, one hospital bed for 326 inhabitants, one nurse for 586 inhabitants and one doctor for 2567 inhabitants. On the other hand, a lack of midwives, sub-equipment and infrastructure that does not meet hospital standards are observed. This health facilities, mainly privately lucrative (79%) with 56% of establishments created in the last 6 years, are variously distributed. The first-line care offer represents 34% and incorporates a medical practice in 43% of cases. Discussion and Conclusion: This provision of care requires strong regulation from the perspective of a better governed, streamlined and staggered urban health system, which better meets the quality standards and user’s expectations in urban contexts.
Introduction: This study analyzes hospital maternal death factors in six heath zones in the East of the Democratic Republic of Congo. The objective of this study is to identify the determinants and the circumstances of the maternal deaths. Methodology: This study is descriptive and analyzes the content of the medical files and death review of the mother deaths occurred between 2009 and June 2014 in 22 referral hospitals of 6 zones of health of the province of the North Kivu in the East of the RDC. The data collected by binomials of well experimented nurses and physician about 74 mother deaths were analyzed by SPSS software. Results: The hospital maternal mortality is high (106,9 deaths for 100.000 living Births). 87, 5% cases of maternal deaths arrived in time to the referral hospitals and 69,2% of cases were well taken in charge to the primary health level centers. On the other hand, the hospital care has been judged inadequate in 83,1 % of the cases, notably because of non-suitable medical and nursing care and limited availability either of the medicines and transfusion blood. The hemorrhage was the first reason of maternal death (63,4 % of the cases) and also the eclampsia (8,5%) and infections (7%). The indirect reasons were incriminated in less than 6% of the cases. Conclusion: The high level of hospital maternal deaths, the importance of the hemorrhages and limited medical and nurse competencies in maternal deaths, put in evidence the interest to reinforce the nurse and medical competencies and the clinical governance in reference hospitals.