Background: The emergence of several healthcare structures that comply with the health policy has been observed in many health zones in DR Congo, particularly urban ones. The aim of this study is to describe the proliferation of hospital structures in the Ibanda health zone (HZ) and to analyze the determinants of their creation, as well as stakeholders’ perceptions of the care offered by these structures. Methodology: A convergent mixed-methods study was conducted in the Ibanda Health Zone from June 2021 to February 2022. Data were collected through documentary review and interviews. A descriptive analysis of the characteristics of health facilities was carried out; but also an inductive thematic analysis was performed after the qualitative data had been transcribed and then coded through a tree of sub-themes grouped into themes. Results: The study revealed that the Ibanda HZ, has a total of 40 hospital facilities. Not only are these inequitably distributed within the health areas, but 45% of them are outside the administrative and technical control of the provincial authority. Many specialized services are absent from most facilities. The study suggests that the quality of care in the Ibanda HZ has improved over time, but that this quality is not the same in all facilities. Study participants report that the cost of care is high in relation compared to the financial capacity of households. For them, this explains this population’s recourse to alternative solutions such as self-medication or traditional medicine. Conclusion: The study recommends tighter control of the conditions under wich care structures are set up and run, and improved quality of service for the benefit of the community.

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..