The present study was carried out in the Zone of Health of Bwamanda, in the Provincial Division of the South Ubangi in DRC. The various actors on ground, in particular the male nurses, the patients and the population in general were approximate for better including/understanding their attitude and difficulties compared to the frame of reference.
The transport and the costs of care in general like the transport charges, the costs secondary and the tariffs of care probably constitute the most significant barriers compared to the reference.
Nevertheless, other barriers could be identified with certainty, more particularly the negative attitude of the male nurses towards the references (because they would decrease their prestige), the deficit of dialogue between the male nurse and his patients, corruption on the level of the hospital and the visits of the culturally obligatory patients for the population. Other cultural barriers are resignation and the recourse to the traditional therapists.
This study enabled us to better include/understand the stakes of the frame of reference. It now remains to be seen how the medical services can reinforce the system in order to act on the various determinants favorable to the change.