This study is carried out in the Tandala Health Zone, DPS of Sud-Ubangi in the DRC on the impact of flat rate pricing on attendance at the Tandala general referral hospital, In response to this concern that the government of the Democratic Republic of Congo has set up a health project called the PDSS Health System Development Project in acronym created in 2005 and whose official implementation took place in August 2016 reporting directly to the study management and of the planning of the Ministry of Public Health and mainly financed by the World Bank. The results of This study showed that in terms of financing of health services, the impact on improving the use of hospital services remains the flat-rate pricing also called «payment per episode», which constitutes a strict rationalization of care. Heath care based on solidarity between complicated and uncomplicated cases, which allows groups to pay the same price. This especially demonstrated that the flat-rate pricing applied to the Tandala general referral hospital allowed complicated cases which would normally have to pay unaffordable amounts of subsidy for uncomplicated cases, a rationalization of health structures and take into account all acts. To put the patient down without adding additional charges, to promote continuity of care, to keep the population aware of the costs to pay and to ensure the viability and sustainability of the structures providing care.
The general objective of this study is to carry out a qualitative and quantitative analysis of the garbage from the commune of BOLIKANGO in the city of Lisala, Province of Mongala and to test the adequacy of the methods of storage and elimination of this waste. To achieve this, we used the descriptive method for waste identification using living techniques such as direct or indirect observation and structured sowing interviews. Results obtained revealed the following points: Awareness of the problem by the inhabitants of the commune of BOLIKANGO. 80% of the population surveyed recognizes that the waste problem exists and that biodegradable organic matter is the main source of garbage in households. In addition to organic matter, waste made up of metals, such as sardine cans, tomatoes, spare parts for vehicles and motorcycles, cells and batteries come second. These methods enabled us to note that the solid waste produced in the commune of BOLIKANGO is badly managed with enormous risks for the health of the population, of the households all around the commune concerned.The inhabitants of the district have neither trash, nor dump at the level of their installations throw their waste directly on the ground and without service of daily collection, the inhabitants themselves take care of the sweeping and the evacuation of waste. It emerges from this study that:Garbage exists and includes a mixture of constituents, the main ones being plant waste, animal waste, waste from manufacturing products, construction accessories and human waste.The largest single quantity of garbage is produced at the central market in Lisala, i.e. 90000m3.The state service for collecting, sorting and eliminating waste in the municipality is not operational. You can see the hills of waste abandoned in some markets and others throw their waste squarely into rivers.We say that at the level of the municipality, that is to say the real ecological problems exist and because of an unhealthy environment, several contagious and infectious diseases circulate in the population because the application of the law remains not applicable everywhere in the DRC.