[ Apport de l’appui du projet de développement du système de santé sur l’accessibilité financière des ménages aux soins dans la zone de santé de Masina 1, RD Congo ]
Mbusa Kikongo Vavwirwa1, Tumba Lukaba Bin Lubula2, Kambale Byalemene Damien3, Kasereka Sindikulo Barnabé4, Kambale Muholu Jonas5, and Kwilu Nappa Fulbert6
1 Institut Supérieur des Techniques Médicales de Beni, RD Congo
2 Hôpital Général de Référence de Kitatumba, RD Congo
3 Institut Supérieur des Techniques Médicales de Beni, RD Congo
4 Institut Supérieur des Techniques Médicales de Beni, RD Congo
5 Institut Supérieur des Techniques Médicales de Beni, RD Congo
6 Ecole de santé publique, Université de Kinshasa, RD Congo
Original language: French
Copyright © 2026 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 Health System Development Project is one of the performance-based financing strategies in the Democratic Republic of the Congo, in line with the national health development plan and universal health coverage. This study was conducted to assess the contribution of the Health System Development Project to the financial accessibility of healthcare for households in the Masina 1 health zone. Methods: This study is quasi-experimental and employed a quantitative approach. It was conducted in three health areas of the Masina 1 health zone, which is supported by the Health System Development Project, and two health areas of the N’djili health zone, which is not supported, covering the period from 2017 to 2021. The sample consisted of 403 household heads, including 243 from the Masina 1 health zone and 160 from N’djili. Data were collected through interviews. Bivariate analysis was performed using SPSS and STATA software with a significance level of 0.05. Results: Support from the Health System Development Project made healthcare financially accessible to households in the Masina 1 health zone, with 4.2 times higher accessibility compared to those in the unsupported N’djili health zone (OR = 4.2 [3.8–4.5]). The results indicate that from 2019 to 2021, project support improved coverage in CPS by 23.79%, deliveries by 10.88%, curative care by 6.71%, first prenatal consultation (CPN 1) by 2.16%, fourth prenatal consultation (CPN 4) by 4.2%, health facility revenue by 3.32%, and health facility MEG capital by 7.55% in Masina 1. Conclusion: With support from the Health System Development Project, households in the Masina 1 health zone became 4.2 times more financially able to access healthcare compared to those in the N’djili health zone, which does not receive support.
Author Keywords: financial accessibility, healthcare services, health system development project, performance-based financing, DRC.
Mbusa Kikongo Vavwirwa1, Tumba Lukaba Bin Lubula2, Kambale Byalemene Damien3, Kasereka Sindikulo Barnabé4, Kambale Muholu Jonas5, and Kwilu Nappa Fulbert6
1 Institut Supérieur des Techniques Médicales de Beni, RD Congo
2 Hôpital Général de Référence de Kitatumba, RD Congo
3 Institut Supérieur des Techniques Médicales de Beni, RD Congo
4 Institut Supérieur des Techniques Médicales de Beni, RD Congo
5 Institut Supérieur des Techniques Médicales de Beni, RD Congo
6 Ecole de santé publique, Université de Kinshasa, RD Congo
Original language: French
Copyright © 2026 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 Health System Development Project is one of the performance-based financing strategies in the Democratic Republic of the Congo, in line with the national health development plan and universal health coverage. This study was conducted to assess the contribution of the Health System Development Project to the financial accessibility of healthcare for households in the Masina 1 health zone. Methods: This study is quasi-experimental and employed a quantitative approach. It was conducted in three health areas of the Masina 1 health zone, which is supported by the Health System Development Project, and two health areas of the N’djili health zone, which is not supported, covering the period from 2017 to 2021. The sample consisted of 403 household heads, including 243 from the Masina 1 health zone and 160 from N’djili. Data were collected through interviews. Bivariate analysis was performed using SPSS and STATA software with a significance level of 0.05. Results: Support from the Health System Development Project made healthcare financially accessible to households in the Masina 1 health zone, with 4.2 times higher accessibility compared to those in the unsupported N’djili health zone (OR = 4.2 [3.8–4.5]). The results indicate that from 2019 to 2021, project support improved coverage in CPS by 23.79%, deliveries by 10.88%, curative care by 6.71%, first prenatal consultation (CPN 1) by 2.16%, fourth prenatal consultation (CPN 4) by 4.2%, health facility revenue by 3.32%, and health facility MEG capital by 7.55% in Masina 1. Conclusion: With support from the Health System Development Project, households in the Masina 1 health zone became 4.2 times more financially able to access healthcare compared to those in the N’djili health zone, which does not receive support.
Author Keywords: financial accessibility, healthcare services, health system development project, performance-based financing, DRC.
Abstract: (french)
Introduction: Le projet de développement du système de santé est une des stratégies de financement basé sur la performance en République Démocratique du Congo conformément au plan national de développement sanitaire et à la couverture sanitaire universelle. C’est pourquoi cette étude a été menée en vue d’évaluer l’apport du projet de développement du système de santé sur l’accessibilité financière des ménages aux soins de santé dans la zone de santé de Masina 1. Méthodes: Cette étude est quasi-expérimentale. Elle a fait recours à une approche quantitative. Elle a été menée dans 3 aires de santé de la zone de santé de Masina 1 qui est appuyée par le projet de développement du système de santé et 2 aires de santé de celle de N’djili qui n’est pas appuyée; et, porte sur la période allant de 2017 à 2021. L’échantillon est composé de 403 chefs de ménages dont 243 de la zone de santé de Masina 1 et 160 de celle de N’djili. La technique de collecte des données a été l’interview. L’analyse bivariée a été faite avec le logiciel SPSS et STATA au seuil de 0,05. Résultats: L’appui du projet de développement du système de santé a rendu accessibles financièrement les soins aux ménages de la ZS/Masina 1; soit 4,2 fois par rapport à ceux de la ZS/N’djili qui n’est pas appuyée (OR=4,2 [3,8-4,5]). Les résultats de cette étude montrent que de 2019 à 2021, l’appui du projet de développement du système de santé a amélioré la couverture en CPS de 23,79%, en accouchements de 10,88%, en curatif de 6,71%, en CPN 1 de 2,16%, en CPN 4 de 4,2%, en recettes des FOSA de 3,32%, en capital MEG des FOSA de 7,55% dans la ZS/Masina 1. Conclusion: Avec l’appui du projet de développement du système de santé, les ménages de la zone de santé Masina 1 sont devenus 4,2 fois plus accessibles financièrement aux soins par rapport à ceux de la zone de santé de N’djili qui n’a pas d’appui.
Author Keywords: Accessibilité financière, Soins de santé, Projet de développement du système de santé, Financement basé sur la performance, RDC.
