Introduction: The performance-based financing approach was deployed in the Health Zone (ZS) of Miti-Murhesa between 2009 and 2014 by the « Agence d’Achat des Performances » (AAP) South Kivu. This study analyzes whether such an approach can really influence the use of health services. Methods: This is a quasi-experimental evaluation («before-after» study), adapted to the program intervention evaluation framework, using a documentary review and individual interviews that targeted 345 people, including 246 users care services and 99 health care workers. Thematic analysis of the data was applied and concerned the socio-demographic characteristics of the respondents, their perceptions of the program impact, the use of services before and during the program and the use of therapeutic alternatives before and during the program. Results: The proportion of people declaring use of health services in the Health Zone increased from 59% before the program to 93% at the end of the program (n=246). During the program implementation, the number of people who resorted to self-medication, the prayer room or witch doctors decreased, respectively from 126 (i.e. 51.2%) to 55 (i.e. 21.9%); from 9 (i.e. 3.6%) to 6 (i.e. 2.4%) and from 6 (i.e. 2.4%) to 2 (i.e. 0.8%) while that of people who had recourse to traditional healers increased significantly by 24 (9.7%) to 114 (46.3%). The population recognized the positive effects of the performance-based financing (PBF) program of AAP Sud-Kivu. Concerning the perception of the facilitators of the Health Zone, 94% (n=99) attest that the program has motivated the staff, has favored the improvement of the quality of services and has favored the realization of home visits. The lack of care for certain pathologies, including chronic ones such as tuberculosis, is deplored. Conclusion: Performance-based financing can actually improve the use of frontline care services by reducing care costs and improving the quality of services. However, recourse to traditional healers remains the most competitive therapeutic alternative to the care offered by the integrated health structures of the ZS of Miti-Murhesa. This study recommends a sustainability plan for each performance-based financing program and effective regulation of the practice of traditional healers.

Introduction: The present study aims to be carried out in the Bagira health zone in the Democratic Republic of Congo and aims to determine the factors that influence access to health services for children under 5 years of age suffering from malaria in this zone. Specifically, the study will describe the therapeutic route for children under 5 with malaria, identify the specific determinants of the use of health services in the Health Zone by these children and will suggest prospects for improving the access to health care and services. Methodology: The study will be cross-sectional, consisting of a household survey of children who had a fever episode during 2019 in the Bagira Health Zone. The data collected will be mainly analyzed using the Logit multinomial model in order to identify the specific determinants of access to health services by the study population.